1. HIV risk and vulnerabilities of migrant farm workers in South Africa: G ood practice in addressing migrants’ rights to health International Organization for Migration (IOM)

2. HIV Prevention & Care Project: IOM’s HIV Prevention & Care Project: Targets seasonal farm workers on 38 commercial farms in South Africa

3. The Evidence: findings from the IBBS 28.5% HIV Positive Female workers have higher HIV prevalence

4. Young women (18-24 yrs) 3 times more likely to be HIV positive

5. Unmarried women and married men more at risk

6. Females living away from the workplace more at risk

7. Females travelling more than an hour to work more vulnerable than males

8. 38% of workers know their HIV Status

9. Circumcised males lower HIV prevalence but the difference is mainly due to circumcision during early childhood

10. Drivers of HIV infection in a large agri-estate setting Environmental Drivers Structural Drivers Individual Drivers - Seasonal labour - Poverty in rural areas - high % of women - high levels of gender inequality Gender (power) dynamics on farms, esp. transactional sex for jobs, accommodation, transport, exaggerated “masculinity” Separation from regular sexual partners Lack of access to health services due to unstable contract status/ no time/no money for transport Boredom - lack of recreation Low literacy / low skilled Fatalism: “I can be replaced anytime” Lack of targeted and appropriate (culture/language) HIV prevention information - High levels of multiple, concurrent sexual partners with low consistent condom use - Low levels of behaviour change (myths/ misconceptions)

11. IOM’s response: A comprehensive HIV prevention and care project in large agri-estates Farm worker HIV Prevention and Care Project Workplace policies Building life skills Peer education and referral to PHC Gender Social Change Communi- cation Recreational activities Access to health services incl. ARVs Sustainability – building institutional capacity of local partner

12. Impact.. Project started in 2005 78% of employees trust in the confidentiality of the IOM implementing partner. 25% of all employees surveyed in IBBS had been tested 6 months prior to survey suggesting the VCT programme is starting to reach more employees Grown from 18 farms to 38 – the model is being replicated throughout the district All 38 farms have HIV workplace policies Wellness Clinic in the farm community for all farm workers providing primary health care and ARVs Gender: Community Policing Forums are active, men becoming more vocal on GBV related issues Gender on farms - in 2003/4 IOM survey found 52% of female workers had exchanged sex for goods This mural was painted by farm workers and is on one of the farm compounds

13. Contact Details: Barbara Rijks Regional HIV Advisor International Organization for Migration Regional Office for Southern Africa Tel: +27 12 342 2789 Email: brijks@iom.intbrijks@iom.int www.iom.org.za