1. HIV/AIDS - ISSUES FOR THE WORKPLACE
PRINCIPLES, PLANNING, POLICY, PROGRAMMES AND
PROJECT PARTICIPATION
Rose Smart
HIV/AIDS Consultant
South Africa

2. 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

3. 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.

4. 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 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

5. 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 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.

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. Characteristics of a Successful HIV/AIDS/STD/TB workplace policies
are formulated around principles of non-discrimination, 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

14. 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

15. 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

16. 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

17. Project participation: other benefits
facilitating the establishment of partnerships
improving inter-sectoral co-ordination and communication
supporting socio-economic development

18. 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

19. 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