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Abstract

Male migration/mobility and HIV among married couples in India: Findings from a national population-based survey 
Poster presentation at the XVIII International AIDS Conference, Vienna, 20 July
Saggurti,Niranjan; Nair,S.; Decker,Michele R.; Malviya,Alankar; Silverman,Jay G.; Raj,Anita
Publication date: 2010


Background
Migration and mobility have been identified as primary risk factors for HIV among men globally and within India. Men with mobility are purported to be an HIV bridge population to low-risk populations, including monogamous wives. However, there are little data from India or elsewhere examining migration's intersection with mobility and how these in combination may heighten risk for HIV among couples. This study examines such associations between male migration and mobility with HIV among married couples in India.

Methods
Data for this study were obtained from the National Family Health Survey 3 (NFHS-3), conducted across all 29 states of India from 2005 to 2006. This large-scale survey included a subsample of married couples (n=27,771 couples) who were tested for HIV as a part of their study involvement. Surveys included assessments of participant demographics, sexual risk behaviors, migration (relocation to their current residence), and mobility (residing for one month or greater away from current residence in the past 12 months). Bivariate associations and adjusted logistic regression analyses were conducted to examine the relationship between male migration and mobility with HIV infection in couples (serodiscordance or seroconcordance).

Results
Only a very small proportion of couples include an HIV-infected partner (0.5%; n/N=237/27,771); 0.11 percent (n/N=30/27,771) were HIV-seroconcordant, and 0.38 percent (n/N=108/27,771) were HIV-serodiscordant. Adjusted logistic regression analyses demonstrated that HIV infection in couples (seroconcordant or serodiscordant) was significantly more likely among those couples who were migrant but not mobile (adjusted odds ratio [AOR]=1.58, 95% CI=1.01-2.58) and those who were migrant and mobile (AOR=2.92, 95% CI=1.34-6.37) relative to those couples where men were neither migrant nor mobile.

Conclusions
These findings document the need for not only primary prevention efforts to reduce HIV acquisition among migrant male workers, particularly more mobile migrants, but also efforts to reduce subsequent transmission to wives.