(October 2003) While Senegal has managed to avoid the HIV/AIDS epidemic ravaging many of its African neighbors, migration could pose a large threat to the population’s apparent lower risk of infection. Men from northern Senegal have long migrated to larger urban centers within the country.1 More recently, they have been seeking work abroad, particularly France, Côte d’Ivoire, and nations in Central Africa.2
Migrants who travel to other African countries face a greater risk of HIV infection than less mobile populations in Senegal. One study conducted more than 10 years ago by Fadel Kane and colleagues in 11 villages around Matam, a city in northern Senegal, found that 27 percent of returned male international labor migrants were infected with HIV/AIDS, compared with less than 1 percent of nonmigrant males.3 In 1960, a quarter of the male population from northern Senegal migrated for work.4 Migration is still common today, and the destinations are more diverse.5
Migration From Northern Senegal
Northern Senegal is mainly populated by three ethnic groups: the Soninke in the upper valley of Senegal River, the Halpularen in the middle valley, and the Wolof in the delta. The Soninke and the Halpularen are highly mobile populations, but each group has specific migration patterns. The Soninke migrate almost exclusively to France to work in factories, on docks, and in domestic trash collection, while the Halpularen travel to cities in Senegal and to Central and western African countries as traders.6
Increased international migration has had a substantial economic impact. In 2000, the UN’s Department of Economic and Social Affairs estimated that Senegalese migrant workers sent home nearly US$130 million — 2.7 percent of Senegal’s gross domestic product.
Around 1975, migration changed dramatically in northern Senegal, mainly as a response to the region’s severe desertification and drought in the early 1970s.7 Before then, migration consisted mainly of movement from rural villages to big, urban centers such as Dakar and Thies. Since the 1970s, increasing numbers of Halpularen men have been traveling to Côte d’Ivoire, Gabon, Cameroon, the Democratic Republic of Congo (formerly Zaire), and the Republic of Congo for jobs.8 Since many of these countries have higher HIV/AIDS rates, this movement puts Halpularen communities at risk of infection.
Senegal’s HIV Rates Increase as Migration Increases
HIV/AIDS rates remain low in Senegal’s general population, compared with sub-Saharan Africa as a whole. According to UNAIDS, less than 2 percent of the adult Senegalese population was infected with HIV/AIDS in 1999, compared with nearly 9 percent for sub-Saharan Africa.9 Throughout the epidemic, Senegal has maintained steady, low rates of infection while neighboring countries have faced rates as much as six times as high among their adult population, with signs that the epidemic is worsening.10
Senegal’s success at preventing HIV/AIDS, though not fully understood, has been attributed to early and comprehensive governmental interventions, including a strong program to control the spread of sexually transmitted infections (STIs). In addition, Senegal’s social organization and cultural and religious values exert constraints over sexuality.11
As more Senegal residents migrate to endemic countries, however, the link between HIV/AIDS and migration increases. Often associated with poverty and powerlessness, many of these migrants may lack permission to remain in the host country.12 Undocumented workers represent one of the most vulnerable groups with respect to HIV infection. Because they fear deportation, these migrants avoid contact with official government agencies and therefore have little access to health and welfare information and services.13
A recent study conducted in Matam and the northern city of Richard-Toll concluded that mobility contributes to the spread of the disease. The study revealed that risky sexual behavior is common during migration, followed by unprotected sex when migrants returned home.14 In the area around Matam, 40 percent of men who migrated to African countries with high HIV prevalence reported having risky sexual behavior, such as sexual contact with commercial sex workers or casual partners, while away from home.
Migrants Bring HIV Home
Once back home, many migrants continue their risky behavior. One-fourth of males surveyed in the Matam area claimed they continued to be involved in sexually risky behaviors.15 Given that returned migrants do not use condoms consistently at home or during short trips within Senegal, they become bridges by which HIV/AIDS can cross easily from the endemic countries to less affected ones.
Women confirm that returned migrants often contribute to the spread of the virus. In 2001, a set of focus groups and personal interviews were conducted with women in Matam.16 A 22-year-old woman described HIV/AIDS transmission in Matam: “The men who migrate … have sex with women in other countries, then when they arrive home, the husbands will have sex with their wives and the wife will get it … when she dies, he will marry again and contaminate again.” In fact, Kane and his colleagues discovered that 20 of 22 women with HIV in one of their samples were infected by their migrant husbands.
