Determinants of HIV risk among Indian truck drivers.

Although there are very high levels of HIV risk sexual behavior in India, there has been little research on the determinants of this behavior, the psychosocial correlates of condom use, or the potential for effective behavior change interventions. The present research used the information-motivation-behavioral skills model of HIV risk behavior to explore these issues in a sample of Indian truck drivers, a population that comprises an important vector of HIV transmission. This paper presents correlational data on the predictors of HIV risk and preventive behavior in a sample of truck drivers in Chennai, India. The data were collected via detailed individual structured interviews with 300 Indian truck drivers. Results indicated that Indian truck drivers had substantial deficits with respect to HIV prevention information, motivation, and behavioral skills. Consistent with the IMB model, these deficits were often found to be predictive of HIV risk and preventive behavior. The implications of these findings for future intervention are discussed.     

长途卡车司机艾滋病预防干预研究文献综述

长途卡车司机由于其职业的高流动性,使其有可能处在艾滋病传播和感染的高危险中,越来越受到研究者的重视。本研究在对近年来国内期刊发表研究论文做一综述,提出了相关的建议,旨在探索提高干预效果发挥干预常态机制和策略措施提供依据。     

Sexual behavior among truck drivers

A cross-sectional study was conducted on Lucknow highway in Bareilly district of Uttar Pradesh to study the knowledge of truck drivers about HIV transmission and prevention and to study the sexual behaviour of these drivers with reference to HIV/AIDS. Age, marital status, education, income, drinking alcohol, length of stay away from home, knowledge about transmission and prevention of HIV, and HIV-prone behavior of truck drivers were studied. Chi-square, mean, and SD were calculated. In all, 289 (97.6%) drivers had heard about HIV/AIDS. Only 242 (81.8%) were aware of HIV transmission by heterosexual route. Misconceptions such as HIV transmission by mosquito bites, living in same room, shaking hands, and sharing food were found. Out of 174 (58.8%) who visited Commercial Sex Workers (CSW), 146 (83.9%) used a condom. 38 (12.8%) visited more than 5 CSW in the last 3 months. Time away from home on the road, marital status, alcohol use, and income class were associated with visiting CSW. High-risk behavior was established in the study population. Safe sex and use of condoms need to be promoted among the truck drivers and better condom availability needs to be assured on highways.     

Stress among package truck drivers

In 1992, a cross-sectional questionnaire study of package truck drivers in one company was conducted at four widely scattered sites throughout the US; 317 drivers participated, representing 82% of those eligible. The package truck drivers scored significantly above the US working population comparison norm on all summary and individual scales derived from the SCL 90-R, indicating a substantial increase in psychologic distress for this group. The Global Severity Index, the best single summary measure of psychological distress in the SCL 90-R, revealed a mean T score for the drivers of 64.20, 91st percentile of the normative population. The group perceived significantly more daily stressful events than the average working adult, and their sensitivity to these events was also increased. Role overload, a component of the Occupational Stress Inventory, was the most consistent factor associated with symptoms of psychological distress on multiple regression analysis. This study suggests that job stress is a psychological health hazard for these drivers. Am. J. Ind. Med. 31:202–210, 1997. © Wiley-Liss, Inc.     

Social vaccine for HIV prevention: a study on truck drivers in South India

Nearly everywhere that AIDS has been found, HIV infection is fast spreading. No one is known to have recovered from HIV infection. There is no vaccine to cure AIDS (Population Reports, 1989 and The Hindu, dated 9.3.2000). Until a cure or vaccine for HIV infection is found, the only way to prevent the spread of the disease is by changing people's behaviour through AIDS education programmes (Population Reports, 1986). Many national governments are using broadcast, print media, personal contact, counselling methods, etc., to educate people on AIDS and safer sex. Thus, the best vaccine is the 'Social Vaccine.' Social vaccine involves spreading education on how to protect oneself, hundred percent condom use, and changing sexual behaviour. In fact, the social vaccine was so successful in Thailand that the infection rate has come down by 50 per cent (The Hindu, dated 9.3.2000). Truck drivers, prostitutes, and young adults are considered high risk groups for HIV/AIDS in India. An action research study was conducted in Chittoor District of Andhra Pradesh (India) among truck drivers. As part of this study, different strategies, namely mass media, personal contact, group discussion, folk media, and counselling, were adopted to provide AIDS education, to encourage increase in condom use for safer sex, and bring changes in their sexual behaviour. The strategies adopted in this study greatly enhanced the knowledge of the truck drivers on AIDS, changed their attitudes on sex, increased the use of condoms, and modified their sexual behaviour. Thus, the social vaccine would help spread education on AIDS, bring changes in the sexual behaviour of the people, increase condom use, and thus help to prevent the AIDS scourge throughout the world. The social vaccine suggested in this study can also be extended to all the high risk group population for successful prevention of this dreadful disease in the world.     

