The emerging human immunodeficiency virus (HIV) epidemics in
rural areas of India are hypothesized to be linked to circular migrants who are
introducing HIV from destination areas were the prevalence of HIV infection is
higher. We explore the heterogeneity in potential roles of circular migrants in
driving an HIV epidemic in a rural area in north India and examine the
characteristics of the “sustaining bridge population”, which comprises
individuals at risk of HIV acquisition at destination and of HIV transmission
into networks at origin capable of sustaining an epidemic.
Results of a behavioral survey of 639 male migrants from
Azamgarh district, India, were analyzed using χ2 tests and logistic regression.
We estimated the size of various subgroups defined by
specific sexual behaviors across different locations and over time. Only 20%
fit our definition of a sustaining bridge population, with the majority making
no apparent contribution to geographical connectedness between high- and
low-prevalence areas. However, we found evidence of sexual contacts at origin
that could potentially sustain an epidemic once HIV is introduced. Variables
associated with sustaining bridge population membership were self-perceived HIV
risk, current migrant status, and age.
Circular migrants represent a heterogeneous population in
terms of their role as a bridge group. Self-perception of heightened risk could
be exploited in designing prevention programs.
Below: Distribution of migrant men in the sample according to their sexual behavior at origin and destination
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By:
1Department of Infectious Disease
Epidemiology, School of Public Health, Imperial College London
2School of Social and Community Medicine,
University of Bristol, United Kingdom
3Population Council of India, New Delhi
Correspondence: Tanvi Rai, PhD, School of Public Health,
Imperial College London, Norfolk Pl, W2 1PG London, UK (Email:ku.ca.lairepmi@70iar.ivnat).
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