Local understandings of, and responses to, HIV: rural-urban migrants in Tanzania.

Coast E
Social Science and Medicine. 2006 Aug; 63(4):1000-1010.

Migration is an important process of change for rural populations in developing countries. Migration is a primary cause of behaviour change--by their very act of migrating, migrants are different from those who do not migrate. The focus of the current study is male rural--urban migration in Tanzania and its interaction with sexual behaviour. The analysis presents results from a comparison with individual-level analyses of two populations, one (composed of recent rural--urban migrants) in an urban area and one made up of residents in a rural area. Detailed migration histories (n = 96 rural--urban migrants) and in-depth interviews form the basis of the analysis. Three key research questions are addressed: How does the sexual behaviour of migrants differ from that of rural residents? How do HIV knowledge levels vary between rural--urban migrants and rural residents? What factors are associated with either intentions of behaviour change or reported behaviour? The results are counter-intuitive: rural--urban migrants--both married and unmarried--are not having sex in town. Despite limited understanding of the nature of HIV, the migrant population studied here regulates its behaviour in a way that reflects local understandings of the disease. This finding is important, not least because it challenges the view that HIV in sub-Saharan Africa is largely transmitted to rural areas by return migrants. Maasai rural--urban migrants in Tanzania-- both married and unmarried--are not having sex in town. The policy and service provision implications of the results are explored. (author's)

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