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She mixes her business: HIV transmission and acquisition risks among female migrants in western Kenya

机译:她把生意混在一起:肯尼亚西部女性移民中的艾滋病毒传播和感染风险

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摘要

Migration and HIV research in sub-Saharan Africa has focused on HIV risks to male migrants, yet women’s levels of participation in internal migration have met or exceeded those of men in the region. Moreover, studies that have examined HIV risks to female migrants found higher risk behavior and HIV prevalence among migrant compared to non-migrant women. However, little is known about the pathways through which participation in migration leads to higher risk behavior in women. This study aimed to characterize the contexts and processes that may facilitate HIV acquisition and transmission among migrant women in the Kisumu area of Nyanza Province, Kenya. We used qualitative methods, including 6 months of participant observation in women’s common migration destinations and in-depth semi-structured interviews conducted with 15 male and 40 female migrants selected from these destinations. Gendered aspects of the migration process may be linked to the high risks of HIV observed in female migrants— in the circumstances that trigger migration, livelihood strategies available to female migrants, and social features of migration destinations. Migrations were often precipitated by household shocks due to changes in marital status (as when widowhood resulted in disinheritance) and gender-based violence. Many migrants engaged in transactional sex, of varying regularity, from clandestine to overt, to supplement earnings from informal sector trading. Migrant women are at high risk of HIV transmission and acquisition: the circumstances that drove migration may have also increased HIV infection risk at origin; and social contexts in destinations facilitate having multiple sexual partners and engaging in transactional sex. We propose a model for understanding the pathways through which migration contributes to HIV risks in women in high HIV prevalence areas in Africa, highlighting potential opportunities for primary and secondary HIV prevention at origins and destinations, and at key ‘moments of vulnerability’ in the migration process.
机译:撒哈拉以南非洲地区的移徙和艾滋病毒研究集中在男性移徙者面临的艾滋病毒风险上,但是女性参与内部移徙的水平已经达到或超过该地区男性的水平。而且,研究了女性移民对艾滋病病毒的风险的研究发现,与非移民妇女相比,移民中的风险行为和艾滋病毒患病率更高。但是,人们对移民参与导致女性较高风险行为的途径知之甚少。这项研究旨在描述可能促进肯尼亚Nyanza省Kisumu地区移民妇女之间艾滋病毒的获取和传播的环境和过程。我们使用了定性方法,包括在女性常见的移民目的地进行了为期6个月的参与者观察,并对从这些目的地选择的15名男性和40名女性移民进行了深入的半结构化访谈。迁移过程的性别方面可能与女性移民中观察到的艾滋病毒高风险有关—在引发移民的情况,女性移民可用的生计策略以及移民目的地的社会特征下。移徙往往是由于婚姻状况的改变(如丧偶导致丧失继承权)和基于性别的暴力而受到家庭冲击的加剧。从秘密到公开的许多定期性交易性移民,以补充非正规部门贸易的收入。移徙妇女极易感染和传播艾滋病毒:驱使迁徙的情况可能也增加了艾滋病毒原发感染的风险;目的地的社交环境有利于拥有多个性伴侣并从事性交易。我们提出了一个模型,用于了解在非洲艾滋病毒高发地区,移徙对女性艾滋病毒风险造成影响的途径,重点介绍了在起源地和目的地以及在移徙的关键“脆弱时刻”进行一级和二级艾滋病毒预防的潜在机会处理。

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