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

Abstract

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 GPS 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% CI 21.0–30.8); 11.5% had migrated (changed residence, over county or national boundary) in past year and 39.3% in past five years. Over one-third (38.3%) spent nights away from main residence in 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.

Population mobility associated with higher risk sexual behaviour in eastern African communities participating in a Universal Testing and Treatment trial

“…widowhood) may increase HIV risk at the community of origin, and social contexts at destinations and transit points facilitate multiple and higher risk sexual partnerships. We found higher HIV prevalence among female market traders (25.6% in 2013) relative to a comparable population of women of reproductive age from a household survey in Kisumu in western Kenya (15.3% in 2013) . Our qualitative research has revealed that the more mobile market traders (in contrast to those who did not travel) often supplemented their low and sporadic earnings from market trading with transactional sex; the practice was common enough that the phrase “she mixes her business” was used, we were told, to describe this practice.…”

The HIV care continuum among resident and non‐resident populations found in venues in East Africa cross‐border areas

“…Cross‐border areas are important mixing grounds between resident populations and non‐resident populations travelling through the site or visiting the site for work, commerce or socializing. Such mixing between population subgroups provides important opportunities for HIV transmission . Accordingly, “knowing the epidemic” in a cross‐border area involves measuring viral suppression among all people who can be found in the site, and the prevention of HIV transmission must include HIV care and treatment for both resident and non‐resident groups.…”

HIV counseling and testing practices among clients presenting at a market HIV clinic in Kampala, Uganda: a cross-sectional study

“…Indeed, a recent study among female market vendors in Kenya found that 11.5% had migrated, changed residence, over county or national boundary in the past year and 39.3% in the past five years. Over one-third 38.3% spent nights away from their main residence in the past month, with 11.4% spending more than a week away 13 . At the time of the study, there were virtually no data available on HCT practices of people working in the market sub-sector, including market vendors and other people engaged in other market-related activities in Uganda.…”