Pre-migratory, Migratory and Post-migratory Factors Associated with Risky Sexual Behaviour among Women Informal Cross-Border Traders at the COMESA Market, Lusaka, Zambia

Technical Summary: Pre-migratory, Migratory, and Post-migratory Factors Associated with Risky Sexual Behaviour among Women Informal Cross-Border Traders

Problem Statement
Women engaged in informal cross-border trade (ICBT) in Southern Africa face a convergence of economic pressure, frequent mobility, and exposure to unfamiliar social environments, which may heighten vulnerability to risky sexual behaviour and HIV. While existing literature addresses long-term migrants or sex workers, there is a significant empirical gap regarding the specific risk dynamics of women whose movement is driven by trade. This study addresses the lack of evidence on how pre-migratory, migratory, and post-migratory factors interact to shape sexual risk among women ICBT at the COMESA Market in Lusaka, Zambia. The research is grounded in migration and vulnerability theory, which posits that health risks are not inherent to migrants but are produced across the migration continuum through the interaction of individual characteristics and structural contexts.

Methodology
The study employed a cross-sectional survey design conducted in January 2019 at the COMESA Market in Lusaka, a major hub for regional informal trade.

• Population and Sampling: The target population consisted of women aged 18 and above who were members of the Cross-Border Traders Association (CBTA), actively trading, and owning or renting a shop/container. A three-stage multi-stage probability sampling technique was used, yielding a final sample of 499 women (99.8% response rate).
• Data Collection: Trained female research assistants administered structured questionnaires capturing socio-demographics, migration experiences (categorized into pre-, migratory, and post-migratory stages), and self-reported sexual behaviours.
• Outcome Variable: A composite risk index ("RISK_LEVEL") was constructed from 12 items assessing practices such as multiple partners, transactional sex, and inconsistent condom use. Scores ranged from 0 to 11. For analysis, respondents were dichotomized into "low-risk" (scores 0–5) and "high-risk" (scores 6–11).
• Statistical Analysis: Data were analyzed using STATA Version 13. Descriptive statistics summarized the sample. Chi-square tests examined bivariate associations between covariates and risk status. Multivariate binary logistic regression was used to identify independent predictors of high-risk behaviour, controlling for confounders, with results reported as adjusted odds ratios (aOR) and 95% confidence intervals (CI).

Key Results

• Prevalence: A majority of respondents (67.7%, n=338) were classified as engaging in high-risk sexual behaviour.
• Pre-migratory Factors: In multivariate analysis, the source of start-up capital was a significant predictor. Women who used personal savings were 73% less likely to be high-risk compared to those relying on nuclear family capital (aOR = 0.27, 95% CI: 0.10–0.73). Additionally, women with 5–9 years of trading experience had significantly lower odds of high-risk behaviour compared to those with less than 5 years of experience (aOR = 0.21, 95% CI: 0.29–0.96).
• Migratory Factors: The specific border crossing point used was a critical determinant. Women who frequently used the Katima Mulilo border had 15 times higher odds of high-risk behaviour compared to those using the Nakonde border (aOR = 14.59, 95% CI: 1.26–169.50). Other migratory variables, such as days spent away or frequency of trips, were not statistically significant in the adjusted model.
• Post-migratory Factors: Two factors were significant. Women who reported not feeling disconnected while away had over three times the odds of high-risk behaviour compared to those who felt disconnected (aOR = 3.39, 95% CI: 1.03–11.11). Furthermore, women sharing accommodation with one roommate had 4.4 times higher odds of high-risk behaviour compared to those with no roommate (aOR = 4.42, 95% CI: 1.10–17.84).

Significance and Claims
The study claims to demonstrate that risk among women ICBT is not static but is produced across the migration continuum by specific economic dependencies, transit routes, and destination living conditions.

• Theoretical Contribution: The findings support migration and vulnerability theory, illustrating how financial dependence limits bargaining power, specific border routes create unique vulnerability pathways, and shared living conditions may weaken social controls or reinforce peer norms that normalize risk.
• Protective Mechanisms: The results highlight financial autonomy (via personal savings) and migration maturity (5–9 years of experience) as protective factors that reduce reliance on transactional relationships and foster coping strategies.
• Intervention Implications: The authors argue that HIV prevention programmes must move beyond generic individual behaviour change to address structural drivers. They recommend prioritizing financial independence, targeting health and protection services at high-risk borders (specifically Katima Mulilo), and ensuring safe accommodation with peer-led prevention strategies.

Limitations
The authors acknowledge that the cross-sectional design precludes causal inferences regarding the temporal sequence of migration factors and sexual risk. Additionally, the reliance on self-reported data for sensitive sexual behaviours may introduce social desirability bias. The findings are specific to the COMESA Market in Lusaka and may not be fully generalizable to other border markets or countries within the COMESA region without further multi-site and longitudinal research.