Abstract
ABSTRACT Background: Female sex workers (FSWs) and long distance truck drivers (LDTDs) are considered key populations at high risk for HIV transmission due to high prevalence. The intersection of these mobile populations presents unique challenges in the fight against HIV and the movement towards reducing new infections. Objective: The purpose of this study was to explore the nature of sex trade along a particular transport route. Sexual transactions and the vulnerabilities that exist between these two groups with regards to HIV/AIDS are described, with the purpose of furthering the agenda for targeted interventions. Methods: Qualitative in-depth interviews were conducted with 14 participants, seven FSWs and seven LDTDs. We recruited FSWs through snowballing, and LDTDs through intercepts at truck stops. Semi-structured interview guides were used for data collection, and thematic analysis was conducted. Results: The sex trade in this study is characterized by competition, fuelled by money-driven and age-disparate rivalry. Despite widespread HIV knowledge, FSWs contend with persistent challenges regarding condom use negotiation, induced by more money in the exchange for unsafe sex. Despite the placement of wellness centres in truck stops along the highway, LDTDs face stigma related challenges with regards to testing for HIV and personal acknowledgement of their involvement in the sex trade. Conclusion: The nature of the sex trade along the highway continues to be risky despite the availability of HIV testing and antiretroviral treatment (ART). The sex trade is perceived to be increasing along trucking routes, in spite of measures instituted to limit access to FSWs. FSWs struggle to cope with the pressure of unprotected sex because of the need to generate more income, as well as avoid incidents of violence and threats. Interventions along transport routes need to be inclusive of FSWs who could play a vital role in stigma reduction amongst LDTDs through peer education.
Highlights
Female sex workers (FSWs) and long distance truck drivers (LDTDs) are considered key populations at high risk for HIV transmission due to high prevalence
Countries in Eastern and Southern Africa have seen a significant decline in the number of new HIV infections, from 1.7 million in 2001 to 1.2 million in 2011.[1]. Countries such as Swaziland and South Africa have shown rates of decline in new infections ranging between 25 and 49% in the adult population in 2001–2011.[1]. These remarkable declining trends can be attributed to protective factors such as increased condom use, increased access to antiretroviral treatment (ART), and progress in preventing mother to child transmission.[1]
We explored sexual transactions and vulnerabilities manifesting at the nexus between FSWs and LDTDs, with the purpose of furthering the agenda for targeted and tailored health promotion and interventions
Summary
Female sex workers (FSWs) and long distance truck drivers (LDTDs) are considered key populations at high risk for HIV transmission due to high prevalence. Key populations are poorly represented in national HIV surveillance studies and health care interventions because they are perceived as difficult to access.[3,5,6] FSWs, by the nature of their work, are exposed to stigmatization, discrimination, and vulnerability to arrest, which inhibit them from seeking health care.[5,6,7,8,9] As a consequence of high numbers of their multiple sexual partners, high frequency of sexual exposure, and low levels of condom use, FSWs are at high risk of contracting HIV and other sexually transmitted infections.[10,11,12] A recent study conducted along the N3 highway between Kwa-Zulu Natal and Free State in South Africa reported 90.6% HIV prevalence among FSWs.[13] FSWs are exposed to genderbased violence and physical abuse, which places
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