Lesotho migrant miners’ access to anti-retroviral therapy: Conversion factors during mobility

Southern Africa’s history of institutionalised migrant labour created a link between migration and HIV&AIDS. Mining companies initially ignored the HIV&AIDS pandemic despite evidence that early treatment suppresses HIV, improves life quality and reduces HIV transmission. When anti-retroviral therapy (ART) became available, access was difficult and the migratory nature of the workforce complicated implementation. Using the capabilities approach, we investigated their perceptions of conversion factors that help or hinder Lesotho male migrant miners in accessing ART. We interviewed 50 miners who work in South Africa. Capability-constricting factors were stigma, gender-insensitive HIV services, poor policies and programmes, the anti-migrant attitudes of healthcare workers and hindrances in work environments. Capability-expanding factors were ease of access, not experiencing stigma, availability of drugs, bulk access, someone to access the drugs on your behalf and freedom to migrate. To access ART, migrant workers have to travel unnecessarily between Lesotho and South Africa, increasing health risks.