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June 2004 Senators Visit Horizons Border Program for Truckers In December 2003, two United States senators visited Foz do Iguaçu, Brazil, to see an unusual clinic whose work the Population Council is evaluating. The senators were Tom Harkin of Iowa and Ernest Hollings of South Carolina, and the clinic—called Saúde na Estrada (“health on the road”)—serves truck drivers while their rigs are parked nearby. Two years earlier, the U.S. Agency for International Development (USAID/Brazil) and the Brazilian Ministry of Health had asked the Population Council/Brazil to assess the prevalence of HIV/AIDS in six border communities. This research identified areas with the highest incidence of HIV and with high-risk social conditions, such as the presence of prostitution. These results became the springboard for a new initiative by the Council-led Horizons Program—with technical assistance and partial funding by USAID/Brazil—to design and support the ministry in implementing a prevention and care center for truck drivers.
The clinic is in Foz do Iguaçu, a city of about a quarter million inhabitants at the border with Paraguay and Argentina. Each day approximately 400 trucks cross over this border; at any given time as many as 1,500 truckers are in the customs area, which is in close proximity to a red-light district. Truckers are at particular risk for sexually transmitted infections (STIs), including HIV, due to their mobility and their limited access to health care. STIs have been shown to be a significant factor in the spread of HIV globally. Housed in a trailer near customs, the clinic provides easy access for the truckers. Advised by physician and Council principal investigator Juan Díaz, the ministry-trained clinic staff offer general preventive health care, deliver messages intended to decrease high-risk behavior, provide condoms, administer HIV and other tests, offer pre- and post-test education, and treat STIs. By evaluating these strategies, Council researchers hope to develop a replicable program to address the needs of truckers, migrant workers, and other mobile groups elsewhere in Brazil and in neighboring countries. Researchers are preparing an interim report on the project for the XV International AIDS Conference in Thailand, in July 2004. Full analysis of the program is not due until 2005, the final year of its funding from USAID. Meanwhile, as Díaz notes, “We have a better than 90 percent return rate on truckers picking up their test results, which is a very good sign that our health messages are getting through.” Senators Hollings and Harkin conversed at length with the truckers, asking about their lives and work. Horizons researcher M. Silvia Setubal reports that Senator Harkin was particularly enthusiastic: “He paid attention to every detail. And when he left, he said he had ‘good news to take home’ about the program.” See Also
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