RESUMEN
Background: The human immunodeficiency virus (HIV) prevalence among transport workers in sub-Saharan Africa remains high, estimated at as high as 9.9% in western Uganda compared with the national prevalence of 5.4%. The prevalence of HIV among transport workers has been partly attributed to the level of knowledge regarding HIV prevention, perceived HIV risk, and stigma. Accordingly, these have been linked to high-risk HIV transmission behaviours that increase the chances of acquiring HIV among adults. Therefore, this study investigated the predictors of HIV knowledge, perceived HIV risk, and stigma among transport workers in Mbarara city in southwestern Uganda. Methods: The survey was conducted between November 2021 and February 2022 among transport workers (motorcycle taxi riders, motor vehicles taxi, and truck drivers), aged 18 to 55 years. Face-to-face interviews using a semi-structured questionnaire were conducted with the study's participants. Chi-square and binary multivariate logistic regression statistics were used to assess the predictors of knowledge about HIV prevention, HIV perceived risk, and stigma. Results: Out of 420 participants, 69.3%, 75.4%, and 62% had good knowledge of HIV prevention, a high perceived HIV risk, and stigma, respectively. Predictors of knowledge of HIV prevention comprised education level (AOR=2.28, 95% CI=1.36-3.84), knowing HIV status (AOR=0.47, 95% CI=0.27-0.81), and perceived HIV risk (AOR=3.04, 95% CI=1.74-5.32). Whereas the determinants of perceived HIV risk included education level (AOR=1.34, 95% CI=1.34-4.24), knowing HIV status (AOR=0.26, 95% CI=0.15-0.48), HIV knowledge (AOR=2.38, 95% CI=1.36-4.178), and perceived stigma (AOR=0.47, 95% CI=0.24-0.89). Last, the predictors of perceived HIV stigma included perceived HIV risk (AOR=0.41, 95% CI=0.21-.791), and knowledge of HIV prevention (AOR=0.29, 95% CI=0.16-0.54). Conclusions: The study found a high proportion of participants with good knowledge about HIV prevention, a high HIV perceived risk, and HIV-related stigma. In addition, this study suggests that the level of education and awareness of one's HIV status positively influences HIV knowledge and perceived risk. Whereas HIV-related stigma was in turn negatively influenced by the transport workers' HIV knowledge and perceived risk. This calls for multifaceted approaches at individual, group (interpersonal), and community levels to reduce HIV stigma among this study group. Incorporating continuous health education programs about HIV and encouraging HIV testing among transport workers remains critical.
RESUMEN
The use of multiple HIV prevention services has been found to decrease the risk of acquiring HIV when tailored to individuals at risk of HIV exposure, including transport workers. Therefore, we assessed the uptake of multiple HIV prevention services (≥2) and associated factors among transport workers in a city in Southwestern Uganda. This cross-sectional study comprised motorcycle taxi riders, motor vehicle and truck drivers, aged 18 to 55 years who were selected and responded to an interviewer-administered questionnaire, between November 2021 and February 2022. Data was analyzed using descriptive statistical and modified Poisson regression analyses. Out of 420 participants, 97.6% were male, with a median age of 28 years and the majority were aged <34 years (84.6%). Overall, less than half (45.3%) of the participants had used multiple (≥2) HIV prevention services within a one-year period. Many participants had used condoms (32.2%) followed by voluntary HIV counseling and testing (27.1%), and safe male circumcision (17.3%). Most participants who tested for HIV had ever used condoms (16.2%), followed by those who received safe male circumcision and had ever used condoms (15%), and those who tested for HIV and had started on antiretroviral therapy (ART) (9.1%). In the adjusted model, factors that were significantly associated with the use of multiple HIV prevention services included religion (aPR = 1.25, 95% CI = 1.05-1.49), the number of concurrent sex partners (aPR = 1.33, 95% CI = 1.10-1.61), prior HIV testing and awareness of HIV serostatus (aPR = 0.55, 95% CI = 0.43-0.70), awareness of HIV prevention services (aPR = 2.49, 95% CI = 1.16-5.38), and financial payment to access HIV services (aPR = 2.27, 95% CI = 1.47-3.49). In conclusion, the uptake of multiple HIV prevention services among transport workers remains suboptimal. Additionally, individual behavioral factors influence the use of multiple HIV services compared with other factors. Therefore, differentiated strategies are needed to increase the utilization of HIV prevention services among transport workers.