Young Ruth, Ssekasanvu Joseph, Kagaayi Joseph, Ssekubugu Robert, Kigozi Godfrey, Reynolds Steven J, Nonyane Bareng A S, Chang Larry W, Kennedy Caitlin E, Paina Ligia, Anglewicz Philip A, Quinn Thomas C, Serwadda David, Nalugoda Fred, Grabowski M K
Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
J Acquir Immune Defic Syndr. 2025 Feb 1;98(2):150-160. doi: 10.1097/QAI.0000000000003553.
In Africa, migrants are more likely to be living with HIV and HIV viremic than nonmigrants, but less is known about HIV outcomes among nonmigrants living in households with migrants. We compared HIV outcomes in nonmigrating persons in households with and without migration.
We analyzed cross-sectional data collected between August 2016 and May 2018 from nonmigrating participants aged 15-49 years in the Rakai Community Cohort Study in Uganda. Migrant households were classified as those reporting ≥1 member moving into or out of the household since the prior survey. HIV serostatus was determined using a validated testing algorithm, and viremia defined as >1000 copies/mL. Modified Poisson regression was used to estimate prevalence ratios between household migration and HIV outcomes. Analyses were stratified by gender, direction of migration (into/out of household), and relationship between nonmigrants and migrants (eg, spouse).
There were 14,599 nonmigrants (52% women) and 4415 (30%) lived in a household with ≥1 migrant. Of these, 972 (22%) had migrant spouses, 1102 (25%) migrant children, and 875 (20%) migrant siblings. Overall, HIV prevalence and viremia did not differ between nonmigrants in households with and without migration. However, in stratified analyses, nonmigrant women with migrant spouses were significantly more likely to be HIV seropositive compared with nonmigrant women with nonmigrant spouses [adjusted prevalence ratio: 1.44, 95% confidence interval: 1.21 to 1.71]. Conversely, nonmigrant mothers living with HIV who had migrant children were less likely to be viremic (adjusted prevalence ratio: 0.34, 95% confidence interval: 0.13 to 0.86).
Nonmigrating women with migrating spouses are more likely be living with HIV, and may benefit from additional HIV support services.
在非洲，移民感染艾滋病毒和处于艾滋病毒病毒血症状态的可能性高于非移民，但对于生活在有移民家庭中的非移民的艾滋病毒感染情况了解较少。我们比较了有移民和无移民家庭中未迁移者的艾滋病毒感染情况。
我们分析了2016年8月至2018年5月期间在乌干达拉凯社区队列研究中收集的15至49岁未迁移参与者的横断面数据。移民家庭被定义为自上次调查以来报告有≥1名家庭成员迁入或迁出的家庭。使用经过验证的检测算法确定艾滋病毒血清学状态，病毒血症定义为>1000拷贝/毫升。采用修正泊松回归估计家庭迁移与艾滋病毒感染情况之间的患病率比。分析按性别、迁移方向（迁入/迁出家庭）以及未迁移者与移民之间的关系（例如配偶）进行分层。
共有14599名未迁移者（52%为女性），其中4415人（30%）生活在有≥1名移民的家庭中。其中，972人（22%）有移民配偶，1102人（25%）有移民子女，875人（20%）有移民兄弟姐妹。总体而言，有移民和无移民家庭中的未迁移者的艾滋病毒患病率和病毒血症情况没有差异。然而，在分层分析中，与有非移民配偶的未迁移女性相比，有移民配偶的未迁移女性艾滋病毒血清学阳性的可能性显著更高[调整患病率比：1.44，95%置信区间：1.21至1.71]。相反，有移民子女的感染艾滋病毒的未迁移母亲病毒血症的可能性较小（调整患病率比：0.34，95%置信区间：0.13至0.86）。
有移民配偶的未迁移女性感染艾滋病毒的可能性更高，可能会从额外的艾滋病毒支持服务中受益。
