title: Migration patterns following HIV diagnosis among adults residing in the nonurban Deep South.
abstract: Health care needs of those infected with the human immunodeficiency virus (HIV) and subsequent transmission dynamics are altered by migration after infection. We interviewed 760 HIV-infected persons attending HIV-specialty clinics living in non-urban Alabama and Mississippi to ascertain the likely geographic origins of their infections, determine their post-HIV diagnosis mobility, and identify predictors of this mobility. Most subjects (81%) were living in these two states when diagnosed and have not moved since learning of their HIV status (70%). Of those who moved their primary residence post-HIV diagnosis (25% of the entire study population), the majority in-migrated to Alabama or Mississippi from elsewhere. Persons who had moved post-HIV diagnosis were more likely to be male, an injection drug user, an urban resident at HIV diagnosis, have an AIDS-defining condition, and have moved prior to HIV diagnosis. We conclude that most HIV transmission in non-urban Alabama and Mississippi is acquired locally. These results underline the need to expand HIV prevention programs in the Deep South.
authors.affiliation: University of Alabama at Birmingham, School of Public Health, Birmingham, Alabama 35294-0022, USA. emfunk@uab.edu
authors.forename: Bonita S
authors.initials: BS
authors.lastname: Agee
authors.forename: Ellen
authors.initials: E
authors.lastname: Funkhouser
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Roseman
authors.forename: Hala
authors.initials: H
authors.lastname: Fawal
authors.forename: Scott D
authors.initials: SD
authors.lastname: Holmberg
authors.forename: Sten H
authors.initials: SH
authors.lastname: Vermund
mesh_terms: D000293:Adolescent; D000407:Alabama / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D008297:Male; D008922:Mississippi / Q000453:epidemiology; D011157:Population Dynamics / Q000639:trends*; D012307:Risk Factors; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*