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“尽管他曾表示愿意服用暴露前预防药物,但当他注意到药物被装在与抗逆转录病毒药物类似的容器中时,他拒绝了”:探索肯尼亚长途卡车司机中降低艾滋病毒/艾滋病风险的障碍。

"Even Though He Had Expressed Willingness to Take PrEP, He Declined When He Noticed the Drugs Were Packed in a Container Like That of ARVs": Exploring Barriers to HIV/AIDS Risk Reduction Among Long-Distance Truckers in Kenya.

作者信息

Mutie Cyrus, Kithuci Kawira, Gachohi John, Mbuthia Grace

机构信息

Department of Community Health Nursing, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.

Department of Nursing Education, Leadership, Management and Research, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.

出版信息

J Int Assoc Provid AIDS Care. 2025 Jan-Dec;24:23259582251328814. doi: 10.1177/23259582251328814. Epub 2025 Mar 25.

Abstract

BackgroundDue to high-risk sexual networks along their transit routes, Long-distance truckers' (LDTs) risk of HIV is known to be high, as evidenced by prevalence rates of 14.34% in the region. Besides, the spaces in which LDTs operate are often marred with a multitude of barriers to HIV/AIDS risk reduction. However, there is limited evidence on the barriers encountered by LDTs in Kenya, hence the need for the current study.Methods and MethodologyWe used nine key informants and 18 in-depth interviews from purposively sampled participants, such as nurses and LDT peer educators at Kenya's Busia and Namanga international border points. We used semi-structured interview guides to collect data through audio records. Interviews were transcribed, coded, and thematically analysed using the QDA-Miner software to generate themes and sub-themes around barriers to HIV/AIDS risk reduction among LDTs.FindingsOverall, three themes, namely, health system, individual-level, and trucking career-related barriers emerged. The sub-themes under health system barriers included the location of healthcare facilities far from transit routes, long durations of hospital waiting time, and lack of targeted health facilities for LDTs, among several others. Under trucking career-related barriers, the sub-themes comprised tight work schedules, unfavourable trucking career policies, and insecurity along transit routes. For individual barriers, some of the sub-themes were language barriers and lack of awareness of current HIV/AIDS risk reduction services.ConclusionAlongside health system factors, individual level and trucking career-related factors were highlighted as the barriers to HIV/AIDS risk reduction among LDTs in Kenya. The existence of these barriers may complicate the fight against the pandemic in this hard-to-reach population, given their already known vulnerability to HIV infections.

摘要

背景

由于长途卡车司机在其运输路线上存在高风险的性网络,他们感染艾滋病毒的风险很高,该地区14.34%的患病率就证明了这一点。此外,长途卡车司机工作的场所往往存在许多阻碍降低艾滋病毒/艾滋病风险的因素。然而,关于肯尼亚长途卡车司机所面临障碍的证据有限,因此有必要进行当前这项研究。

方法与方法论

我们从肯尼亚布西亚和纳曼加国际边境点有目的地抽取了参与者,如护士和长途卡车司机同伴教育者,对9名关键信息提供者进行了访谈,并进行了18次深入访谈。我们使用半结构化访谈指南,通过音频记录收集数据。访谈内容被转录、编码,并使用QDA-Miner软件进行主题分析,以围绕长途卡车司机降低艾滋病毒/艾滋病风险的障碍生成主题和子主题。

研究结果

总体而言,出现了三个主题,即卫生系统、个人层面以及与卡车运输职业相关的障碍。卫生系统障碍的子主题包括医疗设施远离运输路线、医院等待时间长以及缺乏针对长途卡车司机的专门医疗设施等。在与卡车运输职业相关的障碍方面,子主题包括紧凑的工作时间表、不利的卡车运输职业政策以及运输路线上的不安全因素。对于个人障碍,一些子主题是语言障碍以及对当前艾滋病毒/艾滋病风险降低服务缺乏认识。

结论

除了卫生系统因素外,个人层面和与卡车运输职业相关的因素也被强调为肯尼亚长途卡车司机降低艾滋病毒/艾滋病风险的障碍。鉴于这一难以接触到的人群已知易感染艾滋病毒,这些障碍的存在可能会使抗击这一流行病的斗争复杂化。

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