Knowledge, Attitudes & Practices Argentina Ruta Nacional 11 Stephen Brushett HIV/AIDS & Transport Focal Point LAC Region
Santa Fe Province Ruta Nacional 11
General Characteristics Based on Ruta Nacional 11, major national/regional corridor Santa Fe province 3 mn population Large port sector - grain, soya, sunflower oil exports, 3rd largest in region 750,000 truck journeys per year Truck throughput varies 850 to 1500 tonnes per hour in San Lorenzo and 700 trucks per day in Rosario
HIV/AIDS Situation National data in 2006 0.6% prevalance. 134,000 living with HIV, predominantly male 2.41/1, transmission 62% heterosexual, 21% MSM, 7% drug use related. Santa Fe province near average but urban areas are higher, such as Rosario 4.5% of total cases in country, 0.65% prevalence rate Services reported available, but not specifically adapted to truckers needs Thus proposal to add service centers in each of the main ports, add later a mobile service system Earlier study carried out 2006 Hombres en Ruta
Target Population (Registered) truckers and assistants, driving more than 100 km (14,000), and also (some) social and sexual networks (6,650 partners indicated) Difficult to estimate how many and how frequently they use the selected Ruta Nacional 11. Assessed level of access and use of services Mapped actors in trucking and related industries (30 different organizations involved) Study on knowledge, practices, attitudes carried out
The Sample 655 truckers interviewed Average age 41 years 86% with partners Average low level of edcuational accomplishment (18% completed secondary or better). 50% working for more than 10 years 23.3 journeys per month, of which 77% less than half a day, only 30% on fixed routes. Long distance drivers mostly on their own (63%), some accompanied by family (35%), assistants (65%) Rest on journey 80% in truck, 13% hotel, 8% truck stop
Knowledge, Practices and Attitudes About 49% of the truckers and partners in the survey had been tested, compared to 36% of the population on average in Argentina. 75% know that treatment is available for HIV 45% don t know about access to services - 4 out of 10 don t know about the availability of free treatment in Argentina. Only 52% think a person with HIV can continue a normal life. Two thirds aware of vulnerability, but much higher for singles (78%) than for marrieds (65%). Those who travel more know more than those who travel less (71% against 65%). Ruta 11 truckers know more than the rest (70% against 66%).
Knowledge, Practices and Attitudes Two thirds claim not to know some one with HIV, or who died of AIDS 30% don t know about mother to child transmission. About two thirds have erroneous information on HIV.no sharing your cup of tea! 3 out of 10 partnering with 2 or more women. Condom use varies with age, number of occasional partners. 7 out of 10 occasional but 7 out of 10 not with regular partner. 20% report paying for sex, 6% MSM. 6 out of 10 had no condoms in cab. But higher proportion of condom use for longer journeys and for singles versus marrieds
Proposed Response Macro regional transport and HIV-AIDS strategy, inter-institutional coordination mechanisms Institutional counseling and voluntary testing, care and treatment for those living with HIV-AIDS Community raise knowledge level, reduce stigma, promote condom use, promote stable relationships. Design 3 year program to be largely supported by the private sector in 2 phases (1) 8 months for creation of networks, basic training and demand generation and (2) 28 months for developing and implementing strategy and carrying out activities. Project helped create a monitoring and evaluation framework
Areas of Intervention 1. Regional trucking industry strategy 2. Provincial and municipal networks 3. Counseling and voluntary testing 4. Treatment, care and support to truck drivers and their families 5. Prevention
Indicators 1. At least 65% of transport organizations identified are involved in its design 2. At least 50% of transport organizations are involved. At least 50% of organizations offering counseling, voluntary testing, treatment, care and support are participating in the network. 3. At least 60% of truck drivers tested in the previous 12 months, know their results and have been counseled. 4. 100% of truck drivers and their families living with HIV receiving ART.Life expectancy of truck drivers (15-49 age bracket) living with HIV and receiving ART. 5. 75% condom use in last non-regular sexual encounter.90% of truck drivers can correctly identify means of HIV transmission and can identify those which are not.at least 60% of truck drivers using the ports of Rosario, San Lorenzo and San Martin have benefited from STI/HIV prevention activities.
Next Steps Based on presentations made to stakeholders in mid 2008 Build on institutional analysis, buy in and political commitment Identify potential sources of financing, beyond resources of private sector Incorporate broader social network into the target group Add new roads Build linkages to initiatives with other mobile populations (maritime, sex workers )