Exploring the relationship between population mobility and HIV risk: Evidence from Tanzania

ABSTRACT

Migration and population mobility has long been regarded as an important structural driver of HIV. Following initial concerns regarding the spatial spread of the disease, mobile populations are viewed to engage in higher levels of risky sexual behaviours than non-mobile groups. However, beyond the case studies of mineworkers and truck drivers, the statistical evidence is inconclusive, suggesting that the relationship between mobility and risk is not well understood. This study investigated how engaging in specific livelihoods that involve mobility influences sexual behaviour and HIV risk. A qualitative research project, including focus groups and in-depth interviews with key mobile groups, was conducted in Northern Tanzania. The findings show that the patterns and conditions of moving related to the requirements of each different economic activity influence the nature of relationships that mobile groups have whilst away, how and where local sexual networks are accessed, and the practicalities of having sex. This has further implications for condom use. Risk behaviours are also shaped by local sexual norms related to transactional sex, emphasising that the roles of mobility and gender are interrelated, overlapping and difficult to disentangle.

KEYWORDS:

• Mobility
• migration
• HIV/AIDS
• structural drivers
• transactional sex

Acknowledgments

This Ph.D. project was supervised by Dr Deborah Johnston (SOAS) and Dr Justin Parkhurst (LSHTM). Fieldwork was supported by John Changalucha and Ray Nsigaye of the National Institute of Medical Research, Tanzania, Mwanza Branch. Research activities were conducted by Lucas Boniface, Penina Samwell and Grace Bulugu, with assistance from Joyce Chuwa, Mathias Shimo and Mpyanjo Chagu. This paper has benefitted from comments from Jim Todd and Tanvi Rai on earlier drafts, and from three anonymous reviewers.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

1 Small dried fish.

2 For a full discussion on the role of research assistants, see Deane and Stevano (2016).

3 Some sections of the focus groups in phase one that involved the participants working in pairs or smaller groups were not recorded.

4 Although this was largely ignored by policy-makers who implemented a standard education and condom promotion scheme, see Stillwaggon (2006).

Additional information

Funding

This project was supported by Bloomsbury Colleges and the London International Development Centre. The Kisesa observational HIV cohort has been funded by the Netherlands Government through TANESA Project and Global Fund Round4 [grant number TNZ-405-GO4-H] and Round9 [grant number TNZ-911-G14-S] through the Tanzania National Coordinating Mechanism (TNCM).