POPULATION MIGRATION AND THE SPREAD OF TYPE-1 AND TYPE-2 HUMAN IMMUNODEFICIENCY VIRUSES

Over 14 million people are estimated to be infected with the human imm unodeficiency viruses (HIV), with nearly three-fourths of the infected persons residing in developing countries. One factor responsible for dissemination of both HIV-1 and HIV-2 worldwide was the intense migrat ion of individuals, from rural to urban centers with subsequent return migration and internationally due to civil wars, tourism, business pu rposes, and the drug trade. In sub-Saharan Africa, between 1960 and 19 80, urban centers with more than 500,000 inhabitants increased from 3 to 28, and more than 75 military coups occurred in 30 countries. The r esult was a massive migration of rural inhabitants to urban centers co ncomitant with the spread of HIV-1 to large population centers. With t he associated demographic, economic, and social changes, an epidemic o f sexually transmitted diseases and HIV-1 was ignited. Migratory patte rns were also responsible for the spread of endemic HIV-2 to neighbori ng West African countries and eventually to Europe, the Americas, and India. Although Southeast Asia was the last region in which HIV-1 was introduced, it has the greatest potential for rapid spread due to popu lation density and inherent risk behaviors. Thus, the migration of poo r, rural, and young sexually active individuals to urban centers coupl ed with large international movements of HIV-infected individuals play ed a prominent role in the dissemination of HIV globally. The economic recession has aggravated the transmission of HIV by directly increasi ng the population at risk through increased urban migration, disruptio n of rural families and cultural values, poverty, and prostitution and indirectly through a decrease in health care provision. Consequently, social and economic reform as well as sexual behavior education need to be intensified if HIV transmission is to be controlled.