‘She Looked Clean’

Truckers intent on being sexually active with strangers on the road should practice extreme caution. While there are treatments for every STD, most are limited in effectiveness. Some of the diseases cannot be cured. Some can be fatal.

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When it comes to sexually transmitted diseases, nurse Sharon Mitchell has seen and heard it all at the truck stop clinic where she works in South Jessup, Md. “Mostly the patients say they thought they were a good judge of character,” says Mitchell, also known on the Internet community www.trucknet.com as Nurse Red. “Or that it was a one-time encounter, and they fell for a sob story the prostitute told.”

Many of her patients – truckers and prostitutes – are vaguely aware of STD symptoms, but don’t think it could happen to them. “I tell my patients that they are playing sexual Russian roulette. You are having sex with all the sexual partners of your partner and all their partners.”

Low awareness of the ease of contamination isn’t uncommon, say those who work with this area of public health. They recommend truckers intent on being sexually active with strangers on the road practice extreme caution. While there are treatments for every STD, most are limited in effectiveness. Some of the diseases cannot be cured. Some can be fatal.

One of the potentially deadly diseases is syphilis. “What’s driving an epidemic?” in the March 1999 American Journal of Public Health looked at a syphilis outbreak in which truckers apparently played a role. The results showed that the syphilis rates among people living along I-95 in rural North Carolina from 1985 to 1994 greatly exceeded rates in non I-95 counties.

Robertson County, N.C. – one of the counties along I-95 – has the highest syphilis rate in the country, says Dr. Peter Leone, medical director for the Wake County STD Clinic and medical director of the state’s HIV Prevention and Control Branch. “Commercial sex workers play a significant role in the disease access and transmission, especially in poverty-stricken rural areas,” he says. “Prostitutes who are too poor to have their own car catch rides with truckers from one truck stop to another,” Leone says. Strip joints next to some truck stops also serve as meeting places.

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When truckers do notice a possible STD symptom, getting diagnosed and treated is difficult because there are virtually no truck stop medical clinics. A small chain of them, Artel Medical Centers, closed two years ago. Mitchell’s clinic is the only one operated by American Business Medical Services.

“I’m worried about truckers on the road who don’t complete their treatments or need to be seen again,” Mitchell says. In some cases, truckers discontinue treatment when symptoms disappear, thinking they are healed, but the disease continues to thrive. “Syphilis and gonorrhea both require follow-up care, and Hepatitis B can be a long-term medical condition,” she says.

Another problem for many truckers is their ignorance of STD symptoms. The most common excuse heard by health care workers after diagnosing an STD – “I thought she looked clean” – is also the most dangerous one, Leone says, because 70 percent to 80 percent of infected sex workers show no current symptoms. “You have to insist they be tested, and you should have yourself tested if you have engaged in unprotected sexual activity,” he says.

The second most common myth is that oral sex is safe. “Every STD can be transmitted orally,” Leone says, “and you can even pick up more than one from one sex partner.”

Even when truckers and prostitutes are exposed to good information on STDs, it doesn’t always help. “People have gotten tired of the message,” Leone says.

Tim Anderson, a gay trucker, agrees. “The whole safe sex message has been out there for 20 years, and people are getting to where they’re ignoring it,” he says. When it comes to AIDS, newer medication can extend quality of life for years, so many people have become complacent about using condoms, he says.

Anderson says he used to give safe sex materials to gay men and female prostitutes. “The most shocking thing was when I would tell girls about condoms and how to use them, some of them weren’t even familiar with them.

“To watch one girl get into 20 trucks in the course of a night is pretty damn frightening,” Anderson says. “You’re thinking, ‘What on earth are these guys thinking?’ It’s like going to a potluck where none of the dishes are edible.”


The only foolproof method of preventing an STD is to never have sex. There are ways to reduce your risk, however, if you choose to be sexually active:

  • Stay in a monogamous relationship.
  • Learn the history of any new sexual partner. Seek testing if you have doubts.
  • Use condoms, even during oral sex. Condoms with spermicide are not always effective. Do not store condoms for prolonged periods in a hot truck.
  • Be alert to signs of infection on your partner’s genitals or mouth. Many infections, however, show no signs for months, even years.
  • Stay sober. Drugs and alcohol may impair your judgment so that you put yourself at risk for contracting an STD.
  • If you have engaged in risky sexual activities, get a checkup at once.
  • Contact all your partners if you are diagnosed with an STD. Even if your symptoms have cleared, you may still have the infection.

    Men and Women

  • Sores, bumps, blisters around the genitals or mouth.
  • Burning or pain during urination or bowel movement.
  • Swelling in the groin or genital area.
  • Persistent swelling or redness in the throat that lasts more than three weeks.
  • Fever, chills, aches or other flu-like symptoms.


  • Discharge from the penis.
  • Sores or lesions on the penis.


  • Unusual vaginal discharge or odor.
  • Pain in the pelvic or lower abdominal area.
  • Burning or itching in vaginal area.
  • Unusual bleeding.
  • Vaginal pain during intercourse.


    Several STDs are treated by antibiotics. Chemicals and laser therapy are used to treat genital warts. For pubic lice (crabs), a topical over-the-counter medication can be effective. Some treatments affect only symptoms because the disease is incurable.


  • To locate a health clinic in any part of the country, call the Centers for Disease Control National STD and AIDS toll-free hotline: (800) 220-8922.
  • The American Social Health Association offers an STD hotline, literature and other information: (919) 361-8400; www.ashastd.org.
  • National Herpes Hotline: (919) 361-8488.
  • National HPV Hotline, focusing on genital warts and cervical cancer prevention: (919) 361-4848.
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