@article{fdi:010031964,
  title = {{M}obility and the spread of human immunodeficiency virus intro rural areas of {W}est {A}frica},
  author = {{L}agarde, {E}. and {S}chim van der {L}oeff, {M}. and {E}nel, {C}. and {H}olmgren, {B}. and {D}ray-{S}pira, {R}. and {P}ison, {G}. and {P}iau, {J}ean-{P}ierre and {D}elaunay, {V}al{\'e}rie and {M}'{B}oup, {S}. and {N}doye, {I}. and {C}oeuret-{P}ellicer, {M}. and {W}hittle, {H}. and {A}aby, {P}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {I}n eastern and southern {A}frica, the human immunodeficiency virus ({HIV}) epidemic appeared first in urban centres and then spread to rural areas. {I}ts overall prevalence is lower in {W}est {A}frica, with the highest levels still found in cities. {R}ural areas are also threatened, however, because of the population's high mobility. {W}e conducted a study in three different communities with contrasting infection levels to understand the epidemiology of {HIV} infection in rural {W}est {A}frica. {M}ethod {A} comparative cross-sectional study using a standardized questionnaire and biological tests was conducted among samples in two rural communities of {S}enegal ({N}iakhar and {B}andafassi, 866 and 952 adults, respectively) and a rural community of {G}uinea-{B}issau ({C}aio, 1416 adults). {W}e compared the distribution of population characteristics and analysed risk factors for {HIV} infection in {C}aio at the individual level. {R}esults {T}he level of {HIV} infection was very low in {N}iakhar (0.3%) and {B}andafassi (0.0%), but 10.5% of the adults in {C}aio were infected, mostly with {HIV} type 2 ({HIV}-2). {M}obility was very prevalent in all sites. {S}hort-term mobility was found to be a risk factor for {HIV} infection among men in {C}aio (adjusted odds ratio (a{OR}) = 2.06; 95% {CI}: 1.06-3.99). {W}omen from {C}aio who reported casual sex in a city during the past 12 months were much more likely to be infected with {HIV} (a{OR} = 5.61 95% {CI}: 1.56-20.15). {S}hort-term mobility was associated with risk behaviours at all sites. {C}onclusions {M}obility appears to be a key factor for {HIV} spread in rural areas of {W}est {A}frica, because population movement enables the virus to disseminate and also because of the particularly risky behaviours of those who are mobile. {M}ore prevention efforts should be directed at migrants from rural areas who travel to cities with substantial levels of {HIV} infection.},
  keywords = {{SIDA} ; {EPIDEMIOLOGIE} ; {MIGRATION} ; {PREVALENCE} ; {TEST} {BIOLOGIQUE} ; {COMPORTEMENT} {SEXUEL} ; {ECOLOGIE} ; {MILIEU} {RURAL} ; {ETUDE} {COMPARATIVE} ; {AFRIQUE} {DE} {L}'{OUEST} ; {SENEGAL} ; {GUINEE} {BISSAU} ; {NIAKHAR} ; {BANDAFASSI} ; {CAIO}},
  booktitle = {},
  journal = {{I}nternational {J}ournal of {E}pidemiology},
  volume = {32},
  numero = {5},
  pages = {744--752},
  ISSN = {0300-5771},
  year = {2003},
  DOI = {10.1093/ije/dyg111},
  URL = {https://www.documentation.ird.fr/hor/fdi:010031964},
}