The programme focuses on a variety of workers that are mobile because of their profession. However, the programme believes it is not effective to target individuals without addressing the context and environment in which they live and work. Therefore, even though the programme focuses primarily on a few selected sectors and the migrant workers employed in each sector, activities also target population groups with whom they interact and institutions that may alleviate or facilitate an environment of HIV vulnerability. Sectors that are targeted by PHAMSA include construction, transport, commercial agriculture, fisheries, mining, cross-border informal trade, and cross border sites.

PHAMSA has four distinct, yet inter-related, components:

1. Advocacy for Policy Development: PHAMSA lobbies National Aids Councils (NACs), SADC and UN partners to integrate population mobility and migration in their national strategic plans on HIV and AIDS, regional HIV plans, and UN Development Assistance Frameworks (UNDAFs). PHAMSA also assists policy makers and other partners in the construction, transport, commercial agriculture and fisheries sector to develop regional policies on HIV. Advocacy on issues related to population mobility and HIV is also conducted by actively working with partners from the print and broadcast media who will present stories on the complex relationship between migration, population mobility and HIV.
2. Research: Links between population mobility and HIV is investigated with a focus on concurrent sexual partnerships and sexual networking patterns. PHAMSA also pro-actively engages with the research community in southern Africa to integrate migration and mobility in (public) health courses and health/HIV in migration courses.
3. Technical Co-operation and Regional Coordination: PHAMSA strengthens the links between IOM’s HIV programmes in Africa, facilitating quality control, coordination and consistency of programming approach to HIV and mobility. PHAMSA also facilitates technical assistance on HIV and population mobility to national and regional partners and integrates these issues in training programmes, IEC material and other relevant interventions. PHAMSA also actively facilitates information sharing and increased networking between strategic partners through workshops and study visits.
4. Capacity Building: PHAMSA aims to test the capacity building model that was developed during the first phase in selected migrant and migrant -sending sites in the region. The model provides practical examples and “know how” on implementing the recommendations set out in the SADC/IOM guidelines. It does this by facilitating both technical and organisational capacity building of NGO partners to effect behaviour and social change and to share project challenges and successes between the different NGOs regionally. In addition, the capacity building model will be evaluated and documented on which basis a toolkit will be developed that can be used to replicate the model in other migrant sending and receiving sites in the region.

The general message of all information/communication and advocacy initiatives of PHAMSA is that migrants and mobile populations are not a threat, but rather that they may contribute positively to the economic development and diversity of a society. Thus, the expected outcomes of the interventions are as follows:

• Counter the myths that foreign migrant workers bring in HIV and other diseases among co-workers, employers and the general population in the recipient environment;
• Raise awareness among the general population and key stakeholders on the structural and environmental causes of HIV vulnerability of migrants and mobile populations (such as lack of access to health/VCT/STI services, poor living/working conditions, separation from families) and possibly induce action; and
• Promote positive perceptions of migration such as economic development and cultural diversity.

Furthermore, PHAMSA information/communication initiatives have the following aims:

• Enable migrants and mobile workers to make informed decisions regarding their mobility including border crossing (visa requirements, legal rights, customs procedures, etc.), transport arrangements, accommodation, and access to health services and information;
• Increase understanding among migrants and mobile workers and the people they interact with on a daily basis (custom officials, immigration officials, law enforcement officers, those who provide accommodation, transport, or health services, and other community members) of the specific HIV vulnerabilities associated with the migration process; and
• Increase understanding and empathy towards migrants and their daily challenges, etc., among the general public.

HIV/AIDS.

Within sub-Saharan Africa, the countries of southern Africa are the worst affected by the HIV epidemic. A number of different factors have been advanced to explain why HIV and AIDS are particularly affecting southern Africa. They include poverty and economic marginalisation; differing strains of HIV; high rates of sexually transmitted infections (STIs) and other opportunistic infections; sexual networking and patterns of sexual contact, including high levels of concurrent sexual partners; the absence of male circumcision; and the role of core-groups such as commercial sex workers. Related to some of these causes and perhaps explaining the rapid spread of HIV over the last decade is population mobility. Population mobility and migration especially contribute to the phenomenon of concurrent sexual partnerships, which is arguably one of the main drivers of the HIV epidemic in Southern Africa. Because migrants and mobile workers are regularly separated from their permanent partners, they are more inclined to engage in short or long - term sexual relations with other partners.

The evidence confirms that migrants and migrant households are particularly at risk. There is a higher rate of HIV infection in “communities of the mobile”, which often include socially, economically and politically marginalised people. There are at least three key ways in which mobility is tied to the spread of HIV:

1. Mobility per se can encourage or make people vulnerable to high-risk sexual behaviour;
2. Mobility makes people more difficult to reach, whether for prevention education, condom provision, HIV testing, or post-infection treatment and care; and
3. Migrants’ multi-local social networks create opportunities for sexual networking.

PHAMSA was developed in line with the overall objectives and strategic areas of focus of the SADC HIV/AIDS Strategic Framework and Programme of Action (2003-2007). It aims to contribute to the strategic areas of Policy Development and Harmonization, and Facilitating Resource Networks identified as priorities within the SADC HIV/AIDS Strategic Framework.