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The studies have shown the problem amongst miners to be larger than expected, and questions are now being asked as to whether the mining industry should take action.
The current scenario at the mines
Millions of young men spend weeks away from home to earn an income in order to support their families. They are housed in single-sex hostels and given easy access to alcohol and sex workers, with minimal access to condoms. Many of these men become infected with HIV and return to their rural homes, eventually passing the virus on to their spouses.
However, Lurie found that the virus is not only transmitted from the returning migrant worker to his rural partner, but also vice versa.
The scenario is believed to have existed for over a century, and is also the result of the Apartheid system, during which government relied heavily on cheap black labour to serve the country’s economic sector. At the same time, companies were exempt from the responsibility of caring for their employees. If workers were ill, they were simply sent home to the ‘homelands’.
It was this scenario that formed the basis of Lurie’s research programme, which he conducted in Kwazulu-Natal, the province with the highest HIV prevalence in South Africa. Lurie's aim was to obtain a better perception of the role migrant workers play with regards to the spread of HIV and sexually transmitted infections (STIs), and find ways to control the scourge.
Research reveals shocking statistics
The Wellcome Trust Fund assisted Lurie in setting up a team of field workers, who spent long periods tracking and following participants. Free HIV testing and treatment for STIs was offered, and condoms were issued to participants.
The research showed that couples, where the man was a migrant worker, were twice as likely as non-migrant couples to have one or both partners infected.
In a third of the couples, where only one person was infected with HIV, the woman was infected with HIV and not her husband. In such a case, it is virtually impossible that the husband infected his wife.
The research conducted in the province has raised much concern and changed the understanding of migration as a risk factor, as both migrants and their partners are likely to become infected through infidelity. Furthermore, the survey proved that separating families for long periods has a direct impact on the HIV/Aids growth in South Africa.
More social support needed
Since then, Lurie has called for more efficient social support for migrant couples as a whole, and not just the one partner. Such activities include couple counselling, aggressive treatment of STIs, education awareness and more effective antiretroviral treatment for rural inhabitants.
On a larger scale, Lurie feels that the tradition of migrant labour needs to be addressed. He says mining companies should attempt to make more family-friendly housing available. Currently, only approximately 2% of miners have such perks.
Having such housing available to migrant workers gives them the opportunity to remain close to their families, and thus reduces the risk of HIV infection for both partners.
(Matthew Louw, Health24, September 2005)
Source: MRC News, July 2005
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