This presentation aims to draw lessons for a better understanding of the gendered nature of migration and health and to explore some of the gaps and challenges in HIV/AIDS related research.
Say something about the restriction for black migrants during apartheid to migrate.
South Africa has the biggest population living with HIV globally. It has an adult prevalence estimated in almost 20%. It is in an increasingly urban problem. A number of different reasons have been advanced to explain the general picture of HIV/AIDS : poverty, economic marginalisation, patters of sexual contacts. Migration patterns in South Africa have been seen as one of the key aspects to understanding the high rates of infection in the region. Male migrants and particularly mineworkers and truck drivers, have been the focus of research on the relationship between HIV and migration At times their partners usually called women at risk have been included in the research Yet little attention has been paid to the vulnerabilities of female migrants themselves to HIV infection and the challenges women migrant face in a preventive behaviour.
Gender and Health. Migrants linkages with home: women do not cut off links with the households in their places of origins.... transnational and trans-border
This is the informal settelement with various types of housing the lack of services water, electricity, represents an additional burden for women to perform reproductive task..
The strcuture of the household: The second person in male headed households is mostly a wife or a partner, whereas in the case of women the second person is a son or a daughter. Thus often in a female headed household there is not a second adult to rely on not only for the reproductive work but also in case of sickness
This show migration patterns in terms of migratory networks are structurated by gender. Women migrate to reunite with their partens. They show to have a closer and more diversified network where other women play a supportive role
Almost half of the women interviewed send remittances home in money, food and goods. Women and men send in the first place to their parents but women send more often than men also to their siblings and other relatives. We asked what would they do if they were sick with HIV AIDS and 62.1% migrants would go back home, as opposed to 35 % who declare they would stay. Of those who declare they would stay, they mostly are women, partners or head of households themselves, This shows the responsability of women as a providers and caretakers of others. We asked wether and how would they support their families back home in case of they were sick with HIV Aids, they would help by sending money, in 50% of the cases. Women declare they would bring the sick person from home to the city
We also asked if they know anybody sick with HIV Aids, 20% declared to know somebody and from that percentage 24.5 were members of the household. Only women reporterd thta their own child and a neighbour as being affected by HIV AID.
So while women have tested more often than men, this finding does not reflect women`s perception of risk but rather a routine procedure during pregnancy
2. Differences among gender are more pronounced and significant than being internal or international migrants. This highlights the need to integrate a gender perspective into the studies of migration and health. For example: female headed households in both South African and foreigner migrants are bigger households and larger number of children. Gender dimension explains the dynamics of the migration networks, perception of risk, types of remittances. While women are taking more roles and responsibilities, it seem to be a gap in terms of prevention for HiV Aids
2) There are questions arise around perception of risk and prevention that needs to be addressed
How does a gender lens contribute to a healthy environment and healthy people? Intersections between gender, HIV and migration: Lessons from South Africa
How does a gender lens contribute to a healthy environment and healthy people? <ul><li>Intersections between gender, HIV and migration: Lessons from South Africa </li></ul><ul><li>IDRC-RENEWAL study Migration, HIV/Aids and Food Security among internal and international migrants in Johannesburg </li></ul><ul><li>Lorena Nunez </li></ul>Forced Migration Studies Programme University of the Witwatersrand, Johannesburg
Migration trends in South Africa <ul><li>South Africa is historically a country of migration, mostly male mining workers, from rural South Africa and from neighbouring countries. </li></ul><ul><li>From 1994, democracy enabled access to the cities that were previously restricted. A different migratory pattern began to develop, and internal and international migration to South Africa becomes a noticeable trend. </li></ul><ul><li>Increasingly, women from rural areas and from other African countries are migrating. They migrate as workers in their own right or as partners of male migrants, and increasingly as refugees and asylum seekers. </li></ul>
