Shock findings of HIV/AIDS survey
56% of drivers in KZN test HIV positive

For many years, FleetWatch has warned of the dire consequences of the spread of HIV/AIDS in the trucking industry. Our warnings have been heeded in some quarters and ignored in others. The bad news is that a recent study conducted by the HIV Prevention and Vaccine Research Unit of the Medical Research Council showed that out of 320 truck drivers surveyed in KwaZulu-Natal, 56% of them were infected with HIV. The study concluded that if urgent measures are not implemented, the spread of the HIV epidemic could have a seriously negative impact on the trucking industry of southern Africa. Although the finding have been reported in the general media, FleetWatch sourced more details from the MRC. Here they are.

According to Dr Gita Ramjee, chief investigator of the MRC study, the study reveals a high prevalence rate of HIV and poor condom use among truck drivers and sex workers. The complex web of travel and sexual mixing - both within and outside South Africa - create a milieu that is conducive to the spread of HIV and other Sexually Transmitted Diseases (STDs). It also highlights the urgent need to deal with the HIV epidemic across political boundaries in the Southern Africa region.

The aim of the study was to establish HIV prevalence among truck drivers frequenting sex workers at truck stops in KwaZulu-Natal by determining their migration patterns, frequency of condom use, treatment-seeking behaviour for sexually transmitted diseases (STDs), and frequency of sex with sex workers.

At all the truck stops where this study was conducted, the overall HIV prevalence among truck drivers was 56%. Of the truck drivers recruited in the study, 297 were Black, seven were Coloured, nine were Indian, while nine were White. One hundred and sixty eight (57%) black drivers were found to be HIV positive. Five (71%) of the Coloured men, five of the Indian (56%), and two of the White men (29%) also tested positive. The HIV prevalence for these truck drivers was highest in those aged between 45 and 49 years.

Sex workers recruited
During the study, two sex workers from each of the five truck stops, approximately 300 km from Durban, were recruited as field workers. They were informed of the study objectives and were trained to obtain informed consent, provide pre-test HIV counseling, administer a short questionnaire and collect saliva samples from consenting truck drivers they had sex with during the period of the study. The 6th truck stop in close proximity to Durban was also included.

Furthermore, to avoid duplication of samples, truck drivers were asked if they had supplied a sample of their saliva to any sex worker along the truck route. The questionnaire was used to elicit information of the demographics of the men, condom use, travel patterns and frequency of sex with sex workers.

The mean age of the truck drivers was 37 (range 18-71) years and they had been truck drivers for an average of 8.4 years. For sex workers, the mean age was 25.1 years (range 15-49) with an average education record of six years, and the mean time spent as a sex worker ranged from one month to 31 years.

Sixty percent of the truck drivers reported having an STD (discharge and ulcers) in the past six months and 83 % received treatment. About 34% always stopped for sex at the truck stops. Condom use was not very high. Twenty nine percent reported never using condoms with sex workers while 46% reported always using condoms. Seventy five percent of men had wives/girlfriends and only 12,9% percent never used condoms with their wives/girlfriends.

Neighbouring countries
All men travelled to more than two provinces in South Africa and 64,5% traveled to neighbouring countries. Forty percent reported having sex with sex workers in neighbouring countries. Forty two percent of the men engaged in anal sex and only 23% of these men reported condom use during anal sex.

Interviews with sex workers revealed that the men they had sex with came not only from South Africa but from other SADC countries such as Zimbabwe, Angola, Zambia, Mozambique, Botswana, Swaziland and Namibia. Furthermore, the sex workers often travel with truck drivers to these countries and continue to have sex with other partners.

"Given that men as young as 18 are visiting sex workers at truck stops, urgent measures are needed at the work places of the truck drivers to educate men on HIV/STD transmission issues and to promote condom use. Similarly, interventions are needed at truck stops to promote condom use as well as voluntary testing and counseling," says Dr Ramjee

"In addition, seeing that many men drive large trucks which makes access to city clinics and hospitals difficult, it is imperative that mobile clinics providing STD syndromic treatment and free condoms are made available at strategic places along trucking routes and at border posts. Peer education programmes are urgently needed in these groups to help them adopt risk reduction measures and to contribute positively towards curbing the spread of HIV."

First for South Africa
This is the first study of its kind from South Africa among truck drivers. Other similar studies have been conducted in other countries. A seroprevalence study which was conducted in Kenya in 1991-1992 found that 26% of the 283 truckers and their assistants who transported goods from Kenya to Zaire, were infected with HIV. Another study in five areas of India suggested that a history of STDs was common among inter-city truckers.

It is obvious from this study that every operator within this industry needs to take a hard look at what they are doing to curb the spread of HIV/AIDS among their drivers - and other workers. It's not only a driver thing this. It is also, contrary to some people's views, not a Black or White thing this. HIV/AIDS knows no colour, creed nor class. As the study shows, Black, Coloured, Indian and White men tested HIV positive. Forget the debates. HIV/AIDS is real and your future is at stake. Do something about it!