Background

Long-distance truck drivers are considered a high-risk population in the transmission of HIV due to their occupational mobility, prolonged time away from home, and frequent encounters with commercial sex workers. In Indonesia, particularly on the island of Sulawesi, roadside eateries and coffee stalls often serve as informal meeting points where transactional sex occurs between truck drivers and female vendors. Despite the growing concern over sexually transmitted infections (STIs) among mobile workers, limited data exist on the sexual behavior patterns of this occupational group in the region.

Objectives

The aim of this study was to explore the prevalence of transactional sexual behavior and its potential linkage with HIV risk among truck drivers who travel across the Sulawesi island. The study also aimed to identify age-based patterns in sexual behavior and frequency of engagement in paid sex during transit stops.

Material and methods

This cross-sectional survey was conducted over a 14-month period, from January 2024 to February 2025. A total of 600 male truck drivers aged 17–52 years were recruited using accidental sampling techniques at provincial roadside stops throughout Sulawesi. All participants completed a structured and anonymous questionnaire that gathered data on sociodemographic characteristics, sexual practices while in transit, and history of interactions with female food or beverage vendors. Participants also reported the average payment made per sexual encounter and the consistency of condom use. Ethical approval was granted by the institutional ethics board, and informed consent was obtained from all respondents.

Results

Out of the 600 truck drivers surveyed, 421 (70.2%) reported engaging in transactional sex during their journeys across Sulawesi. Most interactions occurred with female food or beverage vendors stationed along major trucking routes, where truck drivers paid approximately 100,000 Indonesian Rupiah (IDR) per sexual encounter. Age distribution among those engaging in transactional sex revealed the highest prevalence in the 20–35-year-old group (69%), followed by those aged 36–52 years (20%) and 17–19 years (11%). A significant proportion of drivers admitted to inconsistent condom use, and several acknowledged a lack of awareness regarding HIV prevention measures. These behaviors may contribute to increased vulnerability to HIV and other STIs within this mobile population.

Conclusions

The findings of this study highlight a high frequency of risky sexual behavior among long-distance truck drivers operating across Sulawesi. The transactional nature of these interactions, often with limited protection and low awareness of disease transmission, underscores the urgent need for targeted public health interventions. Mobile health outreach, education programs focused on STI prevention, and increased access to condoms and HIV testing services are recommended to reduce the potential spread of HIV in this key population and the wider community.