Mo0PB02 03 Lubna Bhatti

High risk sexual practices of long distance truck drivers: experience from Pakistan BSS 2006: 

High risk sexual practices of long distance truck drivers: experience from Pakistan BSS 2006 Lubna I. Bhatti 1, Naseer Nizamani 1, Hasan Raza 1, Asma Bokhari 2 1 Family Health International, Pakistan 2 National AIDS Control Program, Ministry of Health, Pakistan

Long distance truck drivers: 

Long distance truck drivers

Slide3: 

Lahore Karachi Sukkur D.G.Khan Gujranwala Peshawar Quetta Taxila Torkham Okara Approximately 100,000 truck drivers and cleaners

Study Objectives: 

Study Objectives

Data Source : 

Data Source

Sampling Strategy: 

Sampling Strategy

Definitions : 

Definitions Long Distance Truck Drivers Driving more than 160 km one way on average Assistants (Cleaners) Assisting the drivers in either driving or maintenance of the trucks More than 16 years old

Sample Size: 

Sample Size

Socio-demographic characteristics and truckers life style: 

Socio-demographic characteristics and truckers life style

Baseline Characteristics: Demographic: 

Baseline Characteristics: Demographic

Baseline Characteristics: lifestyle: 

Baseline Characteristics: lifestyle

Sexual history : 

Sexual history %

Sexual network: 

Sexual network

Female sexual partners in last 12 months: 

Female sexual partners in last 12 months %

Condom use with female sexual partners: 

Condom use with female sexual partners %

Male sexual partners: 

Male sexual partners %

Male sexual partners in last 12 months: 

Male sexual partners in last 12 months %

Condom use with male sexual partners: 

Condom use with male sexual partners %

Unprotected sex: 

Unprotected sex

Summary : 

Summary

Limitations: 

Limitations

Recommendations: 

Recommendations

Acknowledgments: 

Acknowledgments

Questions?: 

Questions?

Type of male partners: 

Type of male partners

Trends of risky sex practices: 

Trends of risky sex practices

Estimated number of trucks : 

Estimated number of trucks

Survey Instrument: 

Survey Instrument

Survey Instrument: 

Survey Instrument

Sample Size: 

Sample Size

Time Location Cluster Sampling (TLCS): 

Time Location Cluster Sampling (TLCS)

History of STI symptoms in last year: 

History of STI symptoms in last year

Next steps: 

Next steps

Current living arrangements: 

Current living arrangements

Epidemiology of HIV in Pakistan: 

Epidemiology of HIV in Pakistan 1987- First case of HIV in a Pakistani citizen Late 1980s and 1990s, mostly men living or traveling abroad 1993 - First recognized HIV transmission through breastfeeding During 1990s, HIV/AIDS in sex workers, IDU and jail inmates

Epidemiology of HIV in Pakistan: 

Epidemiology of HIV in Pakistan Pakistan is a low-prevalence high-risk country Official number – 3073 Projected estimates 85,000 Pakistanis infected with HIV HIV Positive 69.5% of HIV positive are between 20-49 years 44.1% acquired through sexual contact Male to female ratio is 7:1

Epidemiology of HIV in Pakistan: 

Epidemiology of HIV in Pakistan Source: National RTI Study 2004. NACP Pakistan

Slide38: 

Commercial Male-Female sexual contact in the past month Source: National RTI/STI study NACP, Pakistan 2004

Condom use in commercial sex: 

Condom use in commercial sex Karachi Lahore

STI Symptoms in high risk groups - Pakistan: 

STI Symptoms in high risk groups - Pakistan Source: National RTI Study 2004. National AIDS Control Program Pakistan

STI care seeking behavior- high risk groups: 

STI care seeking behavior- high risk groups

If we look at behaviours…: 

If we look at behaviours… It is highly likely that the virus will now spread rapidly First through injecting drug networks Then to sex partners of IDU And then through non-injecting sex, especially anal sex HIV will exploit the overlapping risk behaviours that are common in Pakistan Commercial sex among IDU Bisexual behaviour among many male groups

Contents of Package: 

Contents of Package Implement appropriate strategic behavioral communication (SBC) strategies Provide lubricant and condom education and distribution Provide PHC curative services and services for STIs through Clinical Service Delivery Outlets Provide access to VCT services Promote an enabling environment in the project area

Goals: 

Goals Keep HIV prevalence low among target population Reduce new syphilis infections Increase condom use by 60% over baseline rates in extra/premarital sexual acts by truck drivers, cleaners and associated populations.

Targets: 

Targets Knowledge – an 80% increase over baseline of the target population Attitudes – a 70% increase over baseline of the target population’s expression of positive attitudes Skills – a 70% increase over baseline of the target population’s ability Behavior – a 60% increase over baseline of the number of members of the target population