Evaluating the McDonald’s business model for HIV prevention among truckers to improve program coverage and service utilization in India, 2004–2010

Figures & data

Figure 1 Map of India showing trans-shipment locations and operating routes among long-distance truck drivers.

Abbreviation: TCIF, Transport Corporation of India Foundation.

Figure 2 Time lines of occurrence of important program activities during Kavach intervention.

Table 1 Definition of program monitoring indicators

Indicators	Definition
Number of truckers contacted at least once a month per site	Represents the number of unique long-distance truckers who were contacted by the outreach team in a month. This indicator was derived after taking the average for all 12 months in a year divided by the number of intervention sites.
Number of individuals (truckers + nontruckers) utilizing clinical services per month per clinic	Represents the number of unique individuals utilizing clinical services at Khushi clinics in a month. This was calculated as the average for all 12 months in a year divided by the number of clinics in operation.
Percentage of truckers among total Khusi clinic attendees	Calculated as the number of truckers utilizing clinical services in a month divided by the total number of individuals (truckers + nontruckers) utilizing clinical services at Khushi clinics in the same month multiplied by 100.
Percentage of truckers treated for STI-related symptoms	Represents the number of truckers treated for STI-related symptoms in the reporting period divided by the number of truckers utilizing clinical services at Khushi clinics in that reporting period.
Percentage of truckers who bought medicines	Represents the number of truckers buying medicine from Khushi clinic outlets in a reporting period divided by the number of truckers treated with STI-related symptoms in that reporting period.
Number of condoms socially marketed	Represents the number of condoms socially marketed through traditional, nontraditional outlets and condom vending machines within the trans-shipment locations.
Number of condoms sold per trucker in a year	Calculated as total number of condoms socially marketed divided by number of truckers who bought condoms.

Abbreviation: STI, sexually transmitted infection.

Table 2 Program exposure and service utilization as observed in the program monitoring data, 2004–2010

Indicators	Pre redesign stage of intervention		Post redesign stage of intervention
	2004	2005	2006	2007	2008	2009	2010
Number of sites (as of December of the respective year)	11	34	17	17	17	15	12
Number of static clinics	11	34	34	34	34	30	24
Estimated number of truckers	43,535	270,549	322,566	295,000	295,000	285,000	311,667
Number of truckers contacted at least once a month per site$	374	580	910	2791	3576	4045	4327
Number of individuals (truckers + nontruckers) utilizing clinical services per month per clinic$	90	253	382	515	641	682	717
Percentage of truckers among total Khushi clinic attendees per month per clinic$	63.3	67.0	78.9	89.9	95.2	94.4	90.7
Percentage of truckers treated for STI-related symptoms	44.4	33.1	26.0	23.1	22.8	21.4	16.1
Percentage of truckers who bought medicines from Khushi clinic	0.0	0.0	7.0	74.7	91.2	95.1	97.8
Number of condoms socially marketed	33,510	465,149	704,511	1,306,837	1,609,553	1,959,525	2,738,411
Number of condoms sold per trucker in a year	8	24	46	28	26	32	53

Note:

$ Calculated as average of 12 months in the year of observation.

Abbreviation: STI, sexually transmitted infection.

Table 3 Change in level of program exposure and service utilization among long-distance truck drivers from January 2008 to July 2009, according to behavioral tracking surveys

	Round 1a (n = 1402)	Round 2b (n = 1407)	Adjusted ORc (95% CI)
Program exposure in last 12 months
Visited Khushi clinic	20.5	62.8	6.7 (5.6–7.9)
Watched street plays	10.4	56.1	11.3 (9.2–14.0)
Participated in health exhibitions	6.3	34.8	8.6 (6.7–11.1)
Participated in film shows	4.1	23.7	7.8 (5.8–10.6)
Attended trucker festival	12.4	24.7	2.4 (2.0–3.0)
Received audio cassettes	14.1	28.5	2.5 (2.0–3.0)
Service utilization in last 12 months
Received health card	13.1	21.7	1.8 (1.5–2.2)
Attended health camp	6.2	18.9	3.7 (2.8–4.8)
Received condoms	13.4	22.0	1.8 (1.5–2.2)
Received one-one counseling	15.4	20.8	1.5 (1.3–1.9)
Referred to ICTC, detoxification center	2.3	8.7	4.1 (2.7–6.1)

Notes:

a Survey round 1 was conducted in January 2008, n = 1402;

b survey round 2 was conducted in July 2009, n = 1407;

c odds ratio adjusted for age, education, marital status, duration of experience in the industry, and route category.

Abbreviations: CI, confidence interval; ICTC, integrated counseling and testing centers; OR, odds ratio.

Table 4 Change in level of awareness of STI-related symptoms, experience of STI-related symptoms, and treatment-seeking behavior from January 2008 to July 2009

Outcome indicators	Round 1a (n = 1402)	Round 2b (n = 1407)	Adjusted ORc (95% CI)
Aware of STI-related symptoms	74.8	82.4	1.5 (1.3–1.9)
Experienced STI- related symptoms in last 12 months	22.4	27.4	1.2 (1.0–1.5)
Sought treatment from Khushi clinic for STId	15.9	49.9	5.6 (3.8–8.2)

Notes:

a Survey round 1 was conducted in January 2008, n = 1402;

b survey round 2 was conducted in July 2009, n = 1407;

c odds ratio adjusted for age, education, marital status, duration in the trucking industry, and route category;

d analyzed among respondents who had STI-related symptoms in the 12 months prior to the survey.

Abbreviations: CI, confidence interval; STI, sexually transmitted infection; OR, odds ratio.