AIDS: Volume 14(6) 14 April 2000 Pp 756-758

AIDS:Volume 14(6)14 April 2000pp 756-758

HIV prevention information, motivation, behavioural skills and behaviour among truck drivers in Chennai, India

Bryan, Angela D.a; Fisher, Jeffrey D.b; Benziger, T. Josephc

aDepartment of Psychology, CB345, University of Colorado, Boulder, CO 80309-0345, USA; bDepartment of Psychology, U-20, University of Connecticut, Storrs, CT 06269-1020; cBenziger Foundation, No. 37/15, Natesan Street, T. Nagar, Chennai 600 017, India

Received: 23 December 1999; accepted: 12 January 2000.

Approximately 5 million people in India are infected with HIV [1]. Public health agencies (e.g. the World Health Organization, UNAIDS, Centers for Disease Control and Prevention) cite India as a high priority for HIV prevention [2]. HIV seroprevalence and transmission modes vary according to the geographical location in India[3,4], however two generalizations can be made. First, unprotected heterosexual intercourse is the most common mode of HIV transmission in India[2,5-7]. Second, long-distance truck drivers and commercial sex workers (CSW) are seen as critical sources of HIV risk and transmission [7,8]. The goal of this study was to ascertain the levels of Indian truck drivers' HIV prevention information, motivation, and behavioural skills; constructs shown to be related to HIV prevention behaviour across populations [9-13]. Their levels of risky and safer behaviour were also ascertained. Data were analysed using SAS version 6.12 for Windows (SAS Institute, Cary, NC, USA).

Face-to-face structured interviews were conducted in Fall 1998, with 300 male truck drivers in Chennai, the leading industrial and commercial port in southeastern India. Drivers come from all parts of the country and usually stay for between half a day and 3 days. In our sample, over half (52%) belonged to the backward class, 28% most backward class, 7% forward class, 1% scheduled tribe, and 12% scheduled caste. Ages ranged from 20 to 45 years (mean 30.8 years), and most (81%, n = 242) were married. Most were Hindu (61%), and the majority (77%) had not completed high school. Ten per cent reported having had a sexually transmited disease, and 7% (n = 22) reported having had an HIV test. Of those, 15 tested negative, six tested positive, and one did not know his serostatus. Means and statistical tests for differences between married and unmarried truck drivers in overall levels of HIV prevention information, motivation, and behavioural skills for condom use appear in Table 1. Behavioral data appears in the text.

Table 1. Mean levels of HIV prevention information, motivation, and behavioural skills among married and unmarried truck drivers. Standard deviations appear in parentheses beside the means.aNumber correct out of 12 items.bConstructs measured on 1-5 scales, with higher numbers indicating more positive endorsement of the construct. Refers to HIV prevention motivation and behavioural skills for condom use with non-marital partners only.

Information questions were answered with binary true/false response scales, and answers were summed to produce scale scores for the table. Concerning individual information items, only 14% of respondents knew that using condoms could reduce HIV transmission, and only 13% knew that oil-based lubricants should not be used with condoms. More than half (59%) incorrectly believed that condoms only need to be used with CSW. On a more positive note, 92% knew that it was unsafe to reuse a condom, 75% knew that there is currently no vaccine and 79% knew that there is no cure for AIDS. As can be seen in Table 1, married men were better informed than unmarried men, but overall both groups were poorly informed, answering less than half of the 12 questions correctly.

With respect to motivation, attitude and intention questions were answered on five-point scales in which 1 = `disagree a lot' and 5 = `agree a lot'. Married men had extremely negative attitudes about using condoms with their wives, disagreeing strongly that it would be good to use condoms with them (M = 1.58). They had more positive attitudes and slightly higher intentions than did unmarried men towards using condoms with non-marital partners (see Table 1). The perceived risk of HIV was virtually non-existent. Means in Table 1 indicate that both married and unmarried participants perceived almost no risk of contracting HIV/AIDS (1 = `no chance'; 5 = `very high chance').

Behavioural skills were answered on a five-point scale in which 1 = `very hard to do' and 5 = `very easy to do'. Most married participants said it would be sort of hard (21% responded `2' on the above scale) or very hard (51% responded `1' on the above scale) to use condoms all the time with their wife. As can be seen in Table 1, condom use skills with non-marital partners for both groups were stronger, in the `neither hard nor easy' range, with married men reporting higher skills than non-married men.

The average lifetime sexual partners among married men was 6.72, range 1-40. Less than 1% reported `always' using condoms with their wives. Most (96%) married participants reported having intercourse with women other than their wives, and 74% reported intercourse with a CSW. Sexual activity and condom use were slightly more frequent with non-marital partners than with wives among married men, although only 2% reported always using condoms with non-marital partners. Most (93%) non-married participants had had intercourse, and 76% of those reported intercourse with a CSW. Only 2% of unmarried men reported always using condoms.

The results indicate that interventions are urgently needed to increase HIV prevention information, motivation, and behavioural skills in order to decrease HIV risk behaviour among Indian truck drivers and their sexual partners.

Angela D. Bryana

Jeffrey D. Fisherb

T. Joseph Benzigerc

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