The Silk Road Health Project: How Mobility and Migration Status Influence HIV Risks among Male Migrant Workers in Central Asia

Abstract

ObjectivesWe examined whether mobility, migrant status, and risk environments are associated with sexually transmitted infections (STIs) and HIV risk behaviors (e.g. sex trading, multiple partners, and unprotected sex).MethodsWe used Respondent Driven Sampling (RDS) to recruit external male migrant market vendors from Kyrgyzstan, Uzbekistan, and Tajikistan as well internal migrant and non-migrant market vendors from Kazakhstan. We conducted multivariate logistic regressions to examine the effects of mobility combined with the interaction between mobility and migration status on STIs and sexual risk behaviors, when controlling for risk environment characteristics.ResultsMobility was associated with increased risk for biologically-confirmed STIs, sex trading, and unprotected sex among non-migrants, but not among internal or external migrants. Condom use rates were low among all three groups, particularly external migrants. Risk environment factors of low-income status, debt, homelessness, and limited access to medical care were associated with unprotected sex among external migrants.ConclusionStudy findings underscore the role mobility and risk environments play in shaping HIV/STI risks. They highlight the need to consider mobility in the context of migration status and other risk environment factors in developing effective prevention strategies for this population.

Alcohol and Sexual Risk Behaviors Among Male Central Asian Labor Migrants and Non-migrants in Kazakhstan: Implications for HIV Prevention

“…A homiphily index measures the tendency of participants to recruit from their own group rather than at random [51, 52]. Homiphily indices were .72 for non-migrants, .69 for external migrants and .20 for internal migrants [10]. There was a 72% probability that non-migrant seeds recruited new participants at random indicating that a large percentage of random mixing occurred across migrant groups.…”

“…Studies among adult general populations in Central Asia and Eastern Europe suggest that Kazakhstan is among the countries with the highest rates of heavy episodic drinking in the region [8, 9]. There is mounting empirical literature from Eastern Europe and Central Asia suggesting that alcohol use heightens HIV risk behaviors among non-migrant market laborers, people who inject drugs and other populations [10–12]. Globally, dangerous patterns of alcohol consumption constitute a major cause of morbidity and mortality from accidents, injuries, liver damage, and other physical and psychiatric illnesses [13–16].…”

“…Each year, an estimated one million labor migrants enter Kazakhstan, the majority of whom obtain employment at the Baraholka Marketplace in Almaty, the largest marketplace in Central Asia [36]. Prior research on this population found that mobility patterns heightened the risk for biologically confirmed STIs, commercial sex and unprotected sex among internal migrants and non-migrants [10]. External male migrants reported the lowest rates of STIs and sexual risk behaviors [10].…”

“…Prior research on this population found that mobility patterns heightened the risk for biologically confirmed STIs, commercial sex and unprotected sex among internal migrants and non-migrants [10]. External male migrants reported the lowest rates of STIs and sexual risk behaviors [10]. Studies in Russia have found that Central Asian male migrant workers have a high prevalence of alcohol, drug use and sexual risk compared to other migrant groups [32, 33].…”

The Human Security Dimension of China’s Belt and Road Initiative

“…The BRI therefore needs to embrace enhanced scientific research, data collection, and international collaboration to reach sustainable management practices based on international collaboration (Li et al, 2015). Related health factors, including the spread of HIV due to increased mobility, have also found a place in recent research (El-Bassel et al, 2016).…”