Nowhere is this more true than in South Africa. Thriving mining industries attract workers not just from rural areas of the nation, but from neighbouring economies where job opportunities are limited and wages are lower. It is hard to know how many people move into and around South Africa in search of work. More than a decade ago 2.5 million South Africans were registered as migrant workers, and that number is likely to have increased. This year, over half a million people will join the country’s growing urban population.
Carltonville, at the heart of South Africa’s gold mining industry, is home to 88 000 mine workers, 60% of them migrants from other parts of South Africa or from nearby countries: Lesotho, Malawi and Mozambique. With the miners come wages. Some US$ 18 million is paid out to workers every month in Carltonville. With the wages come all manner of goods and services, including, of course, drugs and sex. Some 400-500 sex workers service the Carltonville mines. And with drugs and sex comes HIV.
The city has become the HIV hot spot of Gauteng Province. Around 22% of adults in Carltonville are infected with HIV, a rate over two-thirds higher than the national average. A small survey of sex workers found HIV in three-quarters of them, while one mineworker in five is thought to be infected. That count is probably an underestimate because it does not include the men who have dropped out of the mines because they are too sick to work.
Why are infection levels so high in miners? Most men live lonely lives in single-sex dormitories, often hundreds of miles from their families. They also have a dangerous job. A gold-miner in South Africa has a one in forty chance of being killed by a rock-fall underground and a one in three chance of serious injury. Compared with that, the dangers associated with a long, slow infection like HIV might seem remote.
Of course, the HIV dangers are not just to the mineworkers themselves, or to their sex partners around the mining sites. Most migrant workers return home periodically. Increasingly, they are carrying infection back to their wives and their home communities. In Hlabisa, a rural district of KwaZulu/Natal, some 60% of households are estimated to have one or more male migrants. One study here found that sex outside the primary relationship is accepted as almost inevitable in separated families, for both men and women. In this community, HIV rates are rising dramatically, with the prevalence among pregnant women shooting up to 26% in 1997 from 4% just five years earlier. A study in 1995 found that of women whose partners were at home less than a third of the time, 13% were infected. No infections were recorded among women who spent more than two-thirds of the time with their husbands or regular partners.