Risk Assessment for Long-Haul Truck Drivers

描述（由申请人提供）：一些国际研究记录了生活在印度、孟加拉国、南非和泰国等不同环境下的长途卡车司机的性风险行为水平和性传播感染和艾滋病毒感染率很高。在美国，虽然众所周知性传播感染和艾滋病毒感染病例经常集中在主要交通路线附近，但对这个国家300多万卡车司机中具体的艾滋病毒/性传播感染风险行为和艾滋病毒/性传播感染流行情况知之甚少。在美国为数不多的针对这一问题的研究中，最近佛罗里达的一项研究发现，大约30%的长途卡车司机在路上与多个伴侣频繁性交，但很少有人使用避孕套。此外，在研究参与者中，关于异性恋艾滋病毒传播的知识不足和误解很常见。因此，基于现有的少量数据，美国这一人群对艾滋病/性病预防干预的需求似乎是相当大的。迄今为止，基本上所有对卡车司机进行的国内和国际研究都是从卡车停靠站或为卡车司机提供服务的企业中招募研究参与者。该应用程序将与美国几家大型货运公司合作，寻求设计一个可持续的风险评估和筛查方案，目的是为这一人群提供艾滋病毒/性传播感染干预措施。我们的研究将提出以下具体目标：1)基于跨理论模型的构建，对长途卡车司机进行焦点小组和深度访谈，以指导长途卡车司机行为风险评估工具和可接受的艾滋病毒/STI筛查方案的开发；2)对卡车运输业高管进行深度访谈，以确定对其员工进行常规HIV/STI评估和筛查的障碍；3)根据长途卡车司机的焦点小组数据，调整现有的基于理论的行为风险测量方法，以反映这一未被充分研究的人群的态度和文化；4)评估主要性危险行为的流行程度，并探讨这些流行程度的预测因素；5)确定长途卡车司机中HIV、淋病奈瑟菌和沙眼奈瑟菌的流行情况。

DESCRIPTION (provided by applicant): Several international studies have documented substantial levels of sexual risk behaviors and high rates of STI and HIV amongst long-distance truck drivers living in diverse settings including India, Bangladesh, South Africa and Thailand. In the United States, while it is known that STI and HIV cases are frequently concentrated around major transportation routes, less is known regarding specific HIV/STI risk behaviors and HIV/STI prevalence amongst the over 3 million truck drivers in this country. Among the few U.S. studies addressing this topic, a recent Florida-based study found that approximately 30% of the long-haul trucker population studied had frequent sexual intercourse with multiple partners while they were on the road but few used condoms. In addition, knowledge deficits and misconceptions regarding heterosexual HIV transmission were common among study participants. Thus based on what little data are available, the need for HIV/STI prevention intervention in this population in the U.S. appears to be considerable. To date, essentially all of the domestic and international studies performed on truck drivers have recruited study participants from truck stops or businesses catering to truckers. This application will seek to design a sustainable risk assessment and screening protocol in collaboration with several large freight lines in the U.S. with the goal of informing an HIV/STI intervention for this population. Our study will propose to address the following specific aims: 1) To perform focus groups and in-depth interviews based on the constructs of the transtheoretical model with long-haul truck drivers to guide development of both a behavioral risk assessment instrument and an acceptable HIV/STI screening protocol for long-haul truckers; 2) To perform in-depth interviews with trucking industry executives to determine barriers to routine HIV/STI assessment and screening of their employees; 3) To adapt existing theory-based measures of behavioral risk based on focus group data from long-haul truck drivers so as to reflect the attitudes and culture of this understudied population; 4) To estimate the prevalence of key sexual risk behaviors and examine the predictors of those prevalence rates; and 5) To determine the prevalence of HIV, N. gonorrhoeae, and C. trachomatis, in long-haul truck drivers.