Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. C10082)
Muyambo R, Wilson DJ, Dube N, Mhuriyengwe L Project Support Group, Bethal, South Africa
Regional mobility plays a major role in HIV transmission in Southern Africa. Through out southern and eastern Africa, border and highway towns, transit and trading centers, mines and plantations, have far higher HIV rates. This paper addresses why and how epidemiological data support a regional approach focusing on mobility and HIV transmission. Situational assessments were undertaken in 8 border sites in 8 Southern African countries including Botswana, South Africa, Lesotho, Swaziland, Namibia, Zimbabwe, Zambia and Mozambique. A number of methods were employed and the results methodolically triangulated. Three distinct regional clusters emerged namely Durban-Lusaka highway, Lesotho, Swaziland and Southern Mozambique and Botswana and Namibia where commercial and casual sex within mobile communities and resident communities is fostered. Results indicated that the optimal context for HIV transmission is one where men have money, are away from home and surrounded by low income, largely female communities. Such men often seek commercial sex and many women have little choice but to provide it. Borders often juxtapose rich and poor countries and communities, creating economic inequalities conducive to commercial sex, attracting poor rural communities, particularly women. The same borders often have disproportionately large populations of uniformed forces. Informal trade also exposes mobile women to sexual coercion from male border officials, soldiers, police, guards, drivers, tenants and traders. Paradoxically, borders are often lawless places, thronged by fugitives, drug dealers, smugglers and black marketeers, where sexual trade and exploitation flourishes. We recommend that HIV prevention programs are required for priority groups particularly sex workers, bridge populations especially truckers, clients of sex workers. This also include migrant workers, traders and resident communities particularly low income women and young girls in borders and other hot spots.
Keywords: AEGIS, Acquired Immunodeficiency Syndrome, Emigration and Immigration, Transients and Migrants, HIV Infections, Demography, Population, Africa, Southern, HIV Seropositivity, Socioeconomic Factors, Prostitution, Poverty, Africa, Eastern, Botswana, South Africa, Swaziland, Mozambique, Lesotho, Namibia, Zambia, Zimbabwe, Humans, Female, Male, prevention & control, economics