Migrant male workers are not entirely to blame, however, for the higher frequency of HIV/AIDS among their wives. Women often use sex as a survival strategy while their husbands are away. Researcher Christophe Saez found that several women who live near Richard-Toll and who go to the city to sell milk also secretly sell sex. Without the economic support of a migrant husband, women are often forced to sell sex to support their families.17
Local HIV Programs Are Few and Far Between
Few local programs help migrants prevent HIV infection. Piindi Kaabal, an association of returned migrants in Matam, has been involved in an HIV/AIDS awareness-raising campaign for several years. Though successful, such activities are limited and local community networks against HIV are not well developed. Only a few programs care for infected individuals and their families and conduct sensitization campaigns. Moreover, apart from Saint-Louis, the government seat for northern Senegal,18 there is no HIV testing or behavioral surveillance system to accurately monitor the epidemic and individual behaviors in the region.
The relationship between mobility and HIV is recognized and addressed elsewhere in the country. One project, RailLink, is aimed at preventing the spread of HIV along the railways that connect Senegal, Burkina Faso, Mali, and Côte d’Ivoire. The project targets about 2 million people. UNAIDS is also carrying out a project aimed at reducing the vulnerability of mobile people in west Africa.
Macoumba Thiam is a Ph.D. candidate in the department of demography at the University of Montreal in Canada and a member of a research team that studies the relationship between migration and the spread of STIs and AIDS in northern Senegal. Rebecca Perry is a former PRB International Programs Fellow and Fulbright researcher in Matam, Senegal, studying HIV/AIDS. Victor Piché is a professor at the University of Montreal and the Centre Interuniversitaire d’Études Démographiques (CIED) in Canada and coordinator of the Mobility and STI/AIDS in Senegal research project.
- J.-L. Boutillier et al., La Moyenne Vallée du Sénégal: Étude Socio-économique [The Middle Senegal River Valley: Socioeconomic Study] (Paris: PUF, 1962).
- Christophe Z. Guilmoto, “Démographie et Développement dans la Moyenne Vallée du Fleuve Sénégal” [“Demography and Development in the Middle Senegal River Valley”], in N’Guessan Koffi et al., eds., Maîtrise de la Croissance Démographique et Développement en Afrique [Control of the Demographic Growth and Development in Africa] (Paris: ORSTOM Éditions, 1994): 403-17.
- Fadel Kane et al., “Temporary Expatriation Is Related to HIV-1 Infection in Rural Senegal,” AIDS 7 no. 9 (1993): 1261-65.
- Boutillier et al., La Moyenne Vallée du Sénégal: Étude Socio-économique.
- Guilmoto, “Démographie et Développement dans la Moyenne Vallée”: 403-17.
- A. Lericollais, “Peuplement et Migrations dans la Vallée du Sénégal” [“Population and Migration in the Senegal Valley”], Cahier ORSTOM, Série Sciences Humaines 12, no. 2 (1975): 123-35; and Sadio Traoré, Dimension Ethnique de la Migration dans la Vallée du Fleuve Sénégal [Ethnic Dimension of Migration in the Senegal River Valley], doctoral thesis in demography at the University of Montreal (Montreal: 1992).
- Guilmoto, “Démographie et Développement dans la Moyenne Vallée.”
- Guilmoto, “Démographie et Développement dans la Moyenne Vallée.”
- WHO, “Epidemiological Fact Sheets on HIV/AIDS and Sexually Transmitted Infections” (Geneva: WHO, 2002), accessed online at www.who.int/hiv/pub/epidemiology/pubfacts/en/, on May 30, 2003.
- WHO, “Epidemiological Fact Sheets on HIV/AIDS and Sexually Transmitted Infections.”
- UNAIDS, “Acting Early to Prevent AIDS: The Case of Senegal,” UNAIDS Best Practice Collection (Geneva: UNAIDS, 1999).
- UNAIDS, “Gender and HIV/AIDS: Taking Stock of Research and Programmes” (Geneva: UNAIDS, March 1999), accessed online at www.unaids.org/publications/documents/human/gender/una99e16.pdf, on May 30, 2003.
- International Labor Organization, Population Mobility and HIV Vulnerability, Workshop Proceedings, Jakarta, November 15, 2001.
- Victor Piché et al., Migration, Sexualité et Sida dans la Vallée du Fleuve Sénégal [Migration, Sexualité, and AIDS in the Senegal River Valley] (Montreal: University of Montreal, 2003).
- Piché et al., Migration, Sexualité et Sida dans la Vallée du Fleuve Sénégal.
- These interviews were part of fieldwork research conducted by Rebecca Perry in northern Senegal and in South Africa.
- Christophe Saez, Comportements Sexuels et Risque d’Infection au VIH/SIDA chez les Migrants Haalpulaar de la Vallée du Fleuve Sénégal [Sexual Behavior and Risk of HIV/AIDS Infection Amoung the Halpularen Migrants of the Senegal River Valley], Master’s paper in Public Health (Montreal: University of Montreal, 2002).
- Northern Senegal was split into two regions in 2002: Saint-Louis and Matam.