深圳市某港口货柜车司机婚外性行为研究

目的了解货柜车司机婚外性行为情况,为行为干预奠定基础。方法采用整群抽样,对沿海某港口城市货柜车司机进行问卷调查。结果257人接受调查,货柜车司机婚外性行为普遍,安全性行为意识较差,安全套使用率比较低。结论应加大对货柜车司机的艾滋病健康教育和行为干预。     

Sexual behaviour among truck drivers in Pakistan

This study examines the level of risk of acquiring sexually transmitted infections among truck drivers and their helpers in Pakistan. Quantitative, self-reported, sexual behaviour data were collected from 300 randomly selected long-distance truck drivers and their helpers. Qualitative information was gathered through conversations with drivers. The findings show that multiple sexual partnerships with men and women are common among truckers. Awareness of AIDS and knowledge of sexual transmission of HIV is high. However, most truckers do not believe that AIDS exists in Pakistan. Nor are they aware that condoms are an effective way of preventing HIV transmission. Knowledge of the risks associated with unprotected sex is low among truckers, who consider themselves invulnerable to sexually transmitted infections because of their self-perception of being moral persons. Campaigns to increase risk awareness should emphasize the importance of condom use as an STI/HIV prevention method. Interpersonal communication is likely to be important in convincing truckers that sexually transmitted infections can be prevented.     

Outputs and cost of HIV prevention programmes for truck drivers in Andhra Pradesh, India

Background  

HIV prevention programmes for truck drivers form part of the HIV control efforts, but systematic data on the outputs and cost of providing such services in India are not readily available for further planning and use of resources.     

An information-motivation-behavioral skills (IMB) model-based HIV prevention intervention for truck drivers in India

The incidence of HIV/AIDS in India is increasing drastically, and truck drivers are seen as critical sources of HIV transmission due to their high rates of unprotected sex with multiple partners. An intervention based on the Information-Motivation-Behavioral Skills (IMB) model was compared to an information-only control condition in a randomized trial. IMB constructs were assessed among 250 male truck drivers immediately prior to and following implementation of the intervention, and sexual and condom use behaviors were assessed approximately 10 months later. The intervention consisted of a single-session group workshop with 5 interactive activities designed to address HIV prevention-related IMB constructs and to motivate condom use. Findings showed mixed support for the effectiveness of the intervention. There was an effect of the IMB intervention on attitudes, norms, behavioral skills, and intentions specific to condom use with marital partners, but no effects on constructs related to non-marital partners. There was some evidence of greater condom use with marital and non-marital partners at behavioral follow-up for participants in the IMB condition, and effects on condom use with marital partners were mediated by changes in IMB constructs. These findings provide initial evidence for the effectiveness of theoretically-based approaches to HIV prevention in India.     

