AIDS and the City: Exploring the Spatial Characteristics of HIV/AIDS Pandemic in Nairobi, Kenya

抄録

Globally, the HIV/AIDS prevalence rates have been higher in the urban areas. The cities, especially in fast urbanizing Sub-Saharan Africa, present conditions that influence the spatial characteristics of health including that of HIV/AIDS. Comprised of migrants from varying socio-cultural backgrounds, and having spatially diverse socio-economic characteristics, the cities are bound to have spatial patterns of the HIV/AIDS epidemic that are as heterogeneous as those at the global, continental, and country levels. This paper reports an endeavour to understand the spatial characteristics of the epidemic through a case study of people living with HIV/AIDS (PLWHA) in Nairobi, Kenya. The study, through a questionnaire survey on PLWHA, established that the AIDS pandemic within the city of Nairobi is spatially heterogeneous. Most of the PLWHA in the study resided in the densely populated administrative locations of the city. These locations are also characterised by high density of people living below the urban poverty line, unhygienic environment, and insecurity. However, the availability of affordable basic living necessities, and the presence of medical, financial and social support, among other reasons, makes these areas the only feasible residential option for most of the PLWHA. Besides these factors, family reunion (and separations due to HIV/AIDS), job-search, HIV/AIDS stigma and discrimination, among other factors, are influencing the spatial distribution of PLWHA through intra-city residential movement and in-migration to Nairobi. The research suggests that addressing economic as well as medical infrastructure would be very important if other mitigation efforts in the spread of HIV are to gain sustainable effects.