HIV and viremia prevalence in non-migrating members of migrant households in southern Uganda: A cross-sectional population-based study.

Introduction: In Africa, migrants are more likely to be living with HIV and HIV viremic than non-migrants but less is known about HIV outcomes among non-migrants living in households with migrants. We compared HIV outcomes in non-migrating persons in households with and without migration.

Methods: We analyzed cross-sectional data collected between August 2016-May 2018 from non-migrating participants aged 15-49 in the Rakai Community Cohort Study in Uganda. Migrant households were classified as those reporting ≥1 member moving into or out of the household since the prior survey. HIV serostatus was determined using a validated testing algorithm, and viremia defined as >1,000 copies/mL. Modified Poisson regression was used to estimate prevalence ratios (PR) between household migration and HIV outcomes. Analyses were stratified by gender, direction of migration (into/out of household), and relationship between non-migrants and migrants (e.g., spouse).

Results: There were 14,599 non-migrants (52% women) and 4,415 (30%) lived in a household with ≥1 migrant. Of these, 972 (22%) had migrant spouses, 1,102 (25%) migrant children, and 875 (20%) migrant siblings. Overall, HIV prevalence and viremia did not differ between non-migrants in households with and without migration. However, in stratified analyses, non-migrant women with migrant spouses were significantly more likely to be HIV seropositive compared to non-migrant women with non-migrant spouses (adjPR:1.44, 95%CI:1.21-1.71). Conversely, non-migrant mothers living with HIV who had migrant children were less likely to be viremic (adjPR:0.34, 95%CI:0.13-0.86).

Conclusions: Non-migrating women with migrating spouses are more likely be living with HIV, and may benefit from additional HIV support services.