Home›Infectious Disease› Targeted interventions increase condom use and HIV knowledge among long-distance truck drivers
Targeted interventions increase condom use and HIV knowledge among long-distance truck driversTargeted programs improve HIV prevention for long distance truck drivers
BMJ openPublished July 18, 2026Study authors: Mutie Cyrus, Otieno Berrick, Kithuci Kawira, Gachohi John, Mbuthia GracePubMed ↗DOI ↗Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease
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Key Takeaway
Note that targeted interventions significantly improve condom use and knowledge among long-distance truck drivers.
This systematic review and meta-analysis synthesized 24 studies to evaluate the impact of targeted interventions, including peer-led, outreach-based, and mobile health approaches, on HIV prevention outcomes among long-distance truck drivers. The analysis included a global scope with 50% of studies from Sub-Saharan Africa and 37.50% from Asia and the Pacific.
The meta-analysis found significant positive effects for several primary outcomes. Condom use increased (RR=1.25; 95% CI, 1.09 to 1.44, p=0.002) and HIV-related knowledge increased (RR=1.24; 95% CI 1.13 to 1.36, p<0.001). Additionally, there was a significant reduction in sexual risk behaviors (RR=0.86; 95% CI, 0.74 to 0.99, p=0.042). HIV testing showed a modest increase (RR=1.14), but this result did not reach statistical significance (95% CI, 0.91 to 1.42, p=0.248).
The authors noted significant heterogeneity across the included studies. Furthermore, the GRADE assessment indicated predominantly very low certainty of evidence, with only one study showing moderate-certainty and three others showing low-certainty. Due to these limitations, findings should be interpreted with caution. The results suggest a need to upscale targeted interventions along transport corridors to improve HIV prevention outcomes in this population.
Long distance truck drivers face unique challenges when it comes to staying healthy while on the road. A review of 24 studies across Africa and Asia looked at how specific interventions, like peer led groups and mobile health tools, impact HIV prevention for these drivers.
The data shows that these targeted programs significantly increase condom use and improve knowledge about HIV. They also help reduce risky sexual behaviors. While there was a modest increase in the number of people getting tested, this specific result was not statistically significant in the study.
It is important to note that the evidence for these findings is currently considered to be of low certainty. Because the studies varied so much and were often small, the results should be viewed with caution. More high quality research is needed to confirm exactly how well these programs work over time.
What this means for you:
Targeted outreach helps truck drivers use condoms more and gain better knowledge to prevent HIV.
Common questions
What kind of programs helped the most?
The study looked at several types of targeted interventions. These included peer led groups, outreach based programs, and mobile health approaches. These methods were shown to significantly increase condom use and improve knowledge about HIV among long distance truck drivers.
Did these programs help more people get tested for HIV?
The results showed a modest increase in HIV testing at follow up. However, this specific finding was not statistically significant, meaning the data does not clearly prove that testing rates increased significantly through these interventions.
How reliable are these findings for truck drivers?
The evidence is currently considered to be of low certainty. Because the studies included were very different from one another, these results should be interpreted with caution until more rigorous and high quality studies can confirm the findings.
OBJECTIVES: We aimed to systematically summarise and quantify the empirical evidence on targeted interventions and their effects on various HIV prevention outcomes for long-distance truck drivers (LDTDs) globally.
DESIGN: A systematic review and meta-analysis.
DATA SOURCES: We searched PubMed, PubMed Central (PMC), Cumulated Index to Nursing and Allied Health Literature (CINAHL), ProQuest Central, EBSCOhost, ScienceDirect, World Health Organisation (Global Index Medicus), Cochrane Library, Scientific Electronic Library Online (SCiELO), Japan Science and Technology Information Aggregator, Electronic (J-STAGE) and China National Knowledge Infrastructure (CNKI) up to 15 May 2026.
ELIGIBILITY CRITERIA: We included original peer-reviewed interventional studies involving LDTDs of either gender aged above 18 years and reporting findings on HIV prevention interventions from any part of the world. We excluded non-empirical publications like systematic reviews.
DATA EXTRACTION AND SYNTHESIS: We used a predesigned and piloted Microsoft Excel data extraction form to extract information on study details, characteristics of study participants, intervention characteristics, outcome measures and reported effect size measures. The general characteristics of the included studies were summarised using basic descriptive statistics like mean, frequencies and proportions. Where effect estimates for individual studies were missing, risk ratios (RR) were calculated from the proportions of the respective outcomes. Thereafter, we performed a random-effects meta-analysis using R. We performed a sensitivity analysis by excluding individual studies with outlier effect estimates and a subgroup analysis of studies with no high risk of bias. Where adequate data for meta-analysis were not reported, a narrative approach was used to synthesise the findings. The ROB 2 and ROBIN-1 Cochrane risk of bias assessment tools were used to assess the risk of bias for the randomised and non-randomised interventions, respectively. The certainty of evidence for the included studies was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
RESULTS: Of the 2076 records identified, 24 were included. Most of the included studies were conducted in the regions of SSA (50%, n=12) and Asia and the Pacific (37.50%, n=9). The frequently reported outcomes following targeted interventions were condom use, HIV-related knowledge, HIV testing and sexual risk behaviours. The pooled effect estimates showed that interventions on condom use had the most significant effect (RR=1.25; 95% CI, 1.09 to 1.44, p=0.002), followed by HIV-related knowledge (RR=1.24, 95% CI 1.13 to 1.36, p<0.001) and sexual risk behaviour reduction (RR=0.86; 95% CI, 0.74 to 0.99, p=0.042). Interventions on HIV testing showed a modest effect at follow-up, though not statistically significant (RR=1.14; 95% CI, 0.91 to 1.42, p=0.248). Significant heterogeneity was observed, indicating that the pooled effect estimates were not due to chance but other factors, such as intervention variations and sample size. Following sensitivity and subgroup analysis, we did not observe statistically significant changes in pooled effect estimates across most intervention outcomes. Based on the GRADE assessment, the certainty of evidence was predominantly very low, with only one study providing moderate-certainty evidence and three others providing low-certainty evidence.
CONCLUSION: Generally, most of the targeted interventions had significant effects on various HIV prevention outcomes and were randomised controlled trials, peer-led, outreach-based and adopted mobile health approaches. Thus, there is a need to upscale such interventions along transport corridors, as they had the most significant effects in promoting HIV prevention outcomes among LDTDs. However, the predominantly very low certainty of evidence based on the GRADE assessment limits confidence in the effect estimates reported in this study. Consequently, these findings should be interpreted with caution and confirmed through more rigorous, high-quality studies.
PROSPERO REGISTRATION NUMBER: CRD42024505542.
