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.

Keywords:

• burial societies
• economy
• health
• informal sector
• labour migration
• migrants
• sex work
• urban poverty

Notes

1 Wills, 2009, p. 53: “In particular it excludes those who hold secondary jobs in the informal economy but whose main jobs are in formal employment. It also fails to capture [the issue of] children under 15 performing informal work activities. Furthermore, it may undercount foreign immigrants or refugees who are engaged in informal work but fail to report their employment status for fear of reprisal by authorities. Future research on these three groups of workers would require adjustments to current labour force surveys, such as, for example, the inclusion of new modules on work activities among children and foreigners as well as new questions asking the employed about the nature of their secondary job activities.”

2 Department of Labour, 2000, p. 4: “For the purposes of this code, the term ‘workplace’ should be interpreted more broadly than the definition given in the Labour Relations Act, Act 66 of 1995, Section 213, to include the working environment of, amongst others, persons not necessarily in an employeremployee relationship, those working in the informal sector and the self-employed.”

3 Department of Health, 2007, p. 36: “3.3 Populations at higher risk (h) Mobile, casual and atypical forms of work Truck driving, military service and other uniformed services such as security service provision may require regular and sustained travel and may in turn increase the likelihood of multiple sexual partnerships. Such activities have been linked to increased risk of HIV infection. While little is known about prevalence in these sectors in South Africa, it is likely that risk of infection is higher, and these groups also overlap with the broader epidemic as a product of linked sexual networks.”

4 From an interview with the coordinator of the Sisonke Sex Worker Movement, Braamfontein (Johannesburg), South Africa, 25 May 2011.

5 “Stokvels represent a type of savings association where a group of people make monthly contributions to a common pool. The primary activity of the stokvel is saving; however, members can also obtain credit at reasonable interest rates. Stokvels are formed by a group of people in a community, usually along gender lines, to meet specific needs such as food and money” (DGRV SA, 2003).

6 Extract of an interview; from Thomson & Posel (2001).