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Migration and the spread of HIV in rural areas of Africa: the example of Likoma Island, Malawi

Agnes M Chimbiri, United Nations Development Programme (UNDP)
Stephane Helleringer, Columbia University
Hans-Peter Kohler, University of Pennsylvania

Studies of migration and HIV in rural areas of Africa have focused on the role of out-migrants in increasing infection risks, but the composition and direction of migration flows may be more complex. In some settings, rural areas are frequently visited by short-term in-migrants with whom rural dwellers may engage in sexual relations. However, most surveys of sexual behaviors and migration are based on small samples of out-migrants. Thus they do not allow estimating the contribution of in-migration to rural HIV epidemics. In this paper, we use a unique population-based survey of sexual networks conducted in Likoma Island (Malawi) to identify all the relationships connecting rural dwellers and migrants (both in-migrants and out-migrants). We argue that local relationships with temporary in-migrants are not only a common form of sexual partnership, but may also constitute more efficient bridges for HIV transmission across distant areas than sexual contacts during out-migration.

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Presented in Session 84: Consequences of internal migration