Behavioral risk factors for STD/HIV transmission in Bangladesh's trucking industry

• Published in: Social science & medicine (1982) Vol. 56; no. 7; pp. 1411 - 1424
• Main Authors: Gibney, Laura, Saquib, Nazmus, Metzger, Jesse
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.04.2003; Elsevier; Pergamon Press Inc
• Series: Social Science & Medicine
• Subjects: Acquired Immune Deficiency Syndrome; Addictive behaviors; Adolescent; Adult; Adult and adolescent clinical studies; Bangladesh; Bangladesh - epidemiology; Behavior; Biological and medical sciences; condoms; Condoms - statistics & numerical data; Cross-Sectional Studies; Drug Abuse; Drug addiction; Health Behavior; Health risk assessment; HIV; HIV Infections - epidemiology; HIV Infections - psychology; HIV Infections - transmission; Human immunodeficiency virus; Human viral diseases; Humans; Infectious diseases; Injections; Logistic Models; Lorry drivers; Male; Medical sciences; Middle Aged; Occupational Health; Prevalence; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Qualitative Research; Risk behaviour; Risk Factors; Risk-Taking; Sexual Behavior; Sexual Behavior - classification; Sexual Behavior - psychology; Sexually transmitted diseases; Sexually Transmitted Diseases - epidemiology; Sexually Transmitted Diseases - psychology; Sexually Transmitted Diseases - transmission; Sexually transmitted diseases HIV Injections Truck drivers Bangladesh; Socioeconomic Factors; STD; Substance Abuse, Intravenous - epidemiology; Transmission; Transportation; Tropical medicine; Truck drivers; Trucking industry; Venereal Diseases; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Workers; Workforce; Asia; Bangladesh; Sexually transmitted diseases; Injections; Bangladesh; HIV; Truck drivers; Intravenous administration; Condom; Sexual intercourse; Route of administration; Prevention; Dangerous behavior; Transmission from man to man; Human; Immunopathology; Drug addiction; Statistical analysis; Illicit drug; Retroviridae; Exploration; AIDS; Immune deficiency; Lentivirus; Infection; Virus; Sexually transmitted disease; Viral disease; Risk factor; Human immunodeficiency virus
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/S0277-9536(02)00138-7

To examine behaviors that could influence STD/HIV transmission in Bangladesh's trucking industry, a survey was orally administered to 388 truck drivers/helpers at Tejgaon truck stand in Dhaka. A two-tiered sampling strategy was used: 38 trucking agencies were randomly selected and a mean of 10.2 subjects was recruited from each agency. Focus group and in-depth interviews were also conducted. The focus was on behaviors that affect (i) exposure to STD/HIV infection, (ii) efficiency of transmission of infection and (iii) duration of infectiousness. The findings illustrated that intravenous drug use was not an important risk factor; only 1 subject had used drugs intravenously. Sexual risk behaviors, however, were prevalent: the mean number of sexual partners in the past year was 4.57 (SD=8.70) and in the past 3 months was 1.82 (SD=3.27). Premarital and extramarital sex was common, often with commercial sex workers (CSW); 54% of all subjects had relations with at least 1 CSW in the past year. In a multiple logistic regression analysis, subjects who engaged in other types of socially risky behavior (drinking alcohol, ingesting or smoking recreational drugs, having sex with other men) were significantly ( p<0.05) more likely to have had sex with a CSW in the past year. While 7.2% of subjects had a male sex partner in the past year, 21% had ever had one (likely youthful experimentation for most). Condom use was very infrequent: of the 343 subjects who had ever had sexual intercourse only 31% had ever used a condom and most of those subjects had used only once or occasionally. Having sex with CSWs, being married, having heard of AIDS and age were significantly associated ( p<0.05) with ever use of condoms. Frequently, subjects who had genital symptoms either did not have those symptoms treated at all or treated in a timely fashion, and over 1/3 did not change their sexual behavior while infected. To reduce the potential for the spread of STD/HIV in this population, appropriate treatment practices for sexually transmitted infections need to be encouraged and condom use promoted, particularly in the context of casual sexual relations.