Professional Hazard: Migrant Miners Are More Likely to Be Infected with HIV

Swaziland and Lesotho are among the countries with the highest HIV prevalence in the world.
Recent nationally representative estimates reveal an adult HIV prevalence equal to 26% in Swaziland¹ and 23.2% in Lesotho².

These countries have two other main features in common: they are small countries bordering South Africa and, during the past decades, they were exposed to massive recruitment efforts to work in South African mines. For more than a century, about 60 percent of those employed in the mining sector in the Republic of South Africa were migrant workers from Lesotho and Swaziland³.

In a recent paper⁴ with Lucia Corno, we started from this set of facts and investigated whether the massive percentage of migrant workers employed in the South Africa’s mining industry for a long period might be one of the main explanations for the high HIV prevalence observed in Swaziland and Lesotho.

Three main channels could link mining activities with the risk of HIV infection. First, working in South African mines implies long-term separations from the household of origin and this increases the probability of engaging in multiple concurrent sexual partners. Second, miners have traditionally been accommodated in single-sex hostels and this has boosted an active sex industry in the area surrounding the mining sites. Finally, women, who wait for their husbands to come back from the mines, might be more likely to engage in sexual relationships with other partners as well.

In our analysis, we used data from the Demographic and Health Survey (DHS) conducted in Swaziland (2006-2007) and Lesotho (2004). We find that miners and women with a miner as a partner are the groups most vulnerable to HIV/AIDS in Lesotho and Swaziland. Being a miner aged 30-44 years old increases the likelihood of being HIV positive by 15 percentage points. Another interesting and previously unexplored result shows that having a partner employed in the mines increases the probability of infection for women by 8 percentage points.

Are these effects driven by the mining activities themselves or by the migration pattern towards South Africa’s mines? Using the Zimbabwe DHS (2005-2006) as a comparison country, where the mining industry is well-developed and miners do not need to migrate to another country, we find no statistically significant association between mining activities and HIV prevalence in Zimbabwe, suggesting that the migration to the mines plays an important role in HIV transmission.

In addition to HIV infection, we also looked at reported sexual behaviors.  Being a migrant miner or having a miner as a partner is strongly correlated with risky sexual behaviors. Miners and women with a partner employed in the mining sector are less likely to abstain from sex in the last year, compared to individuals with other types of jobs. We also find that women with a miner as a partner are more likely to engage in extra-marital sex during their husbands’ absence. Additionally, miners are less likely to use condoms, especially during extra-marital relationships, and having a miner as partner decreases the probability of using a condom for women within the marriage. This low level of protection during sexual intercourse probably increases the risk of HIV transmission.

Even though the mining industry represents a large fraction of the economy in many African countries, little is known about the association between mining activities and HIV prevalence. Our paper is among the first to explicitly test this relationship. We also highlight a group at high risk for HIV infection that is often overlooked, namely the wives and partners of the migrant miners.

Our findings directly suggest important implications for policies. Prevention efforts need to be reinforced within and around the mining sites. Wives and partners of men working in the mining sector would also benefit from being the focus of HIV prevention interventions.

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1. Swaziland Government and ORC Macro, (2008) “Swaziland Demographic and Health Survey 2006-2007”, Central Statistical Office Mbabane, Swaziland
2. Lesotho Government and ORC Macro, (2005) “Lesotho Demographic and Health Survey 2004”, Bureau of Statistics and Ministry of Health and Social Welfare. Maseru, Lesotho.
3. Lucas, R., (1985) “Mines and Migrants in South Africa”, American Economic Review 75(5): 1094-1108.
4. Harington J. S., McGlashan N. D., Chelkowska E. Z., (2004) “A century of migrant labour in the gold mines of South Africa”, The Journal of South African Institute of Mining and Metallurgy.
5. Corno, Lucia and Damien de Walque. 2012. Mines, Migration and HIV/AIDS in southern Africa. World Bank Policy Research Working Paper #5966, The World Bank, Washington, DC.