Geographic mobility and potential bridging for sexually transmitted infections in Agbogbloshie, Ghana

• Type of Material: Article
• Authors: Susan Cassels, University of California Santa Barbara; Samuel M. Jenness, Emory University; Adriana A.E. Biney, University of Ghana; F. Nii-Amoo Dodoo, The Pennsylvania State University
• Language: English
• Date: 2017-07-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 Elsevier Ltd. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.socscimed.2017.05.003
• Title of Journal or Parent Work: Social Science and Medicine
• ISSN: 0277-9536
• Volume: 184
• Start Page: 27
• End Page: 39
• Grant/Funding Information: This work was supported in part by the NICHD (R00 HD057533) and an NICHD Research Infrastructure grant (R24 HD042828).
• Keywords: SOUTH-AFRICA; PARTNERSHIPS; MIGRATION; POPULATIONS; Sexual network; Social Sciences; Science & Technology; STI; CONCURRENCY; Partner concurrency; FEMALE MIGRANTS; RISK BEHAVIORS; Social Sciences, Biomedical; LIVELIHOOD STRATEGIES; TRANSMISSION; HIV; HIV-INFECTION; Circular migration; Biomedical Social Sciences; Life Sciences & Biomedicine; Public, Environmental & Occupational Health
• Research Categories: Geography; Health Sciences, Epidemiology

Abstract

Short-term mobility can significantly influence the spread of infectious disease. In order for mobile individuals to geographically spread sexually transmitted infections (STIs), individuals must engage in sexual acts with different partners in two places within a short time. In this study, we considered the potential of mobile individuals as bridge populations – individuals who link otherwise disconnected sexual networks and contributed to ongoing STI transmission. Using monthly retrospective panel data, we examined associations between short-term mobility and sexual partner concurrency in Agbogbloshie, Ghana. We also examined bridging by the location of sex acts and the location of sexual partners in concurrent triads, and whether mobile individuals from our sample were more likely to be members of geographic bridging triads. Although reported rates of sexual partnership concurrency were much higher for men compared to women, mobility was only associated with increased concurrency for women. Additionally, this association held for middle-distance mobility and short-duration trips for women. Taking into account the location of sex acts and the location of sexual partners, about 22% of men (21.7% and 22.4% for mobile and non-mobile men, respectively) and only 3% of women (1.4% and 3.3% for mobile and non-mobile women, respectively) were potential bridges for STIs over the last year. Our results highlight the gendered nature of mobility and sexual risk behavior, reflecting the normative social context that encourages women to conceal certain types of sexual behavior.