Sexual behavior and vulnerability to HIV infection among seasonal migrant laborers in Metema district, northwest Ethiopia: a cross-sectional study

BACKGROUND

Poor socio-economic conditions fuel seasonal migration of adult males from Northwestern Ethiopia, but behavioral and other migration-related changes increase their vulnerability to HIV/AIDS. This study examined risky sexual behaviors and associated factors that may lead to increased HIV infection vulnerability among migrant laborers in Metema District, Ethiopia.

METHODS

A community-based cross-sectional study was conducted from July 8-18, 2013 at farms with migrant laborers. We enrolled 756 participants through multistage random sampling. Data were collected using structured questionnaires and analyzed using EPI Info7; bivariate and multivariate logistic regression analyses were performed using SPSS.

RESULTS

582 (77%) migrant workers had sexual intercourse in their lifetime. 68% (397/582) reported non-marital sexual intercourse in the preceding six months. Of these, 74% reported sexual intercourse with commercial sex workers, 49% reported having transactional sex, 49% reported unprotected sexual intercourse with CSWs, 69% reported multiple sexual partners in the preceding six months (mean = 2.9 ± 0.7). Being aged between 20-29 (AOR = 2.15, 95% CI: 1.16, 3.99) and 30 years or older (AOR = 2.51, 95% CI: 1.1, 5.71), receipt of HIV prevention information in the preceding six months (AOR = 1.74, 95% CI: 1.15, 2.63), and staying longer on the farm (AOR = 2.74, 95% CI: 1.46, 5.14) were factors significantly associated with condom use at last non-marital sexual intercourse. Respondents aged ≤19, not receiving HIV information in the preceding six months, or staying on the farm for ≤2 months were less likely to have used condoms at their last non-marital sexual intercourse. Moreover, having daily income above USD 5.00 (AOR = 2.24, 95% CI: 1.14, 4.41), paying for most recent sexual intercourse (AOR = 2.22, 95% CI: 1.36, 3.61), and drinking alcohol during last sexual intercourse (AOR = 1.69, 95% CI: 1.01, 2.83) were significantly associated with having multiple (≥2) sexual partners during the preceding six months.

CONCLUSIONS

Seasonal laborers commonly exhibit risky sexual behaviors likely to increase their vulnerability to HIV infection. Unprotected and multiple sex partners in these populations pose transmission risks to seasonal laborers and onward to their wives and future sexual partners. The findings support the need for targeted HIV prevention campaigns designed for seasonal workers and their sexual partners.

Commercial Charcoal Production in the Ibarapa District of Southwestern Nigeria: Forestry Dividends and Welfare Implications

Logging activities have long provided both wood fuel and charcoal for household and commercial use in rural and urban communities in developing countries. However, logging problems range from deforestation to threatened household air quality from burning wood and charcoal. This exploratory case study triangulated 15 in-depth interviews among charcoal bulk buyers and the workers, observations of workers at two èédú (charcoal) commercial depots in Igbo-Ora and of workers in the forest, and review of studies in academic database. Three categories of people are working in the business ranging from the producers in the forests ( alaake) to the bulk buyers ( olowo) in the middle and the wholesalers ( ajagunta) in the city. A small team of 4–8 people can produce three pickup truck loads of charcoal in 2 weeks, and a large team between 7–8 loads. The olowo and the alaake have associations, membership cards, and meet to discuss business progress and regulate members' economic behavior. Close to 35,000 bags of charcoal of 450 pickup trucks may make the journey weekly from Ibarapa. Overall, the charcoal business is informal, and the local people also frown at cutting any useful indigenous trees ascertaining that an individual's actions may affect the whole community. The role of community health educators is important in the dissemination of effects of deforestation through charcoal production.

Diverse blood exposures associated with incident HIV infection in Calabar, Nigeria

Few types of blood exposures have been assessed in relation to incident HIV infection in sub-Saharan Africa, despite evidence that penile-vaginal sex cannot account for the epidemic in the region. To investigate correlates of incident HIV infection in Calabar, Nigeria, we surveyed clients at voluntary HIV counselling and testing centres. Participating clients who tested multiple times were generally similar to those testing only once in terms of demographic characteristics, sexual and blood exposures and HIV prevalence. Blood exposures were common. Serial testers had a 10% annual incidence of HIV infection. Seroconverters and seronegative serial testers were similar on most demographic characteristics and sexual exposures. However, seroconverters were more likely than seronegatives to report blood exposures during the test interval, both for most specific exposures as well as summary measures of blood exposures. In particular, seroconverters were substantially more likely to report one of a set of blood exposures that cannot be explained as a consequence of unprotected vaginal sex or of health care for symptoms of HIV infection (adjusted odds ratio = 6.6, 95% confidence interval = 1.2-38). The study design we used is an inexpensive approach for describing the local epidemiology of HIV transmission and can also serve as the foundation for more definitive investigations that employ contact tracing and sequencing of HIV DNA.