Field Note

AIDS in India: Sex Workers and Truck Drivers Playing Vital Roles

By Mohammad Khairul Alam
AIDS Researcher
Rainbowngo@gmail.com

AIDS is a pandemic that kills millions, destroys families and communities and renders millions of children parentless. It threatens the social and economic fabric of many nations.

Truck drivers have been and continue to be a main force in the spread of HIV to epidemic proportions. They work long hours on the road and often spend several days in one place clearing customs or resolving mechanical problems. They turn to sex workers who are at high risk of being HIV/AID positive. As a result, the drivers have high rates of HIV. Their highly mobile lifestyle requires a lot of travel. In other stopover town locations they visit other commercial male/female sex workers thereby potentially transmitting the virus. In addition, many of the truck drivers are married and also have girlfriends (commercial sex partner) who are likely to become infected with HIV and become a pool in their local communities.

Truck drivers and commercial sex workers constitute core transmitter populations of HIV/AIDS throughout India. The sexual interactions between these particular groups are conducive to population-wide HIV/AIDS transmission. Other evidence supports the view HIV was introduced to Indian populations with pre-existing patterns of sexual behavior that have long been susceptible to high STI/STDs rates.

While, a majority of truck drivers have heard of HIV/AIDS, the extent of knowledge about specific aspects of HIV/AIDS was less consistent. Correct knowledge of transmission by sexual contact was found in two-thirds (Bombay). Several studies have attempted to elucidate the percentage of truck drivers who actually do have sex with commercial sex workers (CSWs) and if so, how often they do. Some 80 percent of the truck drivers are frequenting CSW.

Commercial sex workers (CSWs) have sex with different populations of men depending on their class. Some of the CSWs' contacts were with regular partners. CSWs tend to be a highly mobile population and one of the main factors placing CSWs in high-risk categories is that they have multiple partners. Usage of condoms is still low among the truck driver population; however, it seems to be increasing. While use of condoms seems to range between 25 and 60 percent, knowledge surrounding condom use seems to be uneven. Some 90 percent of the truck drivers know condoms prevent transmission of HIV, but many drivers were not aware of the proper storage techniques or proper usage.

The classification of the partners of truck drivers is complex and not standardized across studies or, at times, within studies. Distinguishing between a casual and regular partner is often ambiguous. Many truck drivers report that they have had large numbers of sexual partners. About one-third of the drivers reported more than 50 lifetime partners. The number of partners in the recent past indicates a driver's current sexual behavior trend.

A recent survey of Bangladeshi track drivers conduct by the Rainbow Nari O Shishu Kallyan Foundation found that 80 percent of truck driver in Bangladesh have no clear concept of HIV or AIDS. But 90 percent respond it is a deadly disease. India is the second largest HIV/AIDS infected country in the world, more then 5.2 million people are living with AIDS or HIV. India is a neighboring country of Bangladesh, and every day many people cross borders both officially and also illegally.

Reference: UNAIDS, UNICEF, World Bank