Harbingers of HIV infection

With their risky behaviours and prevalence of STDs, truckers in Bangladesh pose a risk for spread of HIV, confirms a study by Gibney et al. Unusually for a developing country, the prevalence of HIV infection in Bangladesh is low.

Gibney et al determined the prevalence of STDs—syphilis, HSV-2, gonorrhoea, and chlamydia—and associated risk factors—demographic, sexual behaviours, and lifestyle (taking drugs or drinking alcohol). In a cross sectional study they recruited a final number of 388 truckers—245 drivers and 143 helpers—about 10 from each of 38 agencies selected randomly from the 185 agencies at the largest truck stand in Dhaka. Blood and urine samples were tested for evidence of STDs, and the other information was obtained with a structured questionnaire during interviews.

HSV-2 infection was high (26%), as was syphilis (6%), whereas gonorrhoea and chlamydial infection were low (2%, <1%, respectively). The only significant risk factor for bacterial infections was sex with a female commercial sex worker in the past year (odds ratio 3.54, 95% confidence interval 1.29 to 9.72) and for HSV-2 was being a helper rather than a driver on cross district routes (2.51, 1.13 to 5.55).

Bangladeshi truckers showed behaviour typical of the industry, having unprotected sex with multiple sexual partners, including their wives, sex workers, and other men. Although widely available, condoms were not used much, if at all. Convincing this group of the protection condoms afford is crucial to minimise the future spread of AIDS, given the high prevalence of HSV-2 and syphilis—both associated with spread of HIV.