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“She mixes her business”: HIV transmission and acquisition risks among female migrants in western Kenya

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  • Camlin, Carol S.
  • Kwena, Zachary A.
  • Dworkin, Shari L.
  • Cohen, Craig R.
  • Bukusi, Elizabeth A.

Abstract

Migration and HIV research in sub-Saharan Africa has focused on HIV risks to male migrants, yet women's levels of participation in internal migration have met or exceeded those of men in the region. Moreover, studies that have examined HIV risks to female migrants found higher risk behavior and HIV prevalence among migrant compared to non-migrant women. However, little is known about the pathways through which participation in migration leads to higher risk behavior in women. This study aimed to characterize the contexts and processes that may facilitate HIV acquisition and transmission among migrant women in the Kisumu area of Nyanza Province, Kenya. We used qualitative methods, including 6 months of participant observation in women's common migration destinations and in-depth semi-structured interviews conducted with 15 male and 40 female migrants selected from these destinations. Gendered aspects of the migration process may be linked to the high risks of HIV observed in female migrants — in the circumstances that trigger migration, livelihood strategies available to female migrants, and social features of migration destinations. Migrations were often precipitated by household shocks due to changes in marital status (as when widowhood resulted in disinheritance) and gender-based violence. Many migrants engaged in transactional sex, of varying regularity, from clandestine to overt, to supplement earnings from informal sector trading. Migrant women are at high risk of HIV transmission and acquisition: the circumstances that drove migration may have also increased HIV infection risk at origin; and social contexts in destinations facilitate having multiple sexual partners and engaging in transactional sex. We propose a model for understanding the pathways through which migration contributes to HIV risks in women in high HIV prevalence areas in Africa, highlighting potential opportunities for primary and secondary HIV prevention at origins and destinations, and at key ‘moments of vulnerability’ in the migration process.

Suggested Citation

  • Camlin, Carol S. & Kwena, Zachary A. & Dworkin, Shari L. & Cohen, Craig R. & Bukusi, Elizabeth A., 2014. "“She mixes her business”: HIV transmission and acquisition risks among female migrants in western Kenya," Social Science & Medicine, Elsevier, vol. 102(C), pages 146-156.
    • Handle: RePEc:eee:socmed:v:102:y:2014:i:c:p:146-156
    DOI: 10.1016/j.socscimed.2013.11.004
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    2. Tomonori Hoshi & Yoshito Fuji & Samson Muuo Nzou & Chihiro Tanigawa & Ibrahim Kiche & Matilu Mwau & Anne Wanjiru Mwangi & Mohamed Karama & Kenji Hirayama & Kensuke Goto & Satoshi Kaneko, 2016. "Spatial Distributions of HIV Infection in an Endemic Area of Western Kenya: Guiding Information for Localized HIV Control and Prevention," PLOS ONE, Public Library of Science, vol. 11(2), pages 1-14, February.
    3. Salmen, Charles R. & Hickey, Matthew D. & Fiorella, Kathryn J. & Omollo, Dan & Ouma, Gor & Zoughbie, Daniel & Salmen, Marcus R. & Magerenge, Richard & Tessler, Robert & Campbell, Harold & Geng, Elvin , 2015. "“Wan Kanyakla” (We are together): Community transformations in Kenya following a social network intervention for HIV care," Social Science & Medicine, Elsevier, vol. 147(C), pages 332-340.
    4. Susan Cassels & Samuel M. Jenness & Adriana A. E. Biney & William Kwabena Ampofo & F. Nii-Amoo Dodoo, 2014. "Migration, sexual networks, and HIV in Agbogbloshie, Ghana," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 31(28), pages 861-888.
    5. Ly Huynh, 2022. "Vietnamese Women Rural Migrants’ Social Vulnerability Under the Lens of Hegemonic Masculinities and Confucianism," Journal of International Migration and Integration, Springer, vol. 23(4), pages 1855-1874, December.
    6. Cassels, Susan & Jenness, Samuel M. & Biney, Adriana A.E. & Dodoo, F. Nii-Amoo, 2017. "Geographic mobility and potential bridging for sexually transmitted infections in Agbogbloshie, Ghana," Social Science & Medicine, Elsevier, vol. 184(C), pages 27-39.
    7. Ararso Baru & Ikeola A Adeoye & Adeyemi O Adekunle, 2020. "“I was raped by the broker on the first day of my arrival in the town.” Exploring reasons for risky sexual behavior among sexually-active unmarried young female internal migrants in Ethiopia: A qualit," PLOS ONE, Public Library of Science, vol. 15(11), pages 1-14, November.
    8. Fiorella, Kathryn J. & Camlin, Carol S. & Salmen, Charles R. & Omondi, Ruth & Hickey, Matthew D. & Omollo, Dan O. & Milner, Erin M. & Bukusi, Elizabeth A. & Fernald, Lia C.H. & Brashares, Justin S., 2015. "Transactional Fish-for-Sex Relationships Amid Declining Fish Access in Kenya," World Development, Elsevier, vol. 74(C), pages 323-332.

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