© 2015 Sharma et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php HIV/AIDS - Research and Palliative Care 2015:7 83–94 HIV/AIDS - Research and Palliative Care Dovepress submit your manuscript | www.dovepress.com Dovepress 83 ORIgInAl ReSeARCH open access to scientific and medical research Open Access Full Text Article http://dx.doi.org/10.2147/HIV.S76416 Health care coverage among long-distance truckers in India: an evaluation based on the Tanahashi model Varun Sharma 1 nira njan Saggurti 2 Shalini Bharat 1 1 School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India; 2 HIV AIDS Program, Population Council, new Delhi, I ndia Correspondence: Varun Sharma School of Health Systems Studies, Tata Institute of Social Sciences, V n Purav Marg, Deonar, Mumbai 400088, Maharashtra, India Tel +91 98 8046 1550 Fax +91 22 2552 5060 email sharmavarun84@gmail.com Abstract: Long-distance truckers (LDTDs) are vulnerable to human immunodeficiency virus infection and other sexually transmitted infections due to the nature of their work, working environment, and frequent mobility. This paper examines and comments on the health care coverage provisioned under “Kavach” Project. Data from the Integrated Behavioural and Bio- logical Survey, National Highway gathered from 2,066 LDTDs in Round 1 and 2,085 LDTDs in Round 2, who traveled in four extreme road corridors travelled by LDTDs in India, were used for analysis. Analysis reveals that service capacity in terms of socially marketed condoms per thousand LDTDs has increased from Round 1 to Round 2 (4,430 to 6,876, respectively). Accessibility coverage in terms of knowledge about the Khushi clinic has significantly decreased between Rounds 1 and 2 (60.9% to 54.6%; P,0.001). Acceptability coverage has increased between the two rounds (13.8% to 50.6%; P,0.001). Contact coverage has also increased between the rounds (12.7% to 22.3%; P,0.001). Effectiveness coverage for pre- ventive and curative care has also increased significantly. This paper comments on the gaps in accessibility and acceptability of health care coverage and emphasizes the need for further studies to assess the contextual factors that influence the effectiveness and efficiency of inter- ventions designed to address access barriers and to identify what combination of interventions may generate the best possible outcome. Keywords: HIV, long-distance truck drivers, mobility, national highways, Tanahashi frame- work, India Introduction Workers in the transport sector are vulnerable to human immunodeficiency virus (HIV) infection and other sexually transmitted infections (STIs) due to the nature of their occupation, difficult work environment, and poor economic and living conditions. 1 Studies have reported the spread of HIV along major truck routes, and the crucial role played by long-distance truckers (LDTDs) (LDTDs include truck drivers and their helpers traveling 800 km or more in a single direction) in carrying HIV infec- tion from one place to another and transmitting infection from high-risk populations (high-risk population includes female sex workers, men who have sex with men, and injecting drug users) to low-risk populations (low-risk population primarily includes spouses of migrant/mobile population). 2–4 Multiple sex partners, ignorance about the use of condoms, and inconsistent or no condom use during sexual acts are commonly reported behavior patterns among LDTDs. 5–9 In addition, LDTDs lack complete and correct information about HIV and other STIs, resulting in low self-perceived risk of HIV infection and other STIs. 10–12 HIV/AIDS - Research and Palliative Care downloaded from https://www.dovepress.com/ by 103.36.84.65 on 22-Dec-2017 For personal use only.