Several meta-analyses and systematic reviews of the literature examining factors associated with care entry, engagement and retention show that optimal lifelong engagement in HIV care can be threatened by a range of factors at the individual, social, and structural levels. Mobility affects many of the factors found to contribute to delayed entry or lapses in care, including psychological factors (e.g. seeking care away from home because of stigma), clinic characteristics (e.g. waiting times) and structural barriers such as distance to clinic and transportation costs. Yet the direct impact of mobility, and the pathways for this impact, have not been examined in depth.
Better measures and methods are needed to understand how mobility affects the ability of individuals to successfully navigate the HIV care cascade. This is especially urgent for sub-Saharan Africa, where levels of mobility are high and forms of mobility are complex and dynamic. The effects of mobility on initiatives designed to extend the reach of primary HIV prevention interventions in these settings are, to date, unknown— a glaring gap in the literature. The articles in this supplement of the Journal of the International AIDS Society focus on crucial questions regarding the forms and dimensions of mobility and the impact on HIV prevention and care initiatives—particularly in Southern and Eastern Africa, but also in the ‘receiving’ nations in the global north of sub-Saharan African migrants.
The complete supplement file is available at http://www.iasociety.org/Web/WebContent/File/JIAS_Vol21-S4_complete_file.pdf.