Getting the HIV/AIDS message to truckers and sex workers

Long-distance truck drivers on the Mombasa-Kampala highway often spend fewer than 40 days a year at home, according to Kenyan government data. They depend on the hospitality of local inns for shelter, local eateries for food, and local women for company. "When we are on the road, away from home, it gets lonely. We need to have someone to talk to, to entertain us - that's why you find us with these women," said John Maina (not his real name), who regularly travels between Rwanda and Mombasa on the Kenya coast. Without the truckers and their assistants, highway towns would wallow in the same poverty as neighbouring villages, but opportunities are still very limited. Illiteracy among local women keeps them from finding formal employment, and poverty drives them to prostitution. The downside is that towns like Malaba have become AIDS "hotspots", with tens of thousands of people dying from AIDS-related illnesses in the past two decades. "It has been well documented that transport workers and truck drivers in East Africa and Kenya are at much higher risk for HIV than the general population," said a study conducted by the Ministry of Transport and the National AIDS Control Council in 2005. "A survey at Athi River [a highway town in central Kenya] of 970 drivers and assistants at a roadside clinic showed a 27 percent HIV prevalence." Kenya's average HIV infection level is estimated at about six percent. The African Medical and Research Foundation (AMREF), in partnership with the United States Agency for International Development (USAID) and UNAIDS, is running an HIV/AIDS education programme targeting commercial sex workers and truck drivers in major highway towns. "We work in the [Kenyan] towns of Mariakani, Voi, Mlolongo, Naivasha, Salgaa, Malaba and Busia," said Timon Mainja, who manages the AMREF Truckers' Project. "Our aim is to get the truck drivers and their partners to take preventive methods when they engage in sex." The USAID-funded Kenya Long Distance Truck Drivers Welfare Association runs a 'Safe-T Stop' in a converted freight container where truck drivers can relax, play pool and watch movies in Malaba. WORKING WITH THE COMMUNITY The walls of Malaba's bars and restaurants are plastered with posters warning people to avoid excessive alcohol consumption, which often leads to risky sexual behaviour. "We are not here to judge anyone. We are not saying stop selling alcohol or stop selling sex," said Michael Ajwang', who manages the AMREF project in Malaba. "We just want people to be more responsible so they can remain healthy." The AMREF project runs a centre where it regularly meets with sex workers, encouraging them to use protection and pass on the message to their peers and other members of the community, and teaches alternative ways to earn a living. Condoms are available around the clock from a dispenser. "Several commercial sex workers have quit that line of work, fearing the danger of contracting HIV, and are now involved in small-scale businesses," Ajwang' commented. Rispa Mora, 29, says she got out of the sex business because, once she learned about HIV, it became too risky for her. She now teaches her former colleagues about the dangers of the virus and urges them always to use condoms. "I left the work and started a hair salon with my savings, so they can see that it is possible to have a normal life after working in the bars." INTEGRATING THE TRANSPORT COMPANIES AMREF also works with trucking companies to ensure that HIV awareness is incorporated into their policies. Solomon Ndonye, human resources manager at Multiple Hauliers, one of the region's largest transporters, said, "We started our HIV programme in 1999, but joined AMREF's project in 2002. We were experiencing a very high staff turnover because of HIV-related illnesses, so we decided to increase awareness among them." New drivers are taught about HIV during their induction and the process continues during their employment. "We provide counselling and treatment to our HIV-positive drivers," Ndonye said. "And even when they are too ill to work we continue to pay them." Ajwang' feels that although much still needs to be done, "We have seen a lot of behaviour change, especially in terms of both truck drivers and sex workers using condoms more and more. That is our aim - to ensure that they continue to protect themselves from the dangers of HIV and other sexually transmitted infections."