<ul><li>In light of the increasing number of female migrants and female headed households, there is a need to pay attention to the multiple roles of migrant women and their specific vulnerabilities, for example the burden of sickness on their households. </li></ul><ul><ul><li>Economic role </li></ul></ul><ul><ul><li>Reproductive role </li></ul></ul><ul><ul><li>Caring role in the event of sickness </li></ul></ul><ul><ul><li>Women migrants in all these roles are pivotal for the </li></ul></ul><ul><ul><li>subsistence of their transnational and trans-border </li></ul></ul><ul><ul><li>Households. </li></ul></ul>Feminization of migration
Migration, food security, and HIV/ AIDS: results from a household survey in Johannesburg Selected Areas Informal settlement Sol- Plaatjies 200 households Formal Sector Berea, Hillbrow and Jeppestown 300 households
South African Migrants 0 10 20 30 40 50 60 70 80 90 1 2 Non-South Africa Migrants Men Women Men Women <ul><li>Total of 489 households = 489 respondents </li></ul><ul><li>26% of the households were female headed (N=122) </li></ul><ul><li>74% of the households were male headed (N=342) </li></ul><ul><li>Information obtained on 1,533 individuals in total (all household members ). </li></ul>Population Study 0 10 20 30 40 50 60 70 80 1 2
0 20 40 60 80 100 120 Frequency 1 2 3 4 5 6 7 Household size male headed households 0 5 10 15 20 25 30 1 2 3 4 5 6 7 Household size female headed households . Household size and gender of the head of the household Overall, a household of 2 or 3 people is the most common size. Female headed households are bigger than male headed households. Generally, female headed households consist of 3 or more people. Frequency
Men’s Migration Networks: Who did you know in Johannesburg prior to migrating? South African migrant men Foreign migrant men Men, both nationals and foreigners tend to migrate alone. In most cases, men have ‘other relatives’ in Johannesburg as well as a brother. The do not follow their wives or partners Relative frequency 0 5 10 15 20 25 30 35 Brother Other relative 0 5 10 15 20 25 30 35 40 Relative frequency Brother Other relative
South African migrant women Foreign migrant women Women’s Migration Networks 0 5 10 15 20 25 0 5 10 15 20 25 <ul><li>Women tend to have a wider networks than men; </li></ul><ul><li>Women migrate to join their partners and other female close members of their families (sisters, mothers). </li></ul>Partner Sister Mother Other relative Partner Sister Mother Other relative
To who do your send remittances? 0 10 20 30 40 50 60 70 Relative frequency 0 10 20 30 40 50 60 . In the first place for both: remittances sent by men and women are sent to parents. Women are more likely than men to send remittances to siblings and close relatives. Parents Siblings MEN WOMEN Parents Siblings Relative frequency
MEN 0 20 40 60 80 100 120 140 160 YES NO <ul><li>51% of the total surveyed population has tested for HIV. </li></ul><ul><li>More South Africans than foreigners have tested. </li></ul><ul><li>Overall more women than men have tested for HIV and among women, more South African women have tested for HIV. </li></ul><ul><li>T he main reason for testing among women is due to pregnancy. </li></ul>Testing for HIV among men and women 0 20 40 60 80 100 120 140 160 180 200 YES WOMEN . NO
<ul><li>Gender and Perception of Risk of HIV </li></ul><ul><li>A multivariable analysis (categorical PCA considering gender, nationality, age, respondent position in the household and place of residence) based on an ecosystemic perspective, has shown that the main variable associated to perception of risk of HIV is gender. </li></ul><ul><li>Wives and female partners of the head of the household tend to feel the most at risk of HIV. </li></ul><ul><li>South African males are the least likely to feel at risk . </li></ul><ul><li>There is no significant association between perception of risk and testing . </li></ul>
Gender gaps and research challenges <ul><li>Some findings </li></ul><ul><li>There is an observed trend towards the feminization of migration. In this study female headed households made up 26% of the total households surveyed. </li></ul><ul><li>The study’s results show that gender has more explanatory power than types of migration. </li></ul><ul><li>More women than men tested for HIV and women perceive themselves more at risk than men. However perception of risk and having tested are not significantly related. </li></ul>
Gender gaps and research challenges <ul><li>Research challenges </li></ul><ul><li>A gender perspective is central in the study of migration and health and is not always central in studies, policies and interventions. </li></ul><ul><li>Data disaggregated by sex shows general and important trends but it does not provide insights on the power relationships that characterise migration and intra-household relationships. </li></ul><ul><li>Questions about the multiplicity of women’s roles, the economic and reproductive burden, and the burden of sickness in the face of HIV/Aids pandemic need to be addressed. This requires a transdisciplinary perspective to implement more effective interventions. </li></ul>
Acknowledgements <ul><li>Sol Plaatjies participatory photo project participants and the Market Photo Workshop. </li></ul>