Non-stigmatizing HIV/STI services in border areas in Southern Brazil reduce truckers' HIV risk behaviors

Truckers and other mobile populations are particularly vulnerable to HIV/STI due to a high prevalence of risk behaviors and limited access to health services. To determine how to reach truckers crossing international borders in Southern Brazil and change their behaviors, an intervention study was implemented. Formative research revealed that truckers felt stigmatized as vectors of HIV and would prefer broader health services. The resulting intervention consisted of a health post within the customs station providing HIV/STI-focused services (e.g., VCT) and other services (e.g., glucose tests), plus education and condom distribution. Data were collected from male truckers passing through the customs stations of two towns (intervention and comparison) - at baseline (n=1,775) and 2 years later (n=2,415). Qualitative interviews with truckers were conducted following the intervention. At baseline, truckers reported substantial sexual risk behaviors; 45% had more than one partner over the past six months and less than half had ever been tested for HIV. Following the intervention, ever having an HIV test increased 49% in the intervention site and 15% in the comparison site (p<0.01). Reported communication with partners about condoms, HIV testing, and STIs increased (p<0.05) in the intervention site, but not the comparison site. Condom use with occasional partners increased 21% (p<0.05) in the intervention site and decreased 2.5% in the comparison site. Further, the strategy of offering both HIV/STI and non-HIV related services was perceived positively by truckers. Offering more comprehensive services for truckers is one way of reaching and positively impacting their behaviors.