Long-distance truck drivers remain one of the most at-risk populations for HIV infection in Africa, yet many continue to avoid testing for the virus despite engaging in behaviours that heighten their vulnerability. A recent study involving nearly 300 truck drivers along the Uganda Road corridor in Uasin Gishu County reveals a troubling trend: the majority are unaware of their HIV status.
Truck drivers spend extended periods away from home, often engage in transactional sex with sex workers along the highways, and have limited access to consistent healthcare. These factors make them a critical population in the effort to prevent the spread of HIV, particularly because of their mobility across several countries, including Kenya, Uganda, Tanzania, Sudan, Rwanda, and the Democratic Republic of Congo.
Despite the risks, several barriers deter truckers from undergoing HIV testing. One major factor is the fear of receiving a positive result, which brings psychological stress, stigma, and fear of discrimination. Many drivers are anxious about the implications of a positive diagnosis and would rather remain unaware of their status than face that possibility. In addition, some express doubt about the reliability and accuracy of HIV testing, which undermines trust in available services.
Cost is another deterrent. Some drivers cited the high cost of HIV test kits as a reason for not testing. Others noted the lack of pre- and post-test counselling, which left them uncertain about how to handle the outcome of the test. Without the support of proper counselling services, the testing experience can feel isolating and overwhelming, especially for those testing for the first time.
Demographic factors also play a role. Drivers with six to ten years of experience were more likely to self-test than those newer to the profession. This could be attributed to increased awareness, higher risk perception, and behavioural maturity gained over years on the road. In contrast, younger or less experienced drivers often have a lower sense of personal risk, limited knowledge about HIV, or hold biases that discourage testing.
Substance use and sexual activity were common among respondents. Many had used alcohol or drugs and reported recent sexual encounters during their trips. While about half admitted to using condoms within the last year, the rest had not. A significant number had also contracted sexually transmitted infections, underlining the urgent need for better prevention strategies.
Truck drivers’ consistent movement across borders increases the risk of cross-country HIV transmission. To counter this, efforts must focus on scaling up access to affordable testing, counselling services, and targeted education. By addressing the psychological, financial, and systemic barriers to testing, public health stakeholders can significantly reduce HIV transmission among this high-risk group.
