HIV prevalence and risk in long-distance truck drivers in South Africa: a national cross-sectional survey

Delany‐Moretlwe, Sinead; Bello, Braimoh; Kinross, Peter; Oliff, Monique; Chersich, Matthew; Kleinschmidt, Immo; Rees, Helen

doi:10.1177/0956462413512803

Cited by 77 publications

(103 citation statements)

References 27 publications

(34 reference statements)

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“…Even though LDTDs have access to convenient health care in the form of wellness centres situated in various trucks stops along the highway, this access has not made HIV testing any easier. [23] LDTDs experience feelings of fear and shame, which hinder them from seeking the help they need. Thus they may unknowingly continue to spread HIV to their partners who are not in the sex trade.…”

Section: Discussionmentioning

confidence: 99%

“…[21] However, the susceptibility of LDTDs to HIV acquisition is increasingly being acknowledged, with a prevalence of 56%,[22,23] resulting in their designation as a vulnerable population in need of targeted interventions. [2,23] Most studies have investigated either FSWs [6] or LDTDs independently,[23] with little acknowledgement of the intersection between these two groups. [12] The interaction between FSWs and LDTDs is often conceptualized geographically as a high HIV transmission area.…”

Section: Introductionmentioning

confidence: 99%

“…[12] The interaction between FSWs and LDTDs is often conceptualized geographically as a high HIV transmission area. [2,3,21,23] However, we know very little about the nature of sexual transactions between FSWs and LDTDs, especially in this era of widely available HIV testing and the large-scale access to ART. Studies looking at the interaction between FSWs and LDTDs in South Africa were conducted long before the advent of ART,[21,22] indicating the need for further research.…”

Section: Introductionmentioning

confidence: 99%

“…[2,23] Poverty is a driving force of HIV transmission in women in sub-Saharan Africa; growing national-level income inequalities are associated with higher HIV prevalence. [25,26] Women who enter sex work along transport routes are characterized by poverty and unemployment, turning to sex work as a means for survival.…”

Section: Introductionmentioning

confidence: 99%

“…[13] Likewise, the nature of their employment, being on the road for extended periods of time away from intimate partners, renders LDTDs more likely to solicit FSWs along transport routes. [2,23] Therefore, sexual dynamics between these two groups need to be further understood. This study was conducted mainly to explore the nature of the sex trade along a particular highway.…”

Section: Introductionmentioning

confidence: 99%

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Sexual transactions between long distance truck drivers and female sex workers in South Africa

Makhakhe

Lane

McIntyre

et al. 2017

Global Health Action

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Background: Female sex workers (FSWs) and long distance truck drivers (LDTDs) are considered key populations at high risk for HIV transmission due to high prevalence. The intersection of these mobile populations presents unique challenges in the fight against HIV and the movement towards reducing new infections. Objective: The purpose of this study was to explore the nature of sex trade along a particular transport route. Sexual transactions and the vulnerabilities that exist between these two groups with regards to HIV/AIDS are described, with the purpose of furthering the agenda for targeted interventions. Methods: Qualitative in-depth interviews were conducted with 14 participants, seven FSWs and seven LDTDs. We recruited FSWs through snowballing, and LDTDs through intercepts at truck stops. Semi-structured interview guides were used for data collection, and thematic analysis was conducted. Results: The sex trade in this study is characterized by competition, fuelled by money-driven and age-disparate rivalry. Despite widespread HIV knowledge, FSWs contend with persistent challenges regarding condom use negotiation, induced by more money in the exchange for unsafe sex. Despite the placement of wellness centres in truck stops along the highway, LDTDs face stigma related challenges with regards to testing for HIV and personal acknowledgement of their involvement in the sex trade. Conclusion: The nature of the sex trade along the highway continues to be risky despite the availability of HIV testing and antiretroviral treatment (ART). The sex trade is perceived to be increasing along trucking routes, in spite of measures instituted to limit access to FSWs. FSWs struggle to cope with the pressure of unprotected sex because of the need to generate more income, as well as avoid incidents of violence and threats. Interventions along transport routes need to be inclusive of FSWs who could play a vital role in stigma reduction amongst LDTDs through peer education.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sexual transactions between long distance truck drivers and female sex workers in South Africa

Makhakhe

Lane

McIntyre

et al. 2017

Global Health Action

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The HIV care continuum among resident and non‐resident populations found in venues in East Africa cross‐border areas

Edwards

Arimi²,

Ssengooba

et al. 2019

J Intern AIDS Soc

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IntroductionHIV care and treatment in cross‐border areas in East Africa face challenges perhaps not seen to the same extent in other geographic areas, particularly for mobile and migrant populations. Here, we estimate the proportion of people with HIV found in these cross‐border areas in each stage of the HIV care and treatment cascade, including the proportion who knows their status, the proportion on treatment and the proportion virally suppressed.MethodsParticipants (n = 11,410) working or socializing in public places in selected East Africa cross border areas were recruited between June 2016 and February 2017 using the Priorities for Local AIDS Control Efforts method and administered a behavioural survey and rapid HIV test. This approach was designed to recruit a stratified random sample of people found in public spaces or venues in each cross border area. For participants testing positive for HIV, viral load was measured from dried blood spots. The proportion in each step of the cascade was estimated using inverse probability weights to account for the sampling design and informative HIV test refusals. Estimates are reported separately for residents of the cross border areas and non‐residents found in those areas.ResultsOverall, 43% of participants with HIV found in cross‐border areas knew their status, 87% of those participants were on antiretroviral therapy (ART), and 80% of participants on ART were virally suppressed. About 20% of people with HIV found in cross border areas were sampled outside their subdistrict or subcounty of residence. While both resident and non‐resident individuals who knew their status were likely to be on ART (85% and 96% respectively), people on ART recruited outside their area of residence were less likely to be suppressed (64% suppressed; 95% CI: 43, 81) compared to residents (84% suppressed; 95% CI: 75, 93).ConclusionsPeople living in or travelling through cross‐border areas may face barriers in learning their HIV status. Moreover, while non‐residents were more likely to be on treatment than residents, they were less likely to be suppressed, suggesting gaps in continuity of care for people in East Africa travelling outside their area of residence despite timely initiation of treatment.

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Prevalence of HIV and Associated Risk Factors Among Long Distance Truck Drivers in Inchope, Mozambique, 2012

et al. 2015

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This is the first integrated biological and behavioral surveillance survey among long-distance truck drivers (LDTD) in Mozambique. Using modified time-location sampling in 2012 at a key transportation junction (Inchope), we enrolled 327 male LDTD. HIV prevalence was 15.4 % (95 % confidence interval : 11.4–19.4 %, n = 318 tested). Among HIV-positive LDTD, 83.7 % did not know their status. One-third of LDTD had never tested for HIV and three-quarters had not received free condoms, lubricants or HIV literature in the past 12 months. In that same period, 61.4 % of LDTD had at least four sexual partners and 27.1 % paid for sex. Among sexually-active LDTD, 76.5 % did not use a condom at last sex. HIV was associated (p < 0.05) with primary education or lower (AOR 2.1), residence in Mozambique (AOR 2.3) and never having tested for HIV (AOR 2.2). Our findings reveal that broader coverage of HIV prevention and comprehensive care services for LDTD are urgently needed.

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HIV prevalence and risk in long-distance truck drivers in South Africa: a national cross-sectional survey

Cited by 77 publications

References 27 publications

Sexual transactions between long distance truck drivers and female sex workers in South Africa

Sexual transactions between long distance truck drivers and female sex workers in South Africa

The HIV care continuum among resident and non‐resident populations found in venues in East Africa cross‐border areas

Prevalence of HIV and Associated Risk Factors Among Long Distance Truck Drivers in Inchope, Mozambique, 2012

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