This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Job Bwayo, MBChB, PhD; Francis Plummer, MD; Mohamed Omari, MSc; Ann Mutere, MSc; Stephen Moses, MD, MPH; Jeckoniah Ndinya-Achola, MBChB, MSc; Priscilla Velentgas; Joan Kreiss, MD, MSPH

Arch Intern Med. 1994;154(12):1391-1396.

Abstract
Background
A cross-sectional survey was performed to determine the seroprevalence and correlates of human immunodeficiency virus (HIV) infection among long-distance truck drivers in Kenya.

Methods
Truck drivers along the Mombasa-Nairobi highway were enrolled at a roadside research clinic. A standardized interview and serologic evaluation for HIV and syphilis were conducted.

Results
We enrolled 970 truck drivers and their assistants of whom 257 (27%) had HIV antibodies. In univariate analysis, HIV infection was correlated with older age, non-Kenyan nationality, Christian religion, longer duration of truck driving, travel outside of Kenya, less frequent visits to wives, and more frequent visits to prostitutes. Uncircumcised status, history of genital ulcer disease or urethritis during the previous 5 years, and a positive Treponema pallidum hemagglutination assay for syphilis were each associated with positive HIV serostatus. Univariate correlates of uncircumcised status included younger age, non-Kenyan nationality, Christian religion, travel outside of Kenya, and less frequent visits to prostitutes. There was a significant association between uncircumcised status and 5-year history of genital ulcer disease or serologic evidence of syphilis, but not with 5-year history of urethritis. In multivariate analysis, HIV infection was independently associated with uncircumcised status (adjusted odds ratio [OR], 4.9; 95% confidence interval [CI], 2.8 to 8.4), history of genital ulcer disease (adjusted OR, 2.4; 95% CI, 1.5 to 4.1), history of urethritis (adjusted OR, 1.8; 95% CI, 1.1 to 2.9), more frequent sex with prostitutes (more than once per month; adjusted OR, 1.7; 95% CI, 1.1 to 2.8), and positive T pallidum hemagglutination assay (adjusted OR, 1.2; 95% CI, 1.0 to 1.4). The attributable risk percentage for the association between HIV and uncircumcised status was 70%, and the population attributable risk was 25%.

Conclusions
Truck drivers in east Africa are at high risk of HIV infection. The strongest correlates of HIV sero-positivity were uncircumcised status and history of both ulcerative and nonulcerative sexually transmitted diseases.

(Arch Intern Med. 1994;154:1391-1396)

Author Affiliations
From the Department of Medical Microbiology, University of Nairobi (Kenya) (Drs Bwayo and Ndinya-Achola, Mr Omari, and Ms Mutere); Department of Medical Microbiology, University of Manitoba, Winnipeg (Drs Plummer and Moses); and Departments of Epidemiology and Medicine, University of Washington, Seattle (Ms Velentgas and Dr Kreiss).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Male Circumcision for the Prevention of Acquisition and Transmission of Sexually Transmitted Infections: The Case for Neonatal Circumcision
Tobian et al.
Arch Pediatr Adolesc Med 2010;164:78-84.
ABSTRACT | FULL TEXT  

Risk Assessment and Screening for Sexually Transmitted Infections, HIV, and Hepatitis Virus Among Long-Distance Truck Drivers in New Mexico, 2004-2006
Valway et al.
AJPH 2009;99:2063-2068.
ABSTRACT | FULL TEXT  

GenGIS: A geospatial information system for genomic data
Parks et al.
Genome Res 2009;19:1896-1904.
ABSTRACT | FULL TEXT  

HIV infection and associated risk factors among long-distance truck drivers travelling through Azerbaijan
Botros et al.
Int J STD AIDS 2009;20:477-482.
ABSTRACT | FULL TEXT  

Male Circumcision for the Prevention of HSV-2 and HPV Infections and Syphilis
Tobian et al.
NEJM 2009;360:1298-1309.
ABSTRACT | FULL TEXT  