Mobility and its liminal context: Exploring sexual partnering among truck drivers crossing the Southern Brazilian border

Mobile populations, including truck drivers, are at elevated risk of acquiring HIV and other sexually transmitted infections (STI). However, measures of mobility have been poorly operationalized and little research exists exploring the psychosocial context of mobility and sexual risk taking. A systematic sample of 1775 male truck drivers underwent interview at two customs stations on the Southern Brazilian international border in 2003. The psychosocial effect of being mobile was assessed by clustering truckers based on perceptions of the liminal environment, or being outside of one's normal social environment. The relationship between physical mobility (nights spent at home) and liminal cluster with sexual partnerships was assessed. The clustering procedure yielded three dispositions towards the liminal environment. Compared to truckers in the baseline cluster, those who perceive the environment as (1) very, or (2) moderately permissive had increased odds of reporting a commercial sex partner in the past six months and reported increased numbers of commercial partners. For each week slept at home, the odds of reporting a commercial partner decreased by a factor of 0.73 and the average number of commercial partners decreased by a rate of 0.76. Physical and psychosocial measures of mobility were associated independently with increased partnering on the road. Additional exploration of how the liminal environment shapes mobile populations’ sexual decision making and vulnerability to STI is warranted.     

Mobility and its liminal context: exploring sexual partnering among truck drivers crossing the Southern Brazilian border

Mobile populations, including truck drivers, are at elevated risk of acquiring HIV and other sexually transmitted infections (STI). However, measures of mobility have been poorly operationalized and little research exists exploring the psychosocial context of mobility and sexual risk taking. A systematic sample of 1775 male truck drivers underwent interview at two customs stations on the Southern Brazilian international border in 2003. The psychosocial effect of being mobile was assessed by clustering truckers based on perceptions of the liminal environment, or being outside of one's normal social environment. The relationship between physical mobility (nights spent at home) and liminal cluster with sexual partnerships was assessed. The clustering procedure yielded three dispositions towards the liminal environment. Compared to truckers in the baseline cluster, those who perceive the environment as (1) very, or (2) moderately permissive had increased odds of reporting a commercial sex partner in the past six months and reported increased numbers of commercial partners. For each week slept at home, the odds of reporting a commercial partner decreased by a factor of 0.73 and the average number of commercial partners decreased by a rate of 0.76. Physical and psychosocial measures of mobility were associated independently with increased partnering on the road. Additional exploration of how the liminal environment shapes mobile populations' sexual decision making and vulnerability to STI is warranted.     

Locomotor diseases among male long-haul truck drivers and other professional drivers

Objective High risks for locomotor diseases have been reported for bus and truck drivers in general; however, little is known about the specific risks of long-haul truck drivers. Methods Standardised hospitalisation ratios (SHR) for different locomotor diseases of bus drivers, long-haul truck drivers and other truck drivers were compared with each other and with the general Danish working population. Results Intervertebral disc disorders were more common among professional drivers (SHR: 119, 95% CI: 114–125) and of similar magnitude for cervical and non-cervical disorders. Both long-haul truck drivers and bus drivers had higher SHR for intervertebral disc disorders (SHR: 133, 95% CI: 114–155/SHR: 141, 95% CI: 129–154, respectively) than other truck drivers (SHR: 109, 95% CI: 102–116). The SHR for carpal tunnel syndrome was high among long-haul drivers (SHR: 163, 95% CI: 101–249) and for other truck drivers (SHR: 130, 95% CI: 108–156) compared to bus drivers (SHR: 110, 95% CI: 79–149). All drivers had high SHR for lesions of the ulnar nerve (SHR: 159, 95% CI: 119–207), especially bus drivers (SHR: 197, 95% CI: 116–311). Long-haul truck drivers had high SHRs for synovitis and bursitis (SHR: 150, 95% CI: 105–207), in contrast to other truck drivers and bus drivers (SHR: 103, 95% CI: 89–120/SHR: 87, 95% CI: 66–112, respectively). Conclusion All groups of professional drivers experience high risk of various disorders of the locomotor system but type of vehicle and specific working conditions are associated with different health effects on the locomotor system.     

