Predictors of Migration in an HIV Hyper-Endemic Rural South African Community: Evidence From a Population-Based Cohort (2005-2017)

Globally, South Africa ranks worst for people living with HIV (PLHIV) and the unique legacy of internal labour migration continues to be a major driver of the regional epidemic, interrupting treatment-as-prevention efforts. The study examined levels, trends, and predictors of migration in rural KwaZulu-Natal Province, South Africa, using population-based surveillance data from 2005 through 2017. We followed 69 604 adult participants aged 15-49 years and recorded their migration events (i.e., out-migration from the surveillance area) in 423 038 person-years over 525 397 observations. Multiple failure Cox-regression models were used to measure the risk of migration by socio-demographic factors: age, sex, educational status, marital status, HIV, and community antiretroviral therapy (ART) coverage. Overall, 69% of the population cohort experienced at least one migration event during the follow-up period. The average incidence rate of migration was 9.96 events and 13.23 events per 100 person-years in women and men, respectively. Migration rates declined from 2005 to 2008 then peaked in 2012 for both women and men. Adjusting for other covariates, the risk of migration was 3.4-times higher among young women aged 20-24 years compared to those aged ≥40 years (adjusted Hazard Ratio [aHR]=3.37, 95% Confidence Interval [CI]: 3:19-3.57), and 2.9-times higher among young men aged 20-24 years compared to those aged ≥40 years (aHR=2.86, 95% CI:2.69-3.04). There was a 9% and 27% decrease in risk of migration among both women (aHR=0.91, 95% CI: 0.83 – 0.99) and men (aHR=0.73, 95% CI 0.66 – 0.82) respectively per every 1% increase in community ART coverage. Young unmarried women including those living with HIV, migrated at a magnitude similar to that of their male counterparts, and lowered as ART coverage increased over time, reflecting the role of improved HIV services across space in reducing out-migration. A deeper understanding of the characteristics of a migrating population provides critical information towards identifying and addressing gaps in the HIV prevention and care continuum in an era of high mobility.

Chains of art offer connection and care

Art Therapist Tova Speter shares a sample from Translations: connected art reflecting empathy (c.a.r.e.), a creative example of how engagement in a collaborative art experience can help people feel connected despite being physically isolated. This community art experience was launched in response to the isolating effects of the COVID-19 global pandemic. Over 100 artists participated in nineteen chains of six linked artistic expressions translating the words of the community through art. The six links in each chain offered a creative way to connect, which offset the 6 feet of physical distance we were advised to keep from each other in order to care for each other. This project highlights how art can hold and communicate intention and feeling across modalities as it offers connection and inspiration to a wide audience.

Using Design of Location-Based Augmented Reality Experiences to Engage Art-Oriented Girls in Technology and Science

Taking part in creating location-based augmented reality (LBAR) experiences that focus on communication, art and design could serve as an entry point for art-oriented girls and young women towards career pathways in computer science and information communication technology. This conceptual paper presents our theory-based approach and subsequent application, as well as lessons learned informed by team discussions and reflections. We built an LBAR program entitled AR Girls on four foundational principles: stealth science (embedding science in familiar appealing experiences), place-based education (situating learning in one’s own community), non-hierarchical design (collaborations where both adults and youth generate content), and learning through design (engaging in design, not just play). To translate these principles into practice, we centered the program around the theme of art by forming partnerships with small community art organizations and positioning LBAR as an art-based communication medium. We found that LBAR lends itself to an interdisciplinary approach that blends technology, art, science and communication. We believe our approach helped girls make connections to their existing interests and build soft skills such as leadership and interpersonal communication as they designed local environmentally-focused LBAR walking tours. Our “use-modify-create” approach provided first-hand experiences with the AR software early on, and thus supported the girls and their art educators in designing and showcasing their walking tours. Unfortunately, the four foundational principles introduced considerable complexity to AR Girls, which impacted recruitment and retention, and at times overwhelmed the art educators who co-led the program. To position AR Girls for long-term success, we simplified the program approach and implementation, including switching to a more user-friendly AR software; reducing logistical challenges of location-based design and play; narrowing the topic addressed by the girls design; and making the involvement of community partners optional. Overall, our initial work was instrumental in understanding how to translate theoretical considerations for learning in out-of-school settings into an LBAR program aimed at achieving multiple complementary outcomes for participating girls. Ultimately, we achieved better scalability by simplifying AR Girls both conceptually and practically. The lessons learned from AR Girls can inform others using LBAR for education and youth development programming.