Prevalence and risk factors for Chlamydia trachomatis infection among cross-border truck drivers in Hong Kong
Leung et al.
Sex. Transm. Infect. 2009;85:27-29.
ABSTRACT | FULL TEXT  

Epidemiologic and Clinical Characteristics of HIV/AIDS Patients in Turkey, Where the Prevalence Is the Lowest in the Region
Celikbas et al.
J Int Assoc Physicians AIDS Care (Chic Ill) 2008;7:42-45.
ABSTRACT  

Sexual and treatment-seeking behaviour for sexually transmitted infection in long-distance transport workers of East Africa
Morris and Ferguson
Sex. Transm. Infect. 2007;83:242-245.
ABSTRACT | FULL TEXT  

HIV Infection Among Transport Workers Operating Through Siliguri-Guwahati National Highway, India
Bal et al.
J Int Assoc Physicians AIDS Care (Chic Ill) 2007;6:56-60.
ABSTRACT  

Assessment of condom use among Bolivian truck drivers through the lens of social cognitive theory
Sorensen et al.
HEALTH PROMOT INT 2007;22:37-43.
ABSTRACT | FULL TEXT  

Circumcision Status and Risk of Sexually Transmitted Infection in Young Adult Males: An Analysis of a Longitudinal Birth Cohort
Fergusson et al.
Pediatrics 2006;118:1971-1977.
ABSTRACT | FULL TEXT  

Estimation of the sexual transmission of HIV in Kenya and Uganda on the trans-Africa highway: the continuing role for prevention in high risk groups
Morris and Ferguson
Sex. Transm. Infect. 2006;82:368-371.
ABSTRACT | FULL TEXT  

Male circumcision and risk of syphilis, chancroid, and genital herpes: a systematic review and meta-analysis.
Weiss et al.
Sex. Transm. Infect. 2006;82:101-110.
ABSTRACT | FULL TEXT  

HIV/AIDS Prevention Among the Male Population: Results of a Peer Education Program for Taxicab and Tricycle Drivers in the Philippines
Morisky et al.
Health Educ Behav 2005;32:57-68.
ABSTRACT  

The Social Epidemiology of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome
Poundstone et al.
Epidemiol Rev 2004;26:22-35.
FULL TEXT  

Sexually transmitted infections in male clients of female sex workers in Benin: risk factors and reassessment of the leucocyte esterase dipstick for screening of urethral infections
Alary et al.
Sex. Transm. Infect. 2003;79:388-392.
ABSTRACT | FULL TEXT  

Response of a sexually transmitted infection epidemic to a treatment and prevention programme in Nairobi, Kenya
Moses et al.
Sex. Transm. Infect. 2002;78:i114-120.
ABSTRACT | FULL TEXT  

STD in Bangladesh's trucking industry: prevalence and risk factors
Gibney et al.
Sex. Transm. Infect. 2002;78:31-36.
ABSTRACT | FULL TEXT  

Prevalence of infectious diseases in Bangladeshi women living adjacent to a truck stand: HIV/STD/hepatitis/genital tract infections
Gibney et al.
Sex. Transm. Infect. 2001;77:344-350.
ABSTRACT | FULL TEXT  

Human immunodeficiency virus, hepatitis B, C and D in Bangladesh's trucking industry: prevalence and risk factors
Gibney et al.
Int J Epidemiol 2001;30:878-884.
ABSTRACT | FULL TEXT  

A Trade-off Analysis of Routine Newborn Circumcision
Christakis et al.
Pediatrics 2000;105:246-249.
ABSTRACT | FULL TEXT  

Circumcision Policy Statement
Task Force on Circumcision
Pediatrics 1999;103:686-693.
ABSTRACT | FULL TEXT  

Human Immunodeficiency Virus Seroprevalence in an Occupational Cohort in a South African Community
Kravitz et al.
Arch Intern Med 1995;155:1601-1604.
ABSTRACT