Highway cowboys, old hands, and Christian truckers: risk behavior for human immunodeficiency virus infection among long-haul truckers in Florida

This paper reports the results of ethnographic research to describe risk fo r human immunodeficiency virus (HIV) infection among long-haul truck driver s and the contexts and factors that influence risk and protective behaviors . Drivers were selected using purposive and snowball sampling at trucking-r elated businesses along major truck routes in Florida. Interview informatio n was used to categorize truckers' levels of potential risk, describe behav ioral characteristics of each group, identify sex partners, and assess perc eptions of the risk of HIV infection. One-third of the 71 men interviewed h ad frequent sexual intercourse on the road with multiple partners, but few ever used condoms. Commercial sex workers were their most frequent partners for on-the-road sex. The risk was compounded by occupational conditions, w hich motivated truckers to drive long hours, often using drugs to stay aler t. Sex, alcohol, and drugs were perceived as quick, effective stress reliev ers during downtime on long, lonely trips. Despite their high-risk behavior s, truckers tended to consider themselves at low risk for HIV infection and expressed a number of misconceptions regarding HIV transmission. For examp le, many truckers did not associate HV risk with heterosexual contact or th ink that condoms were effective in preventing HIV transmission. In addition , many truckers maintained strong homophobic and anti-government opinions t hat reinforced their suspicion of safe-sex messages. These findings suggest that high-risk sexual behavior is common among long-haul truckers in the U S, who may be at risk for HIV infection primarily because of unprotected se xual intercourse with multiple sex partners. Also, drug use may be associat ed with HIV risk behavior. The authors recommend establishing prevention pr ograms that are developed by and for truckers, determining HIV seroprevalen ce rates of truckers, addressing drug and alcohol abuse among truckers, and altering industry policy that keeps truckers on the road too long for thei r own and others' safety. (C) 2000 Elsevier Science Ltd. All rights reserve d.