Mobile people are those "who move from one place to another temporarily, seasonally or permanently for a host of voluntary or involuntarily reasons" (UNAIDS Technical Update, February 2001). They include truck drivers, seafarers, transport workers, agricultural workers, business people, traders, employees of large industries, government officials, uniformed service officers, construction workers, and sex workers.
Migrants are mobile people who take up residence or who remain in a place away from home for an extended period. Internal migrants are those people who move from home to other locations within their own countries. This includes rural-rural, rural-urban, urban-rural movement and resettlement of people. External migrants refer to people who cross international borders and take up residence in a foreign country. In the GMS region, women make up a growing proportion of migrants, many of whom travel to foreign countries to seek employment in domestic services.
People affected by mobility are those vulnerable to HIV and its impacts through interaction with others who are mobile, even if they are not mobile themselves. They include people who live at the places from where mobile people come, and people living at places where mobile people go. They include spouses, children and elderly people.
Mobility systems are the evolving physical, economic, social, political and cultural contexts in which people are affected by mobility. They are the net effect of the changing environment, development strategies, governance systems, policies and decisions, and cultural stability or transition. All these factors influence people's ability to make choices and participate in, or benefit from, economic and social development.
In essence, migration and mobility are various stages of a process and emphasis should be given to the "continuum" of events and the mobility system. Within the mobility system, the following types of places can be discerned:
Source - where people come from, why they leave, what relationships they maintain at home or while they are away, the role vacated by them after they leave.
Transit - the places people pass through, how they travel and how they behave and interact with others while traveling.
Destination - where people go, the responses of the host community, their living and working conditions in the new place.
Return - the communities to which people return which may or may not be their place of origin, their families or social network, their access to resources.
This strategy recognises, through the mobility system, the importance of supporting people who are affected by mobility and HIV, including communities in transition.
Transition - communities undergo transition from relative isolation to being connected as a result of rapidly changing mobility systems (e.g. introduction of new roads into their localities).
Since population movement is fluid, effective HIV/AIDS responses must address the particular needs and vulnerabilities of mobile people at each stage of the mobility process.
Reasons for movement are as varied as the people who move. For example, economic motives, occupational pursuits, exploration, exploitation and displacement as a result of conflict, disaster or national policies, all contribute to population movements. There are a complex combination of factors leading men and women to leave their homes and travel to new destinations.
People may travel alone or with others such as family or recruiters. They may leave their source communities on a temporary, recurring (e.g. seasonal) or permanent basis. International movement may be legal, whereby they are formally recognised by the host government, or undocumented, in which they do not have the official documents that accord them the right to stay in the host countries. Travel may be involuntary, as a result of coercion, trafficking, conflict, or poverty; or it may be due to voluntary, usually job-related, impulses.
While mobility in and of itself is not a risk factor for HIV/AIDS, some mobile persons are especially vulnerable to the illness as a result of social disruption, the environment and their specific working and living conditions. Undocumented migrants, for example, may lack the power, resources and access to information and services to protect themselves and their partners from STIs including HIV. They may be forced into unsafe working and living conditions and be exploited for meager wages.
Female mobile populations, who make up an increasing proportion of mobile population groups in the GMS, may be subject to discrimination as a result of their gender and mobility status. They may have little access to reproductive health services, and may lack the bargaining power to prevent unwanted and unsafe sex during travel and at destination. Some may also be subject to sexual violence or exploitation.
Some highly mobile occupational groups, such as long distance truck drivers, seafarers, uniformed services personnel, and deminers, engage in work that requires them to be away from traditional social and familial supports, often for extended periods of time. In these contexts, they may be encouraged to seek out and engage in activities, such as illicit drug use and commercial sex, which increase their vulnerability to STIs and HIV/AIDS.
Some environments fuel the spread of HIV/AIDS and/or create conditions that contribute to HIV vulnerability among mobile and host populations. In particular:
Hot spots, such as cross-border areas and occupational sites, emerge from the convergence of mobile populations, the rise of entertainment and sex establishments, and the tendency for HIV risk behaviours. Hot spots are destinations for some mobile populations and transit points for others. These areas generally have high HIV prevalence rates, or the potential for rapid HIV transmission and spread.
Risk zones are places through which large numbers of people pass. They include truck stops, train and bus stations, marketplaces, ports, and customs zones. Risk zones are classified and prioritized by the kinds of risk behaviours that take place in the environment. Focusing on risk zones allows HIV/AIDS programs or projects to cover everyone potentially at risk in the area, rather than specific target groups.
Major infrastructure construction project sites. The development of roads, dams, and other large infrastructure projects can have major impacts on surrounding communities. HIV/AIDS prevalence rates may rise dramatically in such areas as a consequence of increased trade, transport, and mobility of populations.
Source communities. Mobile people often come from poor areas of the GMS. They may have little knowledge of HIV/AIDS, nor the life skills necessary to protect themselves from the virus. Mobile people may return to their home villages, towns, or cities when suffering from illnesses including HIV/AIDS. The burden of caring for such individuals may be beyond a community's existing capabilities and resources.