A Successful Workplace Program for Voluntary Counseling and Testing and Treatment of HIV/AIDS at Heineken, Rwanda

Abstract

Heineken Breweries launched a workplace HIV/AIDS program at its Rwanda subsidiary in September 2001. By January 25, 2005, 736/2,595 eligible individuals had reported for counseling and HIV testing: 380/521 employees (72.9%), 254/412 spouses (61.7%), 99/1,517 children (6.5%), and 3/145 retired (2.0%). As a result, 109 HIV+ individuals were identified: 62 employees, 34 spouses, 12 children, and 1 retired. In September 2003 an anonymous HIV seroprevalence survey was performed with participation rates of 69.4% for employees, 58.2% for spouses, and 79.7% for adolescents. Using the survey result, the expected number of