HIV Among Seafarers

Because of the nature of their work seafarers spend long periods of time away from their families and therefore represent a group at risk for sexually transmitted diseases, including HIV infection. Unsafe sex, drug addiction, or procedures such as tattooing play a relevant role in HIV transmission. HIV cannot be acquired through ordinary occupational and social contact. Due to the fact that nowadays ships spend less time in ports, the crew is rarely allowed to leave the ship. The “tourism element” (including sex tourism) is, thus, rapidly shrinking in contemporary seafaring. Nevertheless, the sex industry in many ports has adapted to recent developments by introducing “sex catering” or organised visits of sex workers to anchored ships and therefore the risk of getting infected with sexually transmitted diseases still remains.

Seafarers are one of the populations worst hit by HIV/AIDS in parts of south east Asia — Cambodia, Lao People’s Democratic Republic Burma, Thailand, Vietnam and Yunan province (China). Prevalence rates among seafarers are as high as 22% in some places.

Working conditions onboard a merchant vessel may make it harder for seafarers to access information about HIV prevention and related services to decrease their risk of becoming infected. Seafarers are a highly mobile population, who aren’t always capable of visting shore-based medical and information services, and who are often prevented from receiving HIV messages through lack of time or ability to understand the local language. This is why it is important that advice and information on HIV and AIDS continues to be provided for seafarers and access to HIV information and services enhanced

2012.12.01 - HIV Among Seafarers Figure 2

Percentages of answer given by 223 interviewed workers to the 7 questions of the questionnaire about HIV/AIDS (Survey on HIV risk perception and sexual behaviours among seafarers – I. Grappasonni, P. Paci, F. Mazzucchi, F. Amenta)

Seafarers appear less likely than other occupational groups to voluntarily receive HIV testing, and more likely to engage in high-risk behaviours. In one survey, 53% of participants reported contact with commercial sex workers and 73% reported that they never used condoms. Other research also suggests that seafarers have lower levels of knowledge about HIV transmission and risk factors than the general population.

The best method for preventing HIV diffusion is represented by health education of people who are vulnerable to infection. Educational interventions on knowledge, modes and routes of transmission of HIV, and on sexual behaviour can considerably decrease the risk of HIV virus diffusion among seafarers.

Seafarers in order to minimize the risk of getting infected with HIV or other sexually transmitted diseases should among others:

Use condoms.
Avoid the use of oil-based lubricants, such as petroleum jelly, with latex “male” condoms since it can reduce the condom effectiveness.
Never re-use injecting equipment.
Avoid transfusions of blood or blood products in certain overseas locations (e.g. areas with percentages of HIV infection). Medical and dental treatments should also be avoided in such locations, if possible.
Avoid puncturing the skin with a sharp instrument for ear-piercing, tattooing and acupuncture.
Avoid sharing of toothbrushes and razors
Be aware that barriers such as gloves, masks, protective eyewear or shields, gowns or aprons that prevent exposure of the skin or mucous membranes to blood-borne pathogens can protect against the transmission of infected blood. Such equipment should be provided on board for seafarers to use.
Seek medical advice and treatment as quickly as possible in case they are concerned that they may have come into contact with HIV.

Regarding HIV prevention, the companies on their behalf should among others:

Consider the adoption of an HIV and AIDS policy as part of its overall health and safety policy.
Promote the health and welfare of seafarers.
Eliminate prejudice and discrimination against employees suffering from HIV infection.
Provide their employees with informative and educational material about HIV and AIDS . This should be updated at regular intervals.
Ensure that supplies of condoms which can be made available to sea staff are carried by all vessels and easily accessed by all seafarers.
Treat in the strictest confidence information concerning the infection of any employee who may have the HIV virus, as would be the case with any other medical condition.

Adequate prevention campaigns and major attention paid to seafarers health is useful for stimulating responsible conduct for the prevention of infectious diseases, including HIV infection. Nevertheless, it is still necessary to increase information about the risk of sexually transmitted diseases and how to reduce it.

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