Kohli, A., Kerrigan, D., Brahmbhatt, H., et al. AIDS Care (January 2017), e-publication ahead of print, doi:10.1080/09540121.2017.1280127.
This analysis described social and structural factors contributing to HIV risk among truck drivers who visited rest stops along the Tanzania–Zambia Highway in Iringa, Tanzania. The authors conducted thematic data analysis (as part of a larger, comprehensive strategic assessment examining HIV risk factors in Iringa) based on 11 in-depth interviews with truck drivers and a transport owner. Interviewees described structural risk factors for HIV, including work conditions, the power imbalance between male drivers and their sexual partners, and low perceived HIV risk with certain partners (e.g., regular partners). The analysis indicated that multiple interrelated social norms associated with truck stop environments influenced HIV risk, including peer influence and expectations, the presence of sex workers, the ability to purchase sex, and alcohol consumption. All drivers interviewed described alcohol consumption as common and often excessive. These factors all contributed to behavior that participants said they would not commonly engage in elsewhere. The authors concluded that HIV prevention strategies with truck drivers should address individual, social, and structural barriers to HIV prevention, and should partner with the health and transportation sectors, local government, and local communities. Strategies suggested by participants included adapting services to drivers’ schedules, offering positive messaging, and addressing the risk environment holistically.