Messina is Africa's busiest commercial border. It is situated in the poorest region of the poorest province in South Africa, bordering poor areas of Zimbabwe and Southern Mozambique. Almost 70% of South Africans living in poverty are black women in rural areas and small towns and Messina is no exception. Whereas men tend to migrate beyond Messina, many low-income women migrate to Messina for vending and sex work, resulting in a disproportionate percentage, approximately, 70%, of women. Although Messina has significantly higher incomes than neighbouring Mozambique or Zimbabwe, poverty among women in Messina is acute. Messina has an acute shortage of low-income housing and many people live in informal settlements. The most crowded informal settlement in Messina is called Rwanda. Many sex workers live in Rwanda and many men visit Rwanda in search of sexual partners.

Bars and shebeens (Informal bars) are a major source of recreation and sexual interaction in Messina. Messina has five bars and at least 30 shebeens. The bars are open from 0800 to 2300 during the week and 0200 during weekends. The bars are quiet during the week, when miners and soldiers are tired after work. At weekends, over 200 sex workers can be counted in major bars. During the week, when sex workers seek trucking clients on the highway, over 100 sex workers may be counted each night on the highway.

Almost 70% of Messina's population are women, nearly all in all paid domestic or retail jobs, vending or sex work. In this context, reliance on men for income and formal and informal sex work flourish.

In Messina, the majority of clients are truckers, soldiers, miners and customs officials. Truckers are most popular, because they pay well and bring beauty products from Johannesburg. Miners are also popular. Soldiers are considered unreliable and abusive. Customs officials seldom pay cash, but exempt women from customs duties for sexual favours.

Although sex work is their primary source of income, many sex workers engage in other activities during the day. They work in shops, salons or markets or conduct cross border trade. They get free lifts with truckers and rely upon assistance from truckers or customs officials to avoid customs duty. Messina sex workers recognize that truckers bring opportunity and danger, saying "We are living well because of truckers" and truckers are loaded with "rands and STDs." They prefer to seek STI care in the private or traditional sectors.

There is a highly explicit sex industry in Messina, focusing primarily on truckers, soldiers and miners. However, there are also ill-defined and discrete forms of sex work, concealed behind many gradations of girlfriend relationships. The subtlety of much sex work also emphasizes the need for workplace peer education, to reach accessible, well-defined male groups.

STIs are largely seen by private and traditional practitioners in Messina. Tuberculosis is common, well-known and of great concern. The link between tuberculosis and HIV offers an important entry point for community AIDS dialogue.

Messina truckers are typically about 30 and have been driving for 10 years. Most acknowledge seeking sex workers. They complain that Zimbabwe customs are so slow to clear goods that they are forced to seek sex workers to alleviate accommodation costs and loneliness. On average, they spend about 14-20 days away from home in a month. No truckers travel with their wives, but many state that they have regular partners in all the countries they visit. Attitudes towards condom use varied, but were significantly more negative among South African than Zimbabwean or Zambian drivers. Truckers seldom use public health services, preferring private or traditional providers.

About 90% of informal traders in Messina are Zimbabwean. They bring Zimbabwean handicrafts to sell in South Africa and earn more than Zimbabwean nurses or teachers. They typically travel to South Africa three times a month, unless they have problems at the border. Some supplement their incomes by engaging in sex work at night, especially with truckers.

Few societies juxtapose poverty with as powerful and pervasive a consumer and media culture as South Africa's. Young South African's material aspirations lead many young women to seek older clients or partners. The involvement of young women in sexual relationships with older men, usually for overt or discrete financial gain, is striking. Schoolgirls solicit openly for truckers and taxi drivers in and around Messina.

In summary, Messina is a town inhabited largely by low-income women, traversed by mobile men, including truckers, soldiers and miners, which creates an optimal context for HIV transmission.