HIV on the Move: Sex Differences in Patterns of Migration and HIV in South Africa.

Abstract

This dissertation advances knowledge of an under-investigated aspect of gender and health: what are women’s unique migration patterns, and how do they contribute to health risks such as HIV/AIDS in southern Africa? Empirical studies of women’s migration remain few in number. Research on migration and HIV/AIDS has largely focused on male migration, finding migration to be a risk factor for men and their non-migrant partners, yet often failing to measure the HIV risks of migration for women. Bodies of literature on migration in Africa have largely presumed a stable female-headed household to and from which male migrants circulate. The very manner in which migration is conventionally studied is shaped by the paradigm of male labor migration, and thus fails to capture the magnitude and complexity of women’s participation in migration in Africa today.

This dissertation pursues three sets of questions: 1) How extensive is women’s participation in migration in southern Africa? Has it increased? What are its characteristics? 2) What are the major causes of migration in southern Africa, and do they differ for men and women? 3) How has migration influenced patterns of HIV/AIDS infection? Does migration present a higher HIV infection risk to women than to men? If so, why? I pursue these questions with data collected from some 45,000 adults since 2000 by a research center based in KwaZulu-Natal, South Africa.

Findings are that the use of innovative measures erases any predominance of males in migration, and reveals distinct sex differences in migration patterns. All of those who are more mobile, not only the population’s ‘labor migrants’, are at higher risk of HIV infection relative to their more stable counterparts. Moreover, women’s involvement in migration exacerbates their already disproportionate infection risk relative to men. The influence of higher risk sexual behavior on HIV infection is modified both by sex and participation in migration, net of the effects of other covariates. Aspects of the migration experience render its ‘behavioral consequences’ more hazardous for women. This study points to an urgent need for HIV prevention efforts in the population, and highlights the particular vulnerability of female migrants to HIV/AIDS.