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Mobility and HIV in Tanzanian couples: both mobile persons and their partners show increased risk

Kishamawe, Colemana,b,*; Vissers, Debby CJb,*; Urassa, Marka,c; Isingo, Raphaela,c; Mwaluko, Gabriela,c; Borsboom, Gerard JJMb; Voeten, Hélène ACMb; Zaba, Basiad; Habbema, J Dik Fb; de Vlas, Sake Jb

doi: 10.1097/01.aids.0000210615.83330.b2
Epidemiology and Social

Objective: To investigate how mobility is related to sexual risk behavior and HIV infection, with special reference to the partners who stay behind in mobile couples.

Methods: HIV status, sexual behavior and demographic data of 2800 couples were collected in a longitudinal study in Kisesa, rural Tanzania. People were considered short-term mobile if they had slept outside the household at least once on the night before one of the five demographic interviews, and long-term mobile if they were living elsewhere at least once at the time of a demographic round.

Results: Overall, whereas long-term mobile men did not report more risk behavior than resident men, short-term mobile men reported having multiple sex partners in the last year significantly more often. In contrast, long-term mobile women reported having multiple sex partners more often than resident women (6.8 versus 2.4%; P = 0.001), and also had a higher HIV prevalence (7.7 versus 2.7%; P = 0.02). In couples, men and women who were resident and had a long-term mobile partner both reported more sexual risk behavior and also showed higher HIV prevalence than people with resident/short-term mobile partners. Remarkably, risk behavior of men increased more when their wives moved than when they were mobile themselves.

Conclusions: More sexual risk behavior and an increased risk of HIV infection were seen not only in mobile persons, but also in partners staying behind. Interventions aiming at reducing risk behavior due to mobility should therefore include partners staying behind.

From the aTanzania Essential Strategies Against AIDS (TANESA), Mwanza, Tanzania

bDepartment of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands

cNational Institute for Medical Research, Mwanza, Tanzania

dCentre for Populations Studies, London School of Hygiene and Tropical Medicine, London, UK.

*Both authors contributed equally to this paper.

Received 30 August, 2005

Revised 30 November, 2005

Accepted 7 December, 2005

Correspondence to Debby Vissers, Department of Public Health, Erasmus MC, University Medical Center Rotterdam. PO Box 1738, 3000 DR Rotterdam, The Netherlands. E-mail: d.vissers@erasmusmc.nl

© 2006 Lippincott Williams & Wilkins, Inc.