The report by Leung et al1 highlights many dimensions of concern from the global perspective of sexually transmitted infection (STI) control, while investigating only Chlamydia trachomatis infection among Hong Kong truckers. This is the only truck driver study, to my knowledge, focused solely on chlamydia infection and its determinants. Because of their screening procedure, one third of the truckers accessed their results—unprecedented for men in this occupation.

Of course, the problematical characteristic of chlamydia infection is its asymptomatic status, thereby reducing the impetus to seek testing. This probably contributes to the moderate to high rates of infection (estimated at 89 million new cases annually)2 experienced globally. The consistency in prevalence rates across time and distance is uncanny. For example, a recent cross-sectional study among 53 000 young men throughout the USA revealed an 8.2% prevalence.3 Another study conducted in an eastern US city a decade earlier showed rates of 10.6% in symptomatic men and 8.2% in asymptomatic men.4 Leung et al1 report …