HIV Infection and Sexual Risk Behavior Among Truck Drivers (TD) Employed by a Large Corporation in the High Prevalence State of Andhra Pradesh (AP), South India

Background: Sentinel surveillance conducted in AP includes sub-populations thought to be at high-risk for HIV, but has not included TD. Some reports suggest an HIV prevalence 11-31 times that of the adult population. There have been no studies of HIV prevalence and risk behavior of TD in AP.

Methods: A cohort of 235 TD aged 15-56 were recruited from a large trucking depot. A quantitative survey instrument was conducted along with blood collection. Multivariate regression models were utilized to determine predictors of HIV infection and risk behavior.

Results: Subjects were married(87%), older(mean=31.2 yrs) and 2.1% HIV+. Married status was protective against HIV infection(OR=0.003; p=0.05), and those with genital symptoms decreased with older age(OR=0.78; p=0.03), but increased with greater income(OR=1.05; p=0.02), from urban areas(OR=6.59; p= 0.04), and spent time away from home(OR=3.02; p=0.002). There was a decrease likelihood of visiting commercial sex workers(CSW) if married(OR=0.1; p<0.01), but there was an increase if from an urban area. Condom usage with regular partners was practiced if had ever visited a CSW(OR=6.52; p= 0.006), but there was a decrease use of condoms with increasing number of children(OR=0.61; p= 0.04) and if more educated(OR=0.6; p= 0.05).

Conclusion: Time away from home, urban residence, income, and marital status were the strongest correlates of risk behaviors and HIV, although none were consistent predictors of all outcomes. Low HIV prevalence might be explained by a cohort that was mostly married, and at home. Novel HIV prevention interventions may choose to focus on young, single and long-haul truck drivers.