Migration, hotspots, and dispersal of HIV infection in Rakai, Uganda.
Journal
Nature communications
ISSN: 2041-1723
Titre abrégé: Nat Commun
Pays: England
ID NLM: 101528555
Informations de publication
Date de publication:
20 02 2020
20 02 2020
Historique:
received:
09
07
2018
accepted:
18
01
2020
entrez:
22
2
2020
pubmed:
23
2
2020
medline:
6
5
2020
Statut:
epublish
Résumé
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.
Identifiants
pubmed: 32080169
doi: 10.1038/s41467-020-14636-y
pii: 10.1038/s41467-020-14636-y
pmc: PMC7033206
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
976Subventions
Organisme : NIAID NIH HHS
ID : K01 AI125086
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI094189
Pays : United States
Organisme : NIAID NIH HHS
ID : R01 AI143333
Pays : United States
Organisme : NICHD NIH HHS
ID : R01 HD091003
Pays : United States
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