Structure & Agency in Long-Distance Truck Drivers’ Lived Experiences of Condom Use for HIV Prevention

Condom promotion has emerged as a mainstay of targeted HIV prevention interventions in India, with its emphasis on individual behaviour change and personal responsibility. However, such approaches often do not account for marginalised populations' structural vulnerability to HIV, arising from social, economic and political factors in the lived environment. 

In this paper, I use a critical health communication framework to analyse how structure and agency interact in influencing condom use among long-distance truck drivers in India. Drawing on an abductive discourse analysis of condom-use discourses among truckers and peer educators in two Indian cities, findings reveal that while truckers understand the biomedical logic of condoms as barriers, they also express anxiety about condom breakage and experience structural barriers to condom use. 

The paper concludes by calling for greater attention to structural vulnerabilities in future HIV prevention efforts with truck drivers.

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By: Sastry S1.

• 1 Department of Communication, University of Cincinnati , Cincinnati , USA.

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Partner Characteristics Associated with HIV Acquisition among Youth in Rakai, Uganda

RESULTS:
In regression analyses controlling for marital status, young women's risk of HIV acquisition increased if their partner was a truck driver, drank alcohol before sex, and used condoms inconsistently. In young men, the risk of HIV acquisition increased with partners who were not enrolled in school, in partnerships with higher coital frequency, and in partnerships where respondents were unable to assess the HIV risk of their partner. Mixed-model regressions adjusting for respondent's individual-level risk factors, showed that young women's risk of HIV acquisition increased with each non-marital sexual partner (IRR: 1.54 [1.20-1.98]), each partner who drank alcohol before sex (IRR: 1.60 [1.11-2.32]), and each partner who used condoms inconsistently (IRR: 1.99 [1.33-2.98]). Among young men, having non-marital partnerships increased HIV acquisition (IRR for each partner: 1.54[1.20, 1.98]).

IMPLICATIONS:
Partner characteristics predicted HIV acquisition among youth. HIV prevention programs should emphasize awareness of partner's risk characteristics to avoid high risk relationships.

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