ArticleeLife2023
The role of migration networks in the development of Botswana's generalized HIV epidemic.
Article in eLife, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Contextual Drivers of HIV Vulnerability and Retention in Care in the Central African Republic: An Ecological Analysis.AIDS and behavior · 2026Article
- Metrics of Mobility by Sex are Associated with HIV Incidence in Rural Kenya and Uganda.AIDS and behavior · 2025Article
- Short-Term Mobility and Risky Sexual Behaviors Among Men Who Have Sex with Men in Guangdong, China.AIDS and behavior · 2025Article
- Prospective longitudinal assessment of Albumin-to-Creatinine ratio (ACR) in a clinical cohort of people living with HIV in Gaborone, Botswana.BMC infectious diseases · 2025Observational
- Retention on antiretroviral therapy and drivers of lost-to-follow up in the Central African Republic: a longitudinal analysis.Journal of the International AIDS Society · 2024Article
- High prevalence of pre-treatment and acquired HIV-1 drug resistance mutations among non-citizens living with HIV in Botswana.Frontiers in microbiology · 2024Article
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Abstract
The majority of people with HIV live in sub-Saharan Africa, where epidemics are generalized. For these epidemics to develop, populations need to be mobile. However, the role of population-level mobility in the development of generalized HIV epidemics has not been studied. Here we do so by studying historical migration data from Botswana, which has one of the most severe generalized HIV epidemics worldwide; HIV prevalence was 21% in 2021. The country reported its first AIDS case in 1985 when it began to rapidly urbanize. We hypothesize that, during the development of Botswana's epidemic, the population was extremely mobile and the country was highly connected by substantial migratory flows. We test this mobility hypothesis by conducting a network analysis using a historical time series (1981-2011) of micro-census data from Botswana. Our results support our hypothesis. We found complex migration networks with very high rates of rural-to-urban, and urban-to-rural, migration: 10% of the population moved annually. Mining towns (where AIDS cases were first reported, and risk behavior was high) were important in-flow and out-flow migration hubs, suggesting that they functioned as 'core groups' for HIV transmission and dissemination. Migration networks could have dispersed HIV throughout Botswana and generated the current hyperendemic epidemic.
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