Khalifa Aleya, Wallach Sara, Grabowski M Kate, Duncan Dustin T, Nalugoda Fred, Abdool Karim Quarraisha, Mathema Barun
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA.
ICAP at Columbia University, New York, New York, USA.
J Int AIDS Soc. 2025 Jun;28(6):e26508. doi: 10.1002/jia2.26508.
Mobility-from overnight travel to permanent migration-can reduce service access and increase HIV risk, driving the epidemic in sub-Saharan Africa (SSA). This scoping review described mobility measures used in HIV research to identify gaps and guide research on mobility to strengthen HIV responses in SSA.
Literature from three databases (PubMed, Embase, Web of Science) were systematically screened to identify research articles examining relationships between mobility and individual-level HIV-related outcomes in SSA from 2014 through 2023. Key terms for mobility included "mobility," "movement," "migration" and "travel." Measures were first extracted according to International Organization of Migration definitions of migration (a change in the place of usual residence) and travel (movement between geographies). Then, metrics used to categorize or quantify mobility were organized by the stage (origin, transit, destination, return) and dimension (spatial, temporal, socio-structural) of the movement captured. Measures were analysed within three research contexts: the HIV outcome(s) of interest, study population and local geographies. Outcomes included HIV acquisition, AIDS-related death, and indicators along the prevention, care and treatment cascade.
We identified 69 studies after screening 5343 titles/abstracts and 200 full texts for eligibility. Studies included research from 16 countries, mostly representing general adult populations in eastern and southern Africa. Most studies measured migration (51) versus travel (21) and examined relationships with HIV prevalent infection (29) or care and treatment indicators (44) compared to other epidemiological and programmatic outcomes. Studies employed a range of metrics, mostly of the duration of stay at the destination (28), the number of mobility events (12) or the geographic boundaries across which individuals moved (14). Socio-structural dimensions like the motivation for movement were measured less often. Only 15 studies examined more than one dimension.
Mobility measures varied widely and were inconsistently studied across research contexts. Future studies should fill evidence gaps, standardize reporting and develop multidimensional mobility measures tailored to local settings and HIV outcomes.
People on the move are a vast and diverse group, yet they are often labelled as a monolith. Improved measures can disentangle how different forms of mobility relate to HIV, generating actionable evidence to enhance HIV programming for ending the epidemic.
从过夜旅行到永久迁移的流动，会减少获得服务的机会并增加感染艾滋病毒的风险，从而推动撒哈拉以南非洲（SSA）地区的艾滋病疫情。本综述描述了艾滋病毒研究中使用的流动测量方法，以识别差距并指导关于流动的研究，从而加强撒哈拉以南非洲地区应对艾滋病毒的措施。
系统筛选了来自三个数据库（PubMed、Embase、Web of Science）的文献，以确定2014年至2023年期间研究撒哈拉以南非洲地区流动与个人层面艾滋病毒相关结果之间关系的研究文章。流动的关键术语包括“流动”“移动”“迁移”和“旅行”。测量方法首先根据国际移民组织对迁移（常住地的变化）和旅行（不同地理区域之间的移动）的定义进行提取。然后，用于对流动进行分类或量化的指标按照所捕捉到的移动的阶段（出发地、中转地、目的地、返回地）和维度（空间、时间、社会结构）进行整理。在三种研究背景下对测量方法进行分析：感兴趣的艾滋病毒结果、研究人群和当地地理区域。结果包括艾滋病毒感染、与艾滋病相关的死亡，以及预防、护理和治疗环节的指标。
在筛选了5343篇标题/摘要和200篇全文以确定其是否符合条件后，我们确定了69项研究。这些研究包括来自16个国家的研究，大多代表了东非和南部非洲的一般成年人群。与其他流行病学和规划结果相比，大多数研究测量了迁移（51项）与旅行（21项），并研究了与艾滋病毒流行感染（29项）或护理和治疗指标（44项）之间的关系。研究采用了一系列指标，大多是目的地停留时间（28项）、流动事件数量（12项）或个人跨越的地理边界（14项）。对社会结构维度，如移动动机的测量较少。只有15项研究考察了多个维度。
流动测量方法差异很大，且在不同研究背景下的研究不一致。未来的研究应填补证据空白，规范报告，并制定适合当地情况和艾滋病毒结果的多维度流动测量方法。
流动人群是一个庞大且多样化的群体，但他们常常被视为一个整体。改进测量方法可以厘清不同形式的流动与艾滋病毒之间的关系，产生可付诸行动的证据，以加强艾滋病毒规划，从而终结疫情。
