title: Decreased incidence of sexually transmitted diseases among trucking company workers in Kenya: results of a behavioural risk-reduction programme.
abstract: OBJECTIVE
  To establish a cohort of high-risk individuals suitable for HIV-prevention trials, and to measure changes in sexual behaviour and sexually transmitted disease (STD) incidence after a behavioural intervention.
  
  
  METHODS
  Prospective cohort study in trucking company depots in Mombasa, Kenya.
  
  
  METHODS
  A total of 556 male HIV-seronegative employees of trucking companies.
  
  
  METHODS
  HIV serological testing, individual counselling, condom promotion, STD diagnosis and management.
  
  
  METHODS
  Sexual risk behaviour and symptomatic STD incidence.
  
  
  RESULTS
  Using time-trend modelling, significant declines in self-reported high-risk sexual behaviour were demonstrated during a 1-year follow-up. The percentage of men reporting any extramarital sex during the 3-month period prior to a follow-up visit decreased from 49% durig the first quarter of follow-up to 36% during the last quarter (P < 0.001). The decline in reported female sex worker contact was from 12% to 6% (P = 0.001). Approximately 30% of men reported consistent condom use during extramarital sex and this percentage remained unchanged during the study period. The incidence of STD declined from 34 per 100 person years (PY) during the first quarter to 10 per 100 PY during the last quarter (P = 0.001). Significant reductions in gonorrhoea (15 to five cases per 100 PY, P = 0.04), non-gonococcal urethritis (10 to two cases per 100 PY, P = 0.05), and genital ulcer disease (nine to two cases per 100 PY, P = 0.02) were observed.
  
  
  CONCLUSIONS
  Among truck company workers who participated in a cohort study in Mombasa, Kenya, there was a significant decrease in sex with high-risk partners, but no change in condom use. The change in heterosexual risk behaviour was accompanied by a significant decrease in incidence of gonorrhoea, non-gonococcal urethritis, and genital ulcer disease.
authors.affiliation: Department of Medical Microbiology, University of Nairobi, Kenya.
authors.forename: D J
authors.initials: DJ
authors.lastname: Jackson
authors.forename: J P
authors.initials: JP
authors.lastname: Rakwar
authors.forename: B A
authors.initials: BA
authors.lastname: Richardson
authors.forename: K
authors.initials: K
authors.lastname: Mandaliya
authors.forename: B H
authors.initials: BH
authors.lastname: Chohan
authors.forename: J J
authors.initials: JJ
authors.lastname: Bwayo
authors.forename: J O
authors.initials: JO
authors.lastname: Ndinya-Achola
authors.forename: H L
authors.initials: HL
authors.lastname: Martin
authors.forename: S
authors.initials: S
authors.lastname: Moses
authors.forename: J K
authors.initials: JK
authors.lastname: Kreiss
mesh_terms: D000293:Adolescent; D000328:Adult; D001334:Automobile Driving; D002602:Chancroid / Q000453:epidemiology; D002690:Chlamydia Infections / Q000453:epidemiology; D015331:Cohort Studies; D017280:Condoms / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006069:Gonorrhea / Q000453:epidemiology; D018023:HIV Seronegativity; D006266:Health Education; D006801:Humans; D015994:Incidence; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012309:Risk-Taking; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000517:prevention & control