Qualitative aspects of HIV transmission in mobile occupations - a global linking of truck drivers and railway workers
C. Grandas, M. Kamani, R. Thapa, E. Venegas, J. Wu
New York University, NYU Master's Program in Global Public Health, New York, United States
Issues: The issue linking migration and HIV is global and affects developed and developing nations alike. Studies demonstrate that increased migration and mobility are risk factors in HIV transmission. Lynch and Marmot's socioeconomic debates contrast the roles played by psychosocial and neo-material influences on individual health. Furthermore, safe sexual behavior positively correlates with education and economic and social well being. Yet, the absence of an international multi sector approach in efforts to combat HIV spread in migrant and mobile populations, and countries heavily relying on a health sector approach model may render HIV prevention efforts ineffective over the long term.
Description: The truck driver group shows a high prevalence of HIV- over 12 times greater than the general population according to a 2004 World Bank Report. Using the truck driver model of migrant workers we examined the qualitative aspects of HIV transmission in railway workers and construction workers across Mexico, China and India through the lens of socioeconomic status including neomaterial and psychosocial conditions leading to HIV transmission, and attitude and perceived risk relating to behaviors and behavior change.
Lessons learned: An in-depth analysis of social trends reveal a lack of macro level structures, stress related to migration, increased vulnerability, loneliness and overall low self risk perception seem to be key emerging factors related to HIV spread. In addition, history of sexually transmitted infections and long hours away from home act as contributing factors.
Next steps: Knowledge of risk behaviors specifically associated with the bridge population and risk mapping to determine areas in which risk behaviors are extensive are important when developing interventions aimed at preventing the spread of HIV and when promoting behavior change. Owing to the advantages of connectivity the transport sector could act as a useful channel when implementing tailored context-specific programs addressing the needs of the migrant population.
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