HIV Prevention Knowledge Base
Structural Interventions: Workplace Interventions to Prevent HIV
Zambia: Support to the HIV/AIDS Response in Zambia (SHARe) Program
The Support to the HIV/AIDS Response in Zambia (SHARe) Program aims to support the institutional response to HIV and AIDS by building local capacity, improving the policy environment and strengthening leadership. The program includes collaborations with employers and workplace HIV prevention projects to enhance prevention, treatment and support services for employees, families and the wider community. This factsheet gives an update on four SHARe Project objectives: targeted assistance for workplace and community activities; a standardized planning template for multi-sectoral plans; a tracking tool to assess ministry-level efforts to address HIV; and HIV and AIDS leadership training for politicians.
School as a Workplace in Kenya: Evaluation of the Teachers Matter HIV/AIDS Project
The "Teachers Matter" project uses a peer-led education program to improve primary and secondary school teachers' HIV-related knowledge and reduce their own risk behavior. This study found that the intervention reached four out of five targeted teachers and despite initial skepticism, the program was well-received. Teachers welcomed the chance to discuss the effect of HIV in their lives (four in ten had first-hand experience of a bereavement due to AIDS), reported greater confidence in coping with HIV-related issues and lowered their perceived risk of HIV. However, fear of the consequences of a positive HIV test result remained, and the program did not have an impact on testing of teachers' partners. To maximize benefits, similar programs should be conducted during school hours or offer incentives for full participation.
Cost Benefit Analysis of Workplace Programmes in Zambia
This cost-benefit analysis of workplace HIV programs in seven Zambian mining and agricultural companies revealed that six of the companies saw a net benefit to their program (an average saving of US$47 per employee in 2006). Workplace programs can also have a positive impact on the surrounding communities (improving access to information, condoms, testing and sometimes treatment), but employers need to explicitly state that getting tested and treated is viewed favorably by the company and is not a threat to employment. Non-permanent staff should be included in workplace programs and community outreach efforts should be in the local language, the authors write. HIV should be seen as a strategic issue for companies, with tangible and identifiable costs and benefits.
Corporate Responses to HIV/AIDS: Case Studies from India
This report highlights key lessons learned from HIV interventions by Indian businesses, such as leveraging local partnerships, and strategies to keep track of highly mobile groups. Countering poor public health infrastructure, social stigma and message fatigue are also discussed. The case studies of five private and public sector companies describe awareness, prevention and advocacy interventions typically targeting contract workers, employees, truckers and local communities. Key messages for those developing corporate responses to HIV are the need for early and decisive action, formal evaluation of cost effectiveness and ensuring continuity of commitment and financing.
HAART for the HIV-infected Employees of Large Companies in Africa
Heineken's decision in 2001 to include highly active antiretroviral therapy in its health benefits package prompted criticism of the company's workplace HAART programs. The authors of this paper take each argument, ranging from cost, practicality and sustainability to corporate responsibility, ethics and political considerations, and refute the reasoning behind each one. The paper describes how the Heineken Workplace Programme chose just two HAART combinations and trained medical staff in three stages, starting with a theory workshop, a practical traineeship and regular teleconferences supported by an electronic database. The authors counter critics' question: "Why do you do this?" with their own question: "When will you start?"
Expanding Workplace HIV/AIDS Prevention Activities for a Highly Mobile Population: Construction Workers in Ho Chi Minh City
Peer-led HIV education programs reach more workers and are more effective than health communicator-based programs, according to this study which randomly assigned 23 construction sites to the two interventions. Contrary to concerns that construction workers would not be capable and reliable peer educators, they contacted more workers and distributed more condoms, had better program retention rates and in time acquired equal or better knowledge about HIV and sexually transmitted infections than the health communicators. Although sexual norms in support of HIV risk reduction were higher at peer educator sites, low reported levels of sexual activity make the impact on risk behavior difficult to assess. Peer education programs cost less than health communicator programs, but management support was crucial.
Private Sector Intervention: Case Example [AngloGold]
In 2002 South African mining company AngloGold had an estimated workforce HIV prevalence of 30%. Under its direct service model for workplace HIV prevention, care, support and treatment it allocated a budget of $58 per employee (total $2.6 million) for HIV prevention. It also provided voluntary testing, anticipated providing antiretroviral therapy for a projected 820 patients and fostered community partnerships. Using peer educators and distributing free condoms were two mainstays of the company's HIV prevention program, along with treatment of sexually transmitted infections at company clinics. Key factors include interventions targeting behavior change and a focus on organizational action rather than risk assessment, but applicability of this model to other organizations may be limited by the substantial economies of scale that AngloGold can achieve.
The Private Sector Responds to the Epidemic: Debswana—a Global Benchmark
This report describes the response of Botswana diamond mining company Debswana to the country's HIV epidemic, and hails it as a "ray of hope in a bleak situation". The report covers the early years of Debswana's response to HIV in the late 1980s and the process behind the company's first institutional HIV audit. In 2000 Debswana's new HIV strategy comprised six major elements (epidemic containment, economic impact containment, minimizing the impact of living with AIDS, stakeholder engagement, evaluation measurement and communication). The report highlights key lessons for other companies, such as the role of the management information system in monitoring the impact of HIV, identification of critical posts and ensuring ownership of HIV audit results though internal company-wide participation.