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

Abstract

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.

Is knowledge of HIV status associated with sexual behaviours? A fixed effects analysis of a female sex worker cohort in urban Uganda

“…This latter finding is different from most of the previous studies on knowledge of HIV status and sexual behaviour, which took place among members of the general population and found that knowledge of HIV‐negative status was not associated with HIV risk‐related sexual behaviours . It is particularly encouraging that FSWs in this setting who learn that they are HIV‐negative forgo the opportunity to make almost triple the amount of money for a sex act without a condom compared to a sex act with a condom – presumably to protect themselves from HIV acquisition. Moreover, FSWs in this study did not appear to be making up for this lost income by increasing their number of clients, suggesting that they are prepared to take potentially substantial losses in income for a reduced risk of HIV acquisition.…”

Prevalence of HIV infection and uptake of HIV/AIDS services among fisherfolk in landing Islands of Lake Victoria, north western Tanzania

“…New HIV infections in Tanzania have been decreasing [4] however some populations are still at higher risk than the general population [5]. These key and vulnerable populations include; commercial sex workers, intra venous (IV) drug abusers and mobile population like, fishermen, prisoners and truck drivers [6–9]. In India, fishermen were reported to have uppermost HIV infection vulnerability however similar observation in Kenya and Uganda has been reported [10–13].…”

Hotspots of Transmission Driving the Local Human Immunodeficiency Virus Epidemic in the Cologne-Bonn Region, Germany

“…Although previous findings from the United States [34] and South Africa [35] indicate that HIV transmission was identified along main trucking routes, association between HIV transmission and human migration has to date not been described for Germany. In fact, Cologne is one of the key hubs for national and international transportation routes, connecting northsouth and east-west, but it remains speculative if trucking routes may be driving interregional HIV transmissions in Germany.…”