HIV Infection, Genital Symptoms and Sexual Risk Behavior among Indian Truck Drivers from a Large Transportation Company in South India

BACKGROUND: Sentinel surveillance conducted in the high Human Immuno-deficiency Virus (HIV) prevalent state of Andhra Pradesh includes sub-populations thought to be at high-risk for HIV, but has not included truck drivers. Novel HIV prevention programs targeting this population increasingly adopt public - private partnership models. There have been no targeted studies of HIV prevalence and risk behavior among truck drivers belonging to the private sector in India. METHODS: A sample of 189 truck drivers, aged between 15 and 56, were recruited from Gati Limited's large trucking depot in Hyderabad, India. A quantitative survey instrument was conducted along with blood collection for HIV 1/2 testing. Multivariate regression models were utilized to determine predictors of HIV infection and risk behavior. RESULTS: 2.1% of subjects were infected with HIV. Older age was protective against self-reported genital symptoms (OR = 0.77; P = 0.03), but these were more likely among those truck drivers with greater income (OR = 1.05; P = 0.02), and those who spent more time away from home (OR = 25.7; P = 0.001). Men with higher incomes also reported significantly more sex partners (OLS coefficient = 0.016 more partners / 100 rupees in monthly income, P = 0.04), as did men who spent a great deal of time away from home (OLS coefficient = 1.30, P = 0.002). Drivers were more likely to report condom use with regular partners if they had ever visited a female sex worker (OR = 6.26; P = 0.002), but married drivers exhibited decreased use of condoms with regular partners (OR = 0.14, P = 0.008). Men who had higher levels of knowledge regarding HIV and HIV preventative practices were also more likely to use condoms with regular partners (OR = 1.22, P = 0.03). CONCLUSION: Time away from home, urban residence, income, and marital status were the strongest correlates of genital symptoms for Sexually Transmitted Infections (STI) and risk behaviors, 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 be most cost effective when focusing upon young, single, and long-haul truck drivers.