Is Migration a Risk Factor for HIV Spread in Urban Settings? An Exploratory Study of International Bordering District in West Bengal

Abstract

Over the years, migration has been recognized to have a profound link with health and development of people, both in the places of origin as well as at destinations. However, the problem of HIV/AIDS has deep social and economic roots and hence its impact reaches far beyond the health sector with severe socio-economic consequences. Therefore, a comprehensive understanding of various pathways linking migration and HIV/AIDS and the socio-demographic and contextual determinants of STI/HIV risk behaviour is critical for devising suitable programmatic response to curb the pace of epidemic. Use of case-control design, primary data of 620 samples has been collected from the district of Darjeeling in West Bengal and the situation of Darjeeling attain special importance in the context of being a tourist center and also being an important international corridor having higher influx of migrants from bordering countries of Bangladesh Nepal and Bhutan. Bi-variate and multivariate analysis including generalized ordered logistic regression and discriminant function analysis have been employed. Discriminant function analysis portrays that more than one casual sex act in last 30 days has emerged as the single most factor contributing to the discriminant function followed by more than one casual partner in last 30 days, casual sex, unprotected casual sex in last 30 days and ever sex with commercial/paying partner, are next in importance as predictors while defining the involvement into risk behaviour. Result depicts that, as compared to non-migrants, migrants are more likely to have moderate to higher composite risk behaviour. Result of bi-variate and multivariate analysis confirms that young aged respondents are more likely to have moderate or higher composite risky sexual behaviour as compared to their older counterparts. Among two indicators of social influence, risk behaviour by friend is coming significant, who have reported their friends involved in risk behaviour are more likely to have higher risk in a composite index. Therefore, all intervention programs for curbing down HIV risk should be of multi targeted on the behavioural aspect. Community outreach programmes among migrants communities and work place interventions can be instrumental in reducing the vulnerability of migrant workers to STI / HIV.