HIV/AIDS - ISSUES FOR THE
WORKPLACE
PRINCIPLES, PLANNING,
POLICY, PROGRAMMES
AND
PROJECT PARTICIPATION
Rose Smart
HIV/AIDS Consultant
South Africa
Preamble
• Only fifteen years ago, if one had called
business, labour, government and non
government representatives together to
discuss how to deal with the AIDS epidemic,
most would not have even more than a
fleeting idea of what it was, let alone why they
should discuss it. Today, companies have lost
top managers, workers have lost colleagues
and huge amounts of time, energy and
emotion have been spent pre-occupied with
issues of illness and loss. Whole families
have collapsed, while companies struggling
against a background of chronic poverty have
taken on deeper burdens of dependency
Statement of the problem
• AIDS causes illness, disability and death
to workers and severe economic and
emotional disruptions to their families. It
also increases the cost of doing business.
• Disease prevention and health promotion
are not commonly thought to be business
concerns. The HIV/AIDS epidemic has
forced a reconsideration of this position.
Ten Workplace Facts(1)
• Fact - The crisis is immense - AIDS is a real problem affecting
workers and business operations - many companies are losing
around 3% of their workers to AIDS each year
• Fact - 80% of HIV transmission in Southern Africa occurs due to
heterosexual sex
• Fact - Young adults have the highest levels of infection and our
nation’s economically active population, parents of young
children and future leaders are at greatest risk
• Fact - AIDS will decrease life expectancy in South Africa by 20
years to about 40 by the year 2008
• Fact - HIV has increased the burden of ill health and mortality in
the 15 - 50 year age group two to three fold. According to the
ILO, an average of 15 years of working life will be lost per
employee due to AIDS
Ten Workplace Facts(2)
• Fact- The indirect costs of HIV/AIDS are greater than
the direct costs. The costs of lost time have been
consistently shown to be the most significant costs to
companies
• Fact- HIV infected persons have 5 - 10 years on
average of asymptomatic productive working life. This
period can be lengthened by health promotion and
stress management.
• Fact- Transmission of HIV poses little or no risk in most
work settings
• Fact- Averting an HIV infection through prevention
programmes yields a cost benefit ratio to companies of
anything from 1:2 to 1:400
• Fact- The workplace is an appropriate and important
setting for AIDS programmes because workers spend a
significant amount of time at work.
Ten Workplace Principles(1)
The following principles apply to the
workplace setting:
• Principle 1: Promote non-discrimination and
openness around HIV/AIDS
• Principle 2:: Because AIDS is a preventable disease
it makes sense to offer prevention education to all
workers and to specifically invest in targeting
situations of high risk
• Principle 3:: AIDS prevention works - we can change
behaviour. But, information alone is not enough to
change behaviour. Behaviour change is only
possible if we reach solutions by developing our own
responses and people need to be taught skills to
enable them to put the information into practice
Ten Workplace Principles(2)
• Principle 4: Education needs to be complemented by
supportive services
• Principle 5: AIDS programmes in the workplace can
help control the epidemic and reduce the impact on
businesses
• Principle 6: Effective AIDS prevention yields
enormous savings in averted AIDS costs
• Principle 7: The most powerful change agents are
our friends and peers
• Principle 8: The involvement of people living with
HIV/AIDS is central to an effective workplace
programme
Ten Workplace Principles(3)
• Principle 9: AIDS programmes must be simple,
specific, concrete and verifiable. Use core
management principles (simplicity, focus, precise
targets, strong performance monitoring) and an
explicit results chain (required inputs, outputs,
outcomes and impacts)
• Principle 10: Strategies and projects in areas of
economic and social development which address
poverty, income inequality, the bargaining power of
women, housing, migrancy and so on will address the
underlying factors which fuel the epidemic
Planning
A three-stage process is recommended to ensure optimal
workplace HIV/AIDS/STD/TB policies and programmes
Step One
• Identify factors related to your workplace which result in
HIV infection i.e. put the epidemic in its social, economic
and cultural context
• (i.e. who is infected or vulnerable to infection and why) by
identifying what is known, what is not known and
what information needs to be collected
• Collect information on:
structural issues (demography of the workforce,
migration, risk factors in the workplace), health issues
(STDs, TB) and policy issues
Planning: Step Two
Identify the obstacles and opportunities:
• (i) at worker level
relating to the context within which people live and
work
in respect of the resources that they have access
to
in the choices that they are empowered to make
• (ii) at organisational level
in respect of education and awareness
in respect of health care
in respect of social development
in respect of impact analysis
Planning: Step Three
• Identify priorities for action which
are realistic
exploit inherent resources
• will receive support from management, workers,
clients and community leaders
• Plans must encompass the three
cornerstones of an effective response to
HIV/AIDS, namely:
• Prevention, Care, Non-discrimination
Policy
There are significant benefits to developing and
adopting an HIV/AIDS/STD/TB workplace policy
which:
defines a company’s position
sets a foundation for the HIV/AIDS programme
provides a framework for consistency of practice
expresses standards of behaviour expected of
employees, supervisors and management
sets standards for communication about AIDS
lets employees know what assistance is available
• assures consistency with Government and
international statutes
Characteristics of a Successful
HIV/AIDS/STD/TB workplace policies
are formulated around principles of nondiscrimination, equity and confidentiality,
rights and responsibilities
are developed in consultation
are based on current medical knowledge
and scientific information
are dynamic and able to adapt to changing
situations
are communicated to all existing and all
new staff members
Programme
The benefits of an HIV/AIDS/STD/TB
workplace programme include:
reducing STDs = reduction in risk behaviour =
HIV infections prevented
reducing absenteeism, morbidity and mortality
creating a more tolerant and accepting attitude
towards HIV infected workers
producing positive effects on morale and
productivity
promoting the company’s image as a good
corporate citizen
Successful HIV/AIDS/STD/TB
programmes:
have top management support
are developed, implemented and monitored by bipartite
committees
are integrated into general health promotion programmes
are backed by access to a company health service
build environments for long-term behaviour change
monitor impact through collection and review of company
health, sick leave, turnover and productivity data
provide training and information support to staff managing
the programme
have a forum to exchange experiences and ideas
Project participation:
Among the many benefits of company participation in
community HIV/AIDS/STD/TB projects are the following:
increasing the capacity of communities to deal with
HIV/AIDS
allowing for the loaning of company resources and
skills such as:
marketing, advertising, public relations
communications and publishing
information technology
market research
employee volunteers
training resources
donation/loan of equipment
distribution networks
Project participation: other benefits
facilitating the establishment of
partnerships
improving inter-sectoral co-ordination and
communication
supporting socio-economic development
Successful project participation
embraces the vision of the National AIDS
Programme
builds alliances with community based
organisations
facilitates the sharing of resources
 is responsive to cultural issues
Conclusion
Employers of today find there are an ever increasing number
of social burdens being placed on them. Although the law
does not require an employer to develop a workplace AIDS
policy and programme, to do so makes good business sense
and makes for good labour relations. It gives a clear message
to the workforce that the employer is committed to social
issues, enables employees to protect themselves against
possible infection, provides the employer with an opportunity
to plan for the impact of HIV/AIDS and allows for the
minimising of the impact of the epidemic