昆明市部分长途卡车司机艾滋病知识和行为现状调查

[目的]通过对昆明市某物流中心停车场长途卡车司机的问卷调查,了解他们对艾滋病防治知识知晓率,不安全性行为的发生率,为制定有针对性的行为干预措施提供基本的数据。[方法]在昆明市某物流中心对居住在停车场内的800名长卡司机进行随机抽样,抽取203名长卡司机进行“行为监测”问卷调查。[结果]大部分长卡司机对艾滋病的基本知识缺乏了解,获得相关艾滋病知识的途径很少,高危险性行为发生率高。[结论]需要立即对长卡司机开展行为干预。     

货柜车司机艾滋病相关知识、态度及行为调查

目的了解货柜车司机艾滋病知识水平,探索有效的干预模式。方法采用整群抽样方法,对深圳市货柜车司机257人进行调查。结果货柜车司机对艾滋病基本知识缺乏了解,只有65.19%的司机知道艾滋病的3种传播途径,有97.28%的司机希望了解更多的AIDS相关知识。货柜车司机性伴关系较复杂,但其中只有61.44%司机与暗娼发生性行为时坚持使用安全套。虽未检出人类免疫缺陷病毒（HIV）感染者,但乙肝病毒和梅毒螺旋体感染检出率分别为13.62%和0.78%,提示货柜车司机普遍存在高危行为。结论货柜车司机高危行为普遍,是感染HIV的高危人群,应采取有针对性的综合干预措施,使其改变高危行为或采取安全性行为,控制艾滋病由高危人群向一般人群传播。     

在长途货运汽车司机中促进避孕套使用的研究

目的 了解长途货车汽车司机对性病／艾滋病的认识,态度,行为以及使用避孕套的情况。方法 采用行为干预的方法,对该人群进行危险行为干预措施的实施。结果 实施干预措施后,该人群对性病／艾滋病预防的知晓率由于预前４５％上升到干预后８９．８％,自我报告避孕套使用率高于对照组。结论健康教育对于性病／艾滋病的预防是有一定效果的。     

Risk behaviors for sexually transmitted diseases among truck drivers in Brazil

OBJECTIVE: To evaluate the frequency of sexually transmitted diseases (STD) and associated risk factors based on self-reporting by long-haul truck drivers in Brazil. METHOD: From October 2005-October 2006, 641 long-haul truck drivers that travel federal highway BR-153, traversing the country from south to north, were interviewed. A structured interview was used to collect sociodemographic data. The truck drivers also completed a self-administered questionnaire on risk behaviors and STD history. The data were adjusted and analyzed using logistic regression. RESULTS: Of 641 drivers interviewed, 620 (96.7%) provided answers on STD history. Of these, 35.6% (95% confidence interval (CI) = 31.9-39.6) reported past or current STD. Being 30 years of age or older was statistically associated with having a history of STD. In addition, truck drivers who reported using amphetamines (odds ratio (OR) = 1.7; 95%CI = 1.1-2.6), having been incarcerated (OR = 2.2; 95%CI = 1.2-4.2), and sexual relations with sex professionals (OR = 1.9; 95%CI = 1.3-2.8) had increased odds for having a history of STD. CONCLUSION: These results confirm that Brazilian truck drivers are highly vulnerable to STD and show the importance of prevention programs targeting this specific group, one that is constantly on the move and may efficiently disseminate STD.     

中国长途汽车司机艾滋病预防干预效果的Meta分析

目的 系统评价我国艾滋病预防干预对控制长途汽车司机高危性行为的效果.方法 计算机检索CBM光盘版(1978-2009)、CNKI(1980-2009)、VIP(1989-2009)以及MEDLINE (1950-2009)数据库发表的中国长途汽车司机艾滋病预防干预的文献,筛选自身前后对照试验或包括自身前后对照试验的空白对照试验.参考Newcastle-Ottawa scale,结合自身前后对照研究的特点评估纳入研究偏倚风险,采用RevMan 5.0软件进行统计分析.结果 共纳入13篇文献,纳入研究存在发生偏倚的高度风险,Meta分析结果显示:(1)知识指标1:纳入7个研究,干预后长途汽车司机的知识指标1高于干预前(RD=0.15,95%CI:0.04～0.26).(2)知识指标2:纳入10个研究,干预后长途汽车司机的知识指标2高于干预前(RD=0.24,95%CI:0.17～0.30).(3)行为指标:纳入6个研究,干预后长途汽车司机的行为指标高于干预前(RD=0.15,95%CI:0.10～0.19).结论 艾滋病预防干预对提高长途汽车司机的知识水平、促进其采取保护性性行为有一定的效果.