Migration and HIV Vulnerabilities in Sub-Saharan Africa

Migration in sub-Saharan Africa encompasses a spectrum of movements, from short-term labour mobility and seasonal travel to permanent internal and cross-border relocation. These patterns are driven by economic opportunity, social networks, conflict and environmental change. Migrant populations often navigate multiple social and structural barriers to HIV prevention and care, including disrupted health-service access, legal and documentation challenges, stigma and language obstacles. Mobility can interrupt continuity of antiretroviral therapy, reduce uptake of regular testing and limit exposure to prevention tools such as pre-exposure prophylaxis. Gender and age further stratify risk: women and young adults who migrate for work or education may face heightened exposure to high-risk sexual networks, while men in labour camps confront crowded living conditions and limited sexual‐health services. Refugees and internally displaced persons experience compounded vulnerabilities through dependence on overburdened refugee-settlement clinics and episodic mobility linked to livelihood needs. An improved understanding of mobility typologies, coupled with adaptive health-system interventions, is essential to closing gaps in the HIV care cascade and to advancing regional and global targets for epidemic control.

Research from Nature Portfolio

Recent analyses of population cohorts in Uganda have challenged assumptions about the role of high-prevalence “hotspots” as primary sources of regional HIV spread. Fine-scale mapping of migration networks revealed that individuals living with HIV are more likely to migrate into prevalence hotspots than to disperse infection outward. Women migrants in particular exhibited elevated HIV prevalence upon entry to urban centres, suggesting selective migration of higher-risk groups rather than unidirectional transmission from hotspots. These findings underscore the importance of understanding directional flows and individual characteristics of migrants, rather than focusing solely on geographic prevalence gradients, when designing targeted prevention and testing campaigns.

Migration and HIV Vulnerabilities in Sub-Saharan Africa publication trend

The graph below shows the total number of articles in migration and hiv vulnerabilities in sub-saharan africa across all publications each year (not limited to Nature Index journals).

Technical terms

Internal migration: Movement of individuals within national borders, often between rural and urban areas, that may be temporary or permanent.

Temporary mobility: Short-term travel for work, caregiving or trade, distinct from formal migration and often unrecorded in health systems.

HIV care cascade: The sequential steps of HIV diagnosis, linkage to care, antiretroviral therapy initiation, retention in treatment and viral suppression.

Hotspots: Geographic locales with markedly higher HIV prevalence compared with surrounding areas, often urban or peri-urban centres.

Antiretroviral therapy coverage: The proportion of people living with HIV who are receiving effective antiretroviral medication within a defined population or household.

Pre-exposure prophylaxis (PrEP): Daily or event-driven antiretroviral medication taken by HIV-negative individuals to prevent acquisition of the virus.

References

1. Cohort Profile: Migrant Health Follow-Up Study (MHFUS) of internal migration in South Africa. International Journal of Epidemiology (2024).
2. Mobility and HIV care engagement: a research agenda. Journal of the International AIDS Society (2023).
3. Migrant men and HIV care engagement in Johannesburg, South Africa. BMC Public Health (2024).
4. Migration, hotspots, and dispersal of HIV infection in Rakai, Uganda. Nature Communications (2020).