South African HIV/AIDS programming overlooks migration, urban livelihoods, and informal workplaces

Abstract

South Africa has the largest population of people living with HIV globally and is associated with high population mobility. The majority of migrants move in search of improved livelihood opportunities, and many who migrate (both internally and across borders) move into urban areas, often through peripheral informal settlements where HIV prevalence is shown to be double that of urban formal areas. While the relationship between migration and the spread of HIV is acknowledged as complex, the context of migration may place individuals at increased risk for acquiring HIV. Studies have demonstrated the long-wave impact of HIV and AIDS on livelihood activities and, more recently, on patterns of migration. Many migrants engage in livelihood strategies situated within the urban 'informal economy'; these informal workplaces are often overlooked in global and national legislation governing workplace responses to health and HIV and AIDS. This study draws on existing research and limited primary data to explore the implications of HIV/AIDS programming for diverse migrant groups labouring in informal workplaces in Johannesburg, South Africa. We describe three case studies: waste-pickers at a dumpsite in a peripheral urban informal settlement; barmen and cleaners working in inner-city hotels where sex is also sold; and, migrants engaged in informal livelihood activities who are also members of burial societies. Given the importance of varied informal livelihood activities for diverse migrant groups, particularly in urban areas of South Africa, we propose that the national HIV/AIDS response can and should engage with internal and cross-border migrants in informal workplaces - which is in line with the principle of universal access and will strengthen the national response. Especially, we point out the potential for burial societies to provide an entry point for HIV/AIDS programming that targets migrant groups involved in the informal economy of South African cities.

Obstacles to HIV prevention, treatment and care in selected public universities in South Africa

“…This was confirmed by many researchers (such as Mbatha 2009, Vearey et al 2011) who note that South Africa has the largest population of people living with HIV globally and that this can be associated with high population mobility. Higher education in South Africa has a significant role to play in the fight against the spread of HIV and AIDS.…”

“…AIDS is one of the most serious, deadly diseases in human history. Since AIDS was first identified in the early 1980s, an unprecedented number of people have been affected (Mann 1989, Mbatha 2009, UNAIDS 2010, Vearey et al 2011). The number of people living with HIV rose from around 8 million in 1990 to 34 million by the end of 2011 (UNAIDS 2012).…”

Enabling Factors for the Existence of Waste Pickers: A Systematic Review

“…The waste pickers have to scratch through the waste in the bins or on the landfill sites. The waste can be toxic or they can be hurt by sharp objects (Vearey et al, 2011). The waste pickers complained about aching backs, upper respiratory infections, bruises and scratches, and toxic waste effects, and indicated that protective clothing like masks, gloves and boots would improve their working conditions (Benson & Vanqa-Mgijima, 2010;Langenhoven & Dyssel, 2007;Mamphitha, 2011;McLean 2000aMcLean , 2000bOelofse & Strydom, 2010;Schenck & Blaauw, 2011a;Sobuce, 2012;).…”

Alcohol use and sexual risk behaviour among men and women in inner-city Johannesburg, South Africa

“…Data on this population are especially important as the majority are internal migrants (from other parts of South Africa), a key group in the South African HIV epidemic [36, 37]. …”