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Effects of Migration on Risky Sexual Behavior and HIV Acquisition in South Africa: A Systematic Review and Meta-analysis, 2000–2017

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Abstract

While human mobility has been implicated in fueling the HIV epidemic in South Africa, the link between migration and HIV has not been systematically reviewed and quantified. We conducted a systematic review of the role of migration in HIV risk acquisition and sexual behaviour based on 29 studies published between 2000 and 2017. Furthermore, we performed a meta-analysis of the association between migration and HIV risk acquisition in four of the studies that used HIV incidence as an outcome measure. The systematic review results show that HIV acquisition and risky sexual behavior were more prevalent among both male and female migrants compared to their non-migrant counterparts. The meta-analysis results demonstrate that migration was significantly associated with increased HIV acquisition risk (aOR = 1.69, 95% CI 1.33–2.14; I2 = 35.0%). There is an urgent need for effective combination HIV prevention strategies (comprising biomedical, behavioral and structural interventions) that target migrant populations.

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Acknowledgements

This research was funded through a Medical Research Council flagship grant from the Republic of South Africa (MRC-RFA-UFSP-01-2013/UKZN HIVEPI). The study design, findings, interpretation of data and conclusions in this paper are those of the authors, and do not necessarily represent the official positions of MRC South Africa or any other surrogate organization.

Funding

This study was funded through a Medical Research Council flagship grant from the Republic of South Africa (MRC-RFA-UFSP-01-2013/UKZN HIVEPI).

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Authors and Affiliations

  1. Africa Health Research Institute, K-RITH Tower Building, 719 Umbilo Road, Congella, Private Bag X7, Durban, South Africa

    Armstrong Dzomba, Andrew Tomita & Frank Tanser

  2. School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa

    Armstrong Dzomba & Frank Tanser

  3. Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa

    Frank Tanser

  4. Research Department of Infection and Population Health, University College London, London, UK

    Frank Tanser

  5. Health Economics and HIV/AIDS Research Division (HEARD), University of KwaZulu-Natal, Westville Campus, Durban, South Africa

    Kaymarlin Govender

  6. KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

    Armstrong Dzomba & Andrew Tomita

  7. Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa

    Andrew Tomita

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  1. Armstrong Dzomba
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Correspondence to Armstrong Dzomba.

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The Biomedical Research Ethics Committee of the University of KwaZulu-Natal (BREC) Durban, South Africa, gave full ethics approval for this study.

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Dzomba, A., Tomita, A., Govender, K. et al. Effects of Migration on Risky Sexual Behavior and HIV Acquisition in South Africa: A Systematic Review and Meta-analysis, 2000–2017. AIDS Behav 23, 1396–1430 (2019). https://doi.org/10.1007/s10461-018-2367-z

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