Fisherfolk

Participation in fishing activities was associated with 1.76 times higher odds of having ever tested for HIV. The individual-level binary fishing activity variable was the only fisherfolk definition that remained robustly associated with lifetime HIV testing across all modelling approaches. Nearly three-quarters of previously undiagnosed HIV cases in this fishing community were women aged 25–52, contrasting with broader Sub-Saharan African patterns. Community-level fisherfolk definitions were generally uninformative for individual-level HIV outcomes, indicating that ecological community-level associations do not translate to individual risk. Fisherfolk face multiple structural and behavioural barriers to consistent HIV care engagement, including geographic mobility, remote locations, and risk behaviours.