Rural-urban mobility in southwestern Nigeria: implications for HIV/AIDS transmission from urban to rural communities

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Abstract
Although the reported incidence of HIV and cases of AIDS is low in Nigeria, the fact that HIV has gained a foothold in metropolitan areas like Lagos is of concern. This article considers how the existing patterns of mobility between a rural community and an urban centre, and high-risk behaviours once there, hold the potential for transmission of HIV/AIDS back to the rural area. A majority (81.7%) of 377 adults of reproductive age interviewed in the rural town of Igbo-Ora, located approximately 150 km from Lagos, had visited that metropolis within the previous 6 months, either on business, for social engagements or to collect support money from relatives. Half had sexual partners in Lagos, including those who left spouses in Igbo-Ora; 17.5% had more than one. Reported condom use was low (26.3%), but there was a positive trend according to educational level. A history of STDs was given by 27 and this group had a significantly higher average number of sexual partners (1.2) in Lagos than did others (0.8). Most (67.5%) were aware of AIDS, but a knowledge score based on nine causative and preventive items was quite low (0.6 average). Follow-up focus group discussions with selected respondents explained in detail the motivations and circumstances for the reported risk behaviours. Greed was expressed as the underlying theme for multiple and indiscriminant sexual relationships in Lagos: men were greedy to prove sexual prowess; women were greedy for economic favours. Crowded living conditions, social occasions and street hawking were mentioned as opportunities to engage in sexual liaisons. The main STD prevention measures espoused by the groups were ability to visibly detect a risky partner, and use of indigenous charms and medications. From the foregoing, the opportunity to acquire STDs and HIV in Lagos and bring these back to spouses and partners in Igbo-Ora clearly exists. The wide chasm of awareness, knowledge and safe sex practices needs to be closed.

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