Male out-migration: a factor for the spread of HIV infection among married men and women in rural India

PLoS One. 2012;7(9):e43222. doi: 10.1371/journal.pone.0043222. Epub 2012 Sep 6.


Introduction: Thus far, the reasons for increasing HIV prevalence in northern and eastern Indian states are unknown. We investigated the role of male out-migration in the spread of human immunodeficiency virus (HIV) infection through a case-control study in rural India.

Methods: Currently married men and women were recruited from HIV testing and treatment centers across seven selected districts with high rates of male out-migration in eastern and northern India in 2010 using a case-control study design. Case subjects (men: 595, women: 609) were people who tested HIV seropositive and control subjects (men: 611, women: 600) were those tested HIV seronegative. For each gender, we obtained adjusted odds ratios (AORs) and population attributable risks (PARs) for migration, and behavioral factors.

Results: For men, the prevalence of HIV was significantly higher among those with a migration history (AOR, 4.4); for women, the prevalence of HIV was higher among those with migrant husbands (AOR, 2·3). For both genders, the returned male migration (men: AOR, 3·7; women: AOR, 28) was significantly associated with higher prevalence of HIV infection. The PAR associated with male migration was higher for men (54.5%-68.6%) than for women (32·7%-56·9%) across the study areas.

Discussion: Male out-migration is the most important risk factor influencing the spread of HIV infection in rural areas with high out-migration rates, thereby emphasizing the need for interventions, particularly, for returned migrants and spouses of those migrants.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Demography
  • Emigration and Immigration*
  • Female
  • HIV Infections / epidemiology
  • HIV Infections / transmission*
  • HIV Seronegativity
  • HIV Seropositivity / epidemiology
  • Humans
  • India / epidemiology
  • Male
  • Marriage / statistics & numerical data*
  • Risk Factors
  • Rural Population / statistics & numerical data*

Grants and funding

United Nations Development Programme (UNDP) provided a grant to Population Council to support this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.