ABSTRACT
Since the emergence of the AIDS pandemic across sub-Saharan Africa, associations have been made between HIV transmission and the ways in which migration and sex work are connected. Much of the early literature emerging from studies conducted in East Africa in the 1980s and 1990s focused attention on sex work and HIV (Kishindo 1995; Walden et al. 1999; Gysels et al. 2001). This early literature concentrated on male mobility as a key vehicle for transmission of HIV where employment-related migration was viewed as one of the main reasons for men engaging with the services of sex workers while away from home. This encompassed the short-to medium-term migration patterns of particular workers such as truck drivers, who would use sex workers while travelling along trading routes between major ports and cities, and soldiers and sailors who regularly engaged with sex workers while stationed away from home (OmaraOtunnu 1987; Wood 1988; Larson 1990; Cohen 1999; Gysels et al. 2001; Varga 2001). In addition, those engaged in longer-term migration, such as male migration throughout southern Africa to the South African gold and diamond mines have also been connected with sex workers (Campbell 2000). More recently, women’s migration has been highlighted as an important
factor although this was previously hidden within the literature. For example, Elder (2003) highlights how migrant women transgressed the spatial laws of South African apartheid that restricted their movement and moved into migrant worker hostel locations to provide sexual services to migrant men. Zuma et al. (2003) found that migrant women in South Africa were more likely than nonmigrant women to engage in risky sexual behaviour, including sex work or transactional sex, had lower condom use and had higher HIV prevalence rates. Female migration for employment has also been identified in the literature as part of the feminisation of the labour force within the global economy. For example, in Lesotho the garment industry is one of the major factors influencing rural to urban female migration and is causing an increasing influx of rural migrant women into urban and peri-urban areas in search of employment. Many of these women are single or living away from home resulting in an increase in the number of sexual partners they have and a rise in HIV prevalence rates (ALAFA 2008). Although this does not conclusively suggest that
poor pay and limited employment opportunities is resulting in migrant women entering into sex work to supplement their income, single migrant women have been found to be more likely to engage in sex with multiple partners and have higher HIV prevalence rates than the national average. This suggests that women who engage in sex work are more likely to be
migratory, often moving into towns from rural areas and resorting to sex work as an alternative to formal employment. However, Campbell (2000) identifies that the literature has generally portrayed sex workers as non-migratory, positioning them either as locally resident women or noting that they congregate in towns along trading routes or near to male employment. Despite this, sex workers are a mobile population which may influence HIV transmission in very direct ways (van Blerk 2007). This chapter therefore considers the links between sex work and migration through exploring the particular movements of sex workers themselves as part of the mobile transmission of HIV. The chapter begins by outlining the research process, highlighting the methods used before considering in more detail the nature of sex work in Ethiopia. The focus is on the impact of migratory pathways into sex work for rural young people and the nature of their subsequent movements on HIV transmission. The chapter concludes by calling for sex worker migration patterns to be more closely linked to HIV transmission and for policy to re-consider the ways in which sex workers are educated regarding HIV and AIDS.
