HIV, mobility and migration

The relationship between population mobility, migration and HIV is one that is both complex and contested. This has particular relevance for the sub-Saharan African (SSA) region, a setting associated with a generalised HIV epidemic (GHE) and a high prevalence of diverse population movements. In this research project, the role of contemporary population mobility in mediating the HIV epidemic in SSA is explored and recommendations for action to assist in strengthening responses to HIV – including the call for migration-aware programming – in the region will be made.

In 2016, the SSA region remains home to the largest number of people living with HIV and – whilst some successes have been reported, such as increased numbers of people on treatment, fewer deaths, and a reduction in new cases of HIV per year – challenges remain to the development and implementation of effective combination prevention interventions.

Population mobility is often assumed to act as a key driver of GHEs but the most recent evidence suggests that whilst this may be true from a historical perspective – with migration fuelling the early spread of epidemics within the region, individual-level associations between (often poorly defined) migration status and HIV are not borne out at a population level; national migration levels are not associated with national HIV prevalence. In 2016, the movement of people is not a determinant of population HIV prevalence within GHE settings such as SSA, including within conflict and post-conflict contexts.

In spite of this, decisions related to the control of HIV are often fuelled by wider political debates linked to anti-(im)migration sentiments (and associated poor understandings of the heterogeneity of population movements), rather than being informed by evidence. These debates involve a range of unfounded assumptions that continue to negatively associate the movement of people with the spread of HIV and other infectious diseases, and fail to consider the complex ways in which other aspects of GHE settings – such as continued access to antiretroviral treatment and combination prevention programming – may be mediated by migration and mobility.

In order to support the call for renewed responses to address the structural drivers of HIV, as part of a combination prevention approach, there is an urgent need to better understand contemporary relationships between diverse population movements and HIV – including any implications for expanding treatment-as-prevention and pre-exposure prophylaxis (PreP) programmes.

In line with renewed calls for a focus on the structural drivers of HIV, this is a critical time – a strategic opportunity – for (re)focusing on structural drivers of HIV; population mobility is one such prevalent structural reality associated with the SSA region that affects HIV policy and programming in multiple ways.

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About Jo Vearey

Jo Vearey is an Associate Professor with the African Centre for Migration & Society, University of the Witwatersrand. She holds an Honorary Fellowship with the School of Social and Political Science at the University of Edinburgh, and a Senior Fellowship at the Centre for Peace, Development and Democracy at the University of Massachusetts, Boston. In 2015, Jo was awarded a Humanities and Social Science Wellcome Trust Investigator Award. Jo holds a MSc in the Control of Infectious Diseases (LSHTM, 2003), a PhD in Public Health (Wits, 2010), and has been rated by the National Research Foundation as a Young Researcher. In 2014 and 2015, Jo received a Friedel Sellschop Award from the University of the Witwatersrand for outstanding young researchers. She was a Marie Curie Research Fellow in 2013, at the UNESCO Chair on Social and Spatial Inclusion of Migrants, University of Venice (SSIM-IUAV), Venice, Italy.

With a commitment to social justice and the development of pro-poor policy responses, Jo’s research explores international, regional, national and local responses to migration, health, and urban vulnerabilities. Her research interests focus on urban health, public health, migration and health, the social determinants of health, HIV, informal settlements and sex work. Jo is particularly interested in knowledge production, dissemination and utilisation including the use of visual and arts-based methodologies.

Jo has a range of international collaborations, including an ESRC-NRF funded project with the University of Edinburgh, a WOTRO funded project with the VU University, Amsterdam on migration and sex work, and partnerships with the University of Massachusetts Boston and the London School of Hygiene and Tropical Medicine‘s Faculty of Public Health and Policy and Gender, Violence and Health Unit.

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