Migration, hotspots, and dispersal of HIV infection in Rakai, Uganda
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Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
Nature Communications
Abstract
HIV prevalence varies markedly throughout Africa, and it is often presumed areas of higher
HIV prevalence (i.e., hotspots) serve as sources of infection to neighboring areas of lower
prevalence. However, the small-scale geography of migration networks and movement of
HIV-positive individuals between communities is poorly understood. Here, we use
population-based data from ~22,000 persons of known HIV status to characterize migratory
patterns and their relationship to HIV among 38 communities in Rakai, Uganda with HIV
prevalence ranging from 9 to 43%. We find that migrants moving into hotspots had significantly
higher HIV prevalence than migrants moving elsewhere, but out-migration from
hotspots was geographically dispersed, contributing minimally to HIV burden in destination
locations. Our results challenge the assumption that high prevalence hotspots are drivers of
transmission in regional epidemics, instead suggesting that migrants with high HIV prevalence,
particularly women, selectively migrate to these areas.
Description
Keywords
Migration, Hotspots, HIV infection, Uganda
Citation
Kate Grabowski, M., Lessler, J., Bazaale, J., Nabukalu, D., Nankinga, J., Nantume, B., ... & Gray, RH (2020). Migration, hotspots, and dispersal of HIV infection in Rakai, Uganda. Nature Communications , 11 (1), 1-12. https://doi.org/10.1038/s41467-020-14636-y |