Sexual and treatment-seeking behaviour for sexually transmitted infection in long-distance transport workers of East Africa

Objective: To investigate the sexual and treatment-seeking behaviour for sexually transmitted infection ( STI) in long-distance transport workers of East Africa. Methods: A health-seeking behaviour survey was carried out at four sites on the Mombasa-Kampala trans-Africa highway ( n = 381). The questionnaires probed details of STI knowledge, symptoms and care-seeking behaviour. In one site at the Kenya-Uganda border, a sexual patterning matrix was used ( n = 202) to measure sexual behaviour in truck drivers and their assistants over the 12-month period before the interview. Results: Over half of the sexual acts of long-distance transport workers over 12 months were with female sex workers, with an annual average of 2.8 sexual partners. Condom use was reported at 70% for liaisons with casual partners. 15% of truckers had had a self-reported STI and one-third exhibited high-risk sexual behaviour in the previous year. Of those with an STI, 85% had symptoms when on the road and 77.2% sought treatment within 1 week of onset of symptoms. 94% of drivers and 56% of assistants sought treatment for STI in a private health facility or pharmacy. The cost of private facilities and pharmacies was not significantly higher than in the public sector. Waiting times were three times longer in the public sector. Only 28.9% of patients completed their medication courses as prescribed. Conclusions: Truck drivers and their assistants in East Africa have high rates of reported STIs and many continue to exhibit high-risk sexual behaviour. The transport workers studied here favoured private health facilities because of convenience and shorter waiting times.