DECREASED INCIDENCE OF SEXUALLY-TRANSMITTED DISEASES AMONG TRUCKING COMPANY WORKERS IN KENYA - RESULTS OF A BEHAVIORAL RISK-REDUCTION PROGRAM

Objective: To establish a cohort of high-risk individuals suitable for HIV-prevention trials, and to measure changes in sexual behaviour and sexually transmitted disease (STD) incidence after a behavioural inte rvention. Design: Prospective cohort study in trucking company depots in Mombasa, Kenya.Participants: A total of 556 male HIV-seronegative e mployees of trucking companies. Interventions: HIV serological testing , individual counselling, condom promotion, STD diagnosis and manageme nt. Main outcome measures: Sexual risk behaviour and symptomatic STD i ncidence. Results: Using time-trend modelling, significant declines in self-reported high-risk sexual behaviour were demonstrated during a 1 -year follow-up. The percentage of men reporting any extramarital sex during the 3-month period prior to a follow-up visit decreased from 49 % during the first quarter of follow-up to 36% during the last quarter (P < 0.001). The decline in reported female sex worker contact was fr om 12% to 6% (P = 0.001). Approximately 30% of men reported consistent condom use during extramarital sex and this percentage remained uncha nged during the study period. The incidence of STD declined from 34 pe r 100 person years (PY) during the first quarter to 10 per 100 PY duri ng the last quarter (P = 0.001). Significant reductions in gonorrhoea (15 to five cases per 100 PY, P = 0.04), non-gonococcal urethritis (10 to two cases per 100 PY, P = 0.05), and genital ulcer disease (nine t o two cases per 100 PY, P= 0.02) were observed. Conclusions: Among tru ck company workers who participated in a cohort study in Mombasa, Keny a, there was a significant decrease in sex with high-risk partners, bu t no change in condom use. The change in heterosexual risk behaviour w as accompanied by a significant decrease in incidence of gonorrhoea, n on-gonococcal urethritis, and genital ulcer disease.