Patterns of movement and risk of HIV infection in rural Zimbabwe

Background. High rates of population movement may have helped spread human immunodeficiency virus (HIV) in southern Africa, including Zimbabwe, but whether mobility continues to influence the epidemic is unclear. Methods. The relationship between movement, risk behaviors, and prevalence of HIV was assessed from a general population survey of 19800 adults in 12 rural communities in Manicaland province in eastern Zimbabwe. Results. HIV prevalence varied with socioeconomic development. In community centers, prevalence among women was 49.9% (95% confidence interval [CI], 46.1%-53.6%), compared with 24.7% (95% CI, 22.6%-26.7%) in the least-developed subsistence-farming areas. Mobility was not associated with risk of HIV infection, except for those who migrated between rural locations. Among migrant agricultural workers, prevalence was 38.8% ( 95% CI, 33.1%-44.6%) for women and 26.4% (95% CI, 23.8%-28.9%) for men, compared with 29.7% ( 95% CI, 28.3%-31.1%) and 20.9% (95% CI, 19.3%-22.4%) for other sexually active women and men, respectively. Risk was increased if an individual traveled to Harare in the last month, without their spouse, but this risk was not transferred to the partner. Conclusion. Rural-urban migration does not appear to be responsible for maintaining the high HIV prevalence in rural Zimbabwe, but rates of HIV infection may be affected by rural-rural migration.