STD in Bangladesh's trucking industry: prevalence and risk factors.

ABSTRACT

OBJECTIVES: This study characterises the prevalence of a broad spectrum of sexually transmitted diseases (STDs) (herpes simplex virus 2, syphilis, chlamydia, gonorrhoea), and examines associations between risk factors and infection in men working in Bangladesh's trucking industry. Given the high risk sexual behaviours of truck drivers and helpers in many contexts, as well as the direct health effects of STDs and their role in facilitating HIV transmission, it is important to understand the prevalence of STDs and associated risk factors in this population. METHODS: A cross sectional study was conducted at Tejgaon truck stand, one of the largest truck stands in Dhaka, the capital city. The study group, comprising 388 truck drivers and helpers, was selected via a two tiered sampling strategy. Of 185 trucking agencies based at the truck stand, 38 agencies were randomly selected, and a mean of 10 subjects (drivers/helpers) were recruited from each agency. Urine and blood samples were collected from subjects after an interview about their lifestyle and a comprehensive physical examination. Gold standard laboratory tests were conducted for the detection of STD. Multiple logistic regression was used to assess associations between infections and potential risk factors. RESULTS: The levels of prevalence of disease were HSV-2 (25.8%), serological syphilis (5.7%), gonorrhoea (2.1%), chlamydia (0.8%). For infection with any bacterial STD (syphilis, gonorrhoea, or chlamydia) the only significant risk factor was having sex with a commercial sex worker in the past year (OR=3.54; CI=1.29-9.72). For HSV-2, truck helpers working primarily on interdistrict routes were significantly more likely to be infected than drivers working on these routes (OR=2.51, CI=1.13--5.55). CONCLUSIONS: The high prevalence of HSV-2, and to a lesser extent syphilis, and the low levels of condom use despite high numbers of casual sexual partners, illustrate the importance of promoting condom use, particularly in commercial sexual encounters, to men in Bangladesh's trucking industry.