Armstrong Dzomba , University of the Witwatersrand, Johannesburg
Andrew Tomita, University of KwaZulu-Natal
Alain Vandormael, University of Minnesota
Kaymarlin Govender, University of KwaZulu-Natal
Frank Tanser, Africa Centre for Health and Population Studies
To reassess whether characteristics of migration identified as risk factors in the early phases of the HIV epidemic are still important in the ART era, we examined migration levels, trends and patterns in rural KwaZulu-Natal, South Africa, using data from the Africa Health Research Institute between 2000 and 2015. Further, we followed 60 203 adult participants aged 20-49 at baseline and recorded their migration events to estimate the time to each migration event for participants, adjusting for socio-demographic covariates; age, sex, marital status, HIV and ART status. 55% of the population experienced at least one migration event over the observation period. At peak, women had over 35 events per 100 PY compared to men with 26 events per 100 PY. Controlling for factors above, the risk of migration increased 18 times among young adults 20-24 years compared to =40 years (aHR = 18.62, 95% CI 11.51 – 30.11); single compared to married (aHR 3.11, 95% CI: 1.57-6.16) and on ART (aHR 1.91, 95% CI: 1.46-2.51) compared to those not on ART. Being on ART almost doubled the odds of migration compared to those not, with significant HRs above 77% in both men and women across separate models. While the ability to migrate among PLHIV may suggest health benefits of successful engagement to care in local clinics, mobile individuals remain at high risk of acquiring HIV. Thus, novel public health interventions tailored to reduce HIV risk and sustain care for this highly vulnerable population are urgently needed.
Presented in Session P3. Poster Session Migration, Economics, Environment, Methods, History and Policy