HIV and STD prevalence among bus and truck drivers in Cameroon

It is generally accepted that transport workers will have a higher level of seroprevalence than the general population--and that their employment means that they are at greater risk. There have been a few studies on this, primarily in east Africa. Among the studies reported in Yokohama was a 1993 survey of 128 truck drivers in Douala and 40 bus drivers in Ekok (on the Cameroon-Nigerian border). The survey found that drivers (whose mean age was 24.5 years) spent an average 14 days away from home on each trip. As might be expected there was a high incidence of seeking partners away from home, 62% had sex during the trip and 25% had sex every night they were away. The main partners were commercial sex workers, followed by girl friends. Drivers had high levels of STDs. 50% had had gonorrhea during the past six months, while 16% had had syphilis. As might be expected, the level of HIV prevalence were also high. 15% of drivers tested positive, the third highest prevalence in the country after commercial sex workers (35%) and prisoners (17%). The conclusion was that special prevention messages should be designed for drivers. The first need is to see the groups as a target who need to change their behavior, the second is to look at the determinants of this behavior and to seek to change the environment in which the drivers operate. For example, can the trips be shorter? Could drivers be encouraged to take partners with them? There is a need to move beyond the simple measuring of prevalence and identifying of the "risk groups" to looking at the socioeconomic setting in which they operate.