MIGRATION, SOCIAL DISADVANTAGE, SEXUAL PARTNERSHIPS, AND HIV/STI IN THE GARÍFUNA POPULATION OF HONDURAS

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  • March 19, 2019
Creator
  • Gandhi, Anisha
    • Affiliation: Gillings School of Global Public Health, Department of Epidemiology
Abstract
  • Anisha D. Gandhi: Migration, Social Disadvantage, Sexual Partnerships, and HIV/STI in the Garífuna Population of Honduras (Under the direction of Audrey Pettifor) This study examined the relationships between HIV/STI status and the social and behavioral factors that are posited to shape the risk of these outcomes in the Garífuna population of Honduras. The Garífuna are a people with African and indigenous origins among whom high rates of HIV and other STIs have been observed. Research from multiple disciplines suggests migration patterns, sexual behavior norms, and social marginalization as a racial/ethnic minority have contributed to this disease burden among the Garífuna. However, gaps in the public health literature pertaining to these relationships persist. Data were collected from a population-based sample of Garífuna men and women in 2012 (n=629) through a survey of sexual behavior and HIV/STI prevalence among key populations in Honduras. Participants completed surveys and provided samples for the diagnosis of HIV, HSV-2, and non-viral STIs. Weighted log-binomial regression models were used to produce prevalence ratios. The first aim of this study assessed whether temporary migration was associated with multiple sexual partnerships and concurrent sexual partnerships in the last 12 months. Multiple sexual partnerships were more prevalent among migrant men and migrant women relative to non-migrant men and non-migrant women, respectively. Concurrent sexual partnerships were also more prevalent among men and women who migrated, relative to men and women who did not migrate. The second aim assessed the relationships between HIV, HSV-2 and non-viral STI prevalence and the following measures of social status and social disadvantage: education, unemployment, lack of income or financial support, labor migration, and experience of discrimination. There were no cases of HIV among men or women who had migrated within the last 12 months. Relationships between markers of social disadvantage and disease status were largely not significant or were of small magnitude. While HIV prevalence has declined in Honduras, the estimated prevalence in this sample of the Garifuna population was 4.1%; HSV-2 and non-viral STI prevalence likewise remained high in comparison to previous estimates. Future research on the social and structural determinants of HIV/STI vulnerability in the Honduran Garífuna population would benefit from continued investigation into the role of mobility and a more thorough assessment of social status.
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  • In Copyright
Advisor
  • Marshall, Stephen
  • Pettifor, Audrey
  • Barrington, Clare
  • Paz-Bailey, Gabriela
  • Behets, Frieda
Degree
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2014
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  • Chapel Hill, NC
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  • This item is restricted from public view for 1 year after publication.
Date uploaded
  • April 23, 2015

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