{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T07:28:10Z","timestamp":1768634890383,"version":"3.49.0"},"reference-count":39,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T00:00:00Z","timestamp":1630540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100009054","name":"U.S. President\u2019s Emergency Plan for AIDS Relief","doi-asserted-by":"publisher","award":["#U2GGH001226"],"award-info":[{"award-number":["#U2GGH001226"]}],"id":[{"id":"10.13039\/100009054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\nBackground<\/jats:title>\nIn the 21st<\/jats:sup> century, understanding how population migration impacts human health is critical. Namibia has high migration rates and HIV prevalence, but little is known about how these intersect. We examined the association between migration and HIV-related outcomes using data from the 2017 Namibia Population-based HIV Impact Assessment (NAMPHIA).<\/jats:p>\n<\/jats:sec>\n\nMethods and findings<\/jats:title>\nThe NAMPHIA survey selected a nationally representative sample of adults in 2017. All adults aged 15\u201364 years were invited to complete an interview and home-based HIV test. Recent infection (<130 days) was measured using HIV-1 LAg avidity combined with viral load (>1000 copies\/mL) and antiretroviral analyte data. Awareness of HIV status and antiretroviral use were based on self-report and\/or detectable antiretrovirals in blood. Viremia was defined as having a viral load \u22651000 copies\/mL, including all participants in the denominator regardless of serostatus. We generated community viremia values as a weighted proportion at the EA level, excluding those classified as recently infected. Significant migrants were those who had lived outside their current region or away from home >one month in the past three years. Recent cross-community in-migrants were those who had moved to the community <two years ago. Separate analyses were done to compare significant migrants to non-migrants and recent cross-community in-migrants to those who in-migrated >two years ago to determine the association of migration and timing with recent infection or viral load suppression (VLS). All proportions are weighted. Of eligible adults, we had HIV results and migration data on 9,625 (83.9%) of 11,474 women and 7,291 (73.0%) of 9,990 men. Most respondents (62.5%) reported significant migration. Of cross-community in-migrants, 15.3% were recent. HIV prevalence was 12.6% and did not differ by migration status. Population VLS was 77.4%. Recent cross-community in-migration was associated with recent HIV infection (aOR: 4.01, 95% CI 0.99\u201316.22) after adjusting for community viremia. Significant migration (aOR 0.73, 95% CI: 0.55\u20130.97) and recent cross-community in-migration (aOR 0.57, 95% CI: 0.35\u20130.92) were associated with lower VLS, primarily due to lack of awareness of HIV infection. The study was limited by lack of precise data on trajectory of migration.<\/jats:p>\n<\/jats:sec>\n\nConclusions<\/jats:title>\nDespite a high population-level VLS, Namibia still has migrant populations that are not accessing effective treatment for HIV. Targeting migrants with effective prevention and testing programs in communities with viremia could enable further epidemic control.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0256865","type":"journal-article","created":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T17:56:31Z","timestamp":1630605391000},"page":"e0256865","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":16,"title":["Migration in Namibia and its association with HIV acquisition and treatment outcomes"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7088-4556","authenticated-orcid":true,"given":"Andrea","family":"Low","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karam","family":"Sachathep","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Rutherford","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne-Marie","family":"Nitschke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Wolkon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Banda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leigh Ann","family":"Miller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chelsea","family":"Solmo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keisha","family":"Jackson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hetal","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"McCracken","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sally","family":"Findley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholus","family":"Mutenda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,9,2]]},"reference":[{"issue":"Suppl 4","key":"pone.0256865.ref001","doi-asserted-by":"crossref","first-page":"e25115","DOI":"10.1002\/jia2.25115","article-title":"Population mobility associated with higher risk sexual behaviour in eastern African communities participating in a Universal Testing and Treatment trial","volume":"21","author":"CS Camlin","year":"2018","journal-title":"Journal of the International AIDS Society"},{"issue":"4","key":"pone.0256865.ref002","doi-asserted-by":"crossref","first-page":"e181","DOI":"10.1016\/S2352-3018(18)30009-2","article-title":"Migration and risk of HIV acquisition in Rakai, Uganda: a population-based cohort study","volume":"5","author":"O Olawore","year":"2018","journal-title":"Lancet HIV"},{"issue":"8","key":"pone.0256865.ref003","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1080\/17441692.2015.1074715","article-title":"Mobility among youth in Rakai, Uganda: Trends, characteristics, and associations with behavioural risk factors for HIV.","volume":"12","author":"AC Schuyler","year":"2017","journal-title":"Glob Public Health"},{"issue":"1","key":"pone.0256865.ref004","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1097\/QAD.0000000000001292","article-title":"Space-time migration patterns and risk of HIV acquisition in rural South Africa","volume":"31","author":"A Dobra","year":"2017","journal-title":"AIDS"},{"issue":"6","key":"pone.0256865.ref005","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1097\/COH.0000000000000192","article-title":"HIV treatment cascade in migrants and mobile populations","volume":"10","author":"F Tanser","year":"2015","journal-title":"Curr Opin HIV AIDS"},{"issue":"4","key":"pone.0256865.ref006","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1093\/infdis\/jis401","article-title":"Projecting the benefits of antiretroviral therapy for HIV prevention: the impact of population mobility and linkage to care","volume":"206","author":"JR Andrews","year":"2012","journal-title":"J Infect Dis"},{"key":"pone.0256865.ref007","unstructured":"International Organization for Migration (IOM). 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