Roadside bars, truckers and sex workers have long been seen as one of the most dangerous combinations for the transmission of HIV, with truckers often blamed for spreading the virus.
But research presented at the International AIDS Conference held in Mexico City this week, suggests that truckers have been misunderstood.
Surveys conducted along some of East Africa’s major transport corridors have found that truckers often make up the minority of clients at highway stops.
Alan Ferguson, a researcher with the US-based non-governmental research organisation, Constella Futures, was part of a team that looked at HIV vulnerability along the transport corridor linking Kenya’s port city of Mombasa with the Ugandan capital, Kampala. Their research revealed that along this route, only 30 percent of female sex worker clients were truckers.
A similar study conducted along the highway from Kampala to Juba in Southern Sudan, found that 28 percent of sex worker clients were truckers. The rest of the clients came from a wide range of occupations including local businessmen, teachers and healthcare workers.
Ferguson said it was time for awareness programmes to “go beyond” truckers and involve the communities surrounding highway stops.
In West Africa, communities surrounding border posts were just as vulnerable to HIV as truckers and female sex workers, noted Dr Justin Koffi, executive director of the HIV/AIDS Corridor Project, a regional initiative supported by UNAIDS, the World Bank and USAID that is targeting people using the highway between Cote D’Ivoire’s economic capital, Abidjan and Lagos, Nigeria.
According to Koffi, studies have found that HIV prevalence rates in border communities are twice as high as national averages, but that awareness programmes remain weak in these areas.
The families of truck drivers were also neglected by existing prevention programmes, according to Dr Asif Altaf of the International Transport Workers Federation. “What about the families? The wife back home? These programmes need to address the family factor otherwise the cycle will continue,” he warned.
The life of a trucker
But truckers are still vulnerable. The Constella Futures study found that along the route between Mombasa and the Uganda border, an average of 2,400 trucks park overnight at 39 “hot spots”, which attract an estimated 5,600 sex workers.
Ferguson noted that as drivers become aware of the risk of engaging in unprotected casual sex, some have opted to maintain semi-regular sexual partners along the transport route. Since this involved some level of trust and intimacy, condom use was less likely.
Studies have found that a significant number of workers in the road transport sector have continued to engage in unprotected casual sex, despite being aware of its dangers. Possible explanations for this behaviour include high levels of fatalism resulting from the dangerous nature of their jobs, widespread alcohol and substance abuse, and stigmatisation of this group.
UN Special Envoy for Africa, Elizabeth Mataka warned against labelling truck drivers responsible for spreading HIV. She noted that it was poor working conditions that made truckers vulnerable.
Altaf of the International Transport Workers Federation confirmed that truck drivers had no proper working conditions, received low wages, and worked alone and away from home for long periods of time.
Another contributing factor was the long delays drivers experienced at borders while waiting for customs to clear goods. In the West Africa corridor for example, the delays at border posts ranged from days to months.
In such instances, Altaf pointed out, sex – a “normal physiological phenomenon” – was a means of coping.
“I’m from Bangladesh and people there say truckers are bad people because they are always having alcohol…but what else do you have?” he asked. “When you’re on the road, it’s sex by the side of the road and bars by the side of the road.”