By far the worst affected region, sub-Saharan Africa is now home to 29.4 million people living with HIV/AIDS, 70% of the total 42.9 million people living with HIV/AIDS globally. Approximately 3.5 million new infections occurred there in 2002, while the epidemic claimed the lives of an estimated 2.4 million Africans in the past year. Ten million young people (aged 15-24) and almost 3 million children under 15 are living with HIV. Countries like Lesotho, Botswana, South Africa, Swaziland and Zimbabwe have the highest HIV prevalence rates in the world. What the exact impact of the HIV/AIDS epidemic will be is still unknown, but the epidemic is likely to have an impact on nearly every aspect of life in southern Africa. The region will be faced by great personal emotional suffering, a major decline in life expectancy, a great loss of both skilled and unskilled labour, rising costs of health care, social and economic disruption at the family and community level and a reduction of human and financial resources available for civil society organisations and the government. Some even consider HIV/AIDS a threat to social and political stability.
The epidemiology of HIV/AIDS is closely linked to the process of migration. Migrants - and mobile populations in general - have played a significant role in the initial spread of HIV in the southern African region. The largely seasonal or temporary character of migration in southern Africa, with migrants returning home to their families on a regular basis, has facilitated the rapid spread of the virus. However, the fact that population movement distributes HIV has becomes less relevant in the current stage of the AIDS epidemic in southern Africa (with extremely high HIV prevalence levels in the population in general). Migrants are no longer agents that help to spread HIV, but have become individuals at high risk. Several studies have shown that migrants are more vulnerable to HIV infection than their non-migrant counterparts.
Because a vaccine or cure for HIV/AIDS is not expected to be available in the near future, efforts to reduce the spread and the impact of HIV/AIDS should be geared towards changing high-risk sexual behaviour, especially in environments facilitating high-risk sexual behaviour. This can only be done successfully if these efforts are supported by a contextual analysis of sexual behaviour. Insight in the environments (context) that are conducive to high-risk sexual behaviour is extremely important.
This paper investigates the interrelatedness of labour migration and the HIV/AIDS epidemic from the point of view of the migrant (the individual). In this paper I have tried to find an answer to the question why migrants are vulnerable to HIV/AIDS (or how mobility and migration increase vulnerability to HIV/AIDS). The paper is the result of a research project conducted during my internship at the regional office of the International Organization for Migration (IOM) in Pretoria, South Africa from 1 April until 1 September 2002. This project involved an extensive literature review and fieldwork in the form of interviews with migrant mineworkers from Lesotho. Both are discussed here in what must be seen as only a short and preliminary summary of my
A comprehensive discussion of a matter of this complexity would exceed the scope of this paper, but within these limitations I have tried to deal with the matter as inclusive as possible.
The first section of this paper deals with the background and framework in which my research took place. It discusses both HIV/AIDS and the role that labour migration has played in the spread of HIV/AIDS in southern
Additionally it gives an overview of existing theories, ideas and research that have tried to link HIV/AIDS and labour migration with a focus on migrants as individuals at risk. The second section gives a more thorough vulnerability analysis of a specific group of migrant labourers: Basotho mineworkers. It is in this section that findings from my interviews with mineworkers are introduced and discussed. The paper concludes with a number of suggestions that might help to reduce migrant labourers' vulnerability.
Intern with IOM's Regional Office for Southern Africa, May - November 2002
See my MA thesis for a more extensive presentation of the findings.
Southern Africa is defined in various ways. For the purpose of this report, southern Africa comprises Angola, Botswana, DRC, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Tanzania, Zambia, and Zimbabwe.