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High Mobility and HIV Prevalence Among Female Market Traders in East Africa in 2014

Camlin, Carol S. PhD, MPH; El Ayadi, Alison M. ScD; Kwena, Zachary A. PhD; McFarland, Willi PhD, MPH; Johnson, Mallory O. PhD; Neilands, Torsten B. PhD; Bukusi, Elizabeth A. MBChB, MMed, PhD, MPH; Cohen, Craig R. MD, MPH

JAIDS Journal of Acquired Immune Deficiency Syndromes: April 15th, 2017 - Volume 74 - Issue 5 - p e121–e128
doi: 10.1097/QAI.0000000000001252

Background: The contribution of women's mobility to the HIV/AIDS epidemic in Africa is poorly understood, despite women's high mobility and evidence that it is associated with higher-risk sexual behavior. We sought to measure levels of mobility, HIV prevalence, and related risk behaviors among female traders in Kisumu, Kenya.

Methods: We used global positioning system mapping to develop a probability-based sample and recruited 305 female market traders for participation in a survey and voluntary HIV counseling and testing in 2014. We estimated HIV prevalence and fitted logistic regression models to measure associations between mobility, risk behaviors, and HIV infection.

Results: HIV prevalence was 25.6% (95% confidence interval: 21.0 to 30.8); 11.5% had migrated (changed residence, over county, or national boundary) in the past year and 39.3% in the past 5 years. More than one-third (38.3%) spent nights away from main residence in the past month, with 11.4% spending more than a week away. Multiple partners were reported by 13.1% of women in the last year; 16% of married women reported a concurrent partnership. Mobility was not significantly associated with HIV prevalence, although recent short-term mobility was significantly correlated with higher numbers of sexual partners in the past year.

Conclusions: Female market traders were highly mobile, and HIV prevalence among traders was higher than in the general population of women of reproductive age in Kisumu (15.3% in 2013), and Nyanza Province, Kenya (16.1% in 2012). High HIV prevalence and risk behavior among women in this study warrant accelerated attention to HIV prevention and care needs of mobile women, including market traders.

*Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, CA;

Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA;

Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA;

§Centre for Microbiology Research, Kenya Medical Research Institute, Kwale, Kenya; and

Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA.

Correspondence to: Carol S. Camlin, PhD, MPH, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, 550 16th Street, 3rd Floor (UCSF Mailcode 1224), San Francisco, CA 94158-2549 (e-mail:

Supported by a grant from the National Institutes of Health, University of California, San Francisco-Gladstone Institute of Virology & Immunology Center for AIDS Research (UCSF-CFAR), P30-AI027763. C.S.C. was supported by a Research Scientist Development Award from the National Institute of Mental Health (NIMH), K01MH093205. M.O.J. was supported by Grant Number K24DA037034.

The authors have no conflicts of interest to disclose.

Received June 24, 2016

Accepted November 09, 2016

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.