HIV Prevention, Testing, and Treatment for Mobile Populations: Focus on Truck Drivers in Brazil
Council researchers examined an intervention for truckers in southern Brazil that provides comprehensive health services, including HIV and STI services, via a mobile health clinic.
Highly mobile populations, including truck drivers, are key targets for HIV prevention and treatment efforts but can be difficult to reach with traditional programs. Researchers with the Council's Horizons program examined the feasibility and impact of an intervention that combined HIV/sexually transmitted infection (STI) prevention, voluntary counseling and testing (VCT), and general health care services for mobile truckers.
Formative research was carried out in August 2002 and included focus group discussions and in-depth interviews with truckers, commercial sex workers, and customs officials in Foz do Iguaçu, a town on the triple border between Brazil, Argentina, and Paraguay. This research suggested that truckers should optimally be offered services at the customs station, and that they were worried about HIV-related stigma and discrimination. In response, the study team developed the Saude na Estrada ("Health on the Road") project, which in addition to HIV and STI services provided regular health services for truckers in a mobile health unit located inside the customs area of Foz do Iguaçu.
The intervention was evaluated through interviews with 1,775 truckers before the intervention (779 in Foz do Iguaçu and 996 in Uruguaiana, the comparison site) and 2,408 truckers after (1,201 in Foz do Iguaçu and 1,207 in Uruguaiana). Focus group discussions and in-depth interviews also were conducted.
The intervention reached thousands with educational materials and condoms. In addition, a large number of truckers took advantage of VCT services. Almost 2,000 truckers received pre-test counseling for HIV and syphilis, and 1,794 gave a blood sample. 1,492 truckers (83 percent) returned 15 days later for test results and post-test counseling.
Key findings include:
- At baseline, a sizable proportion of truck drivers in the study reported sexual risk behaviors.
- Significant improvements were found in truckers’ access to VCT after intervention.
- Significant increases were found in partner communication about condom use and HIV testing.
- Significant positive changes were seen in condom use with occasional partners and in proportion of truckers with concurrent sexual partners.
- HIV prevalence among truckers was unexpectedly low.
Truckers were highly receptive to the intervention. Almost all of the VCT participants rated services as "great" or "good." Focus groups revealed that truckers strongly recommended the service to their peers. The operation of health services has been transferred to a local university, which will continue providing them free of charge.
HIV-related stigma, service utilization, and status disclosure among truck drivers crossing the Southern borders in Brazil (abstract)
Pulerwitz,Julie; Michaelis,Annie P.; Lippman,Sheri A.; Chinaglia,Magda; Diaz,Juan
AIDS Care 20(7): 764-770
Publication date: 2008
Mobility and its liminal context: Exploring sexual partnering among truck drivers crossing the Southern Brazilian border (abstract)
Lippman,Sheri A.; Pulerwitz,Julie; Chinaglia,Magda; Hubbard,Alan E.; Reingold,Arthur; Diaz,Juan
Social Science and Medicine 65(12): 2464-2473
Publication date: 2007
Reaching truckers in Brazil with non-stigmatizing and effective HIV/STI services (PDF)
Chinaglia,Magda; Lippman,Sheri A.; Pulerwitz,Julie; de Mello,Maeve; Homan,Rick; Diaz,Juan
Horizons Final Report
Publication date: 2007
Reaching truckers in Brazil with non-stigmatizing and effective HIV/STI services (PDF)
Chinaglia,Magda; Lippman,Sheri A.; Pulerwitz,Julie; de Mello,Maeve; Homan,Rick; Diaz,Juan
Horizons Research Summary
Publication date: 2007
Project Stats
Location: Brazil (Foz do Iguaçu, Uruguaiana)
Program(s):
HIV and AIDS
Topic(s):
Behavior change
HIV care, support, and treatment
Mobile populations
RTIs/STIs
Duration: 11/2002 - 8/2006
Non-Council collaborators:
Arthur Reingold (University of California, Berkeley)
DKT International
EADI Customs Administration
Goodyear Tire & Rubber Company
Maria Setubal
National, state, and municipal STI/AIDS programs in Brazil
Pathfinder do Brasil
Sheri Lippman (University of California, Berkeley)
Silvia Pedroso
US Agency for International Development/Brazil
Donors:
Ministry of Health, Brazil
US Agency for International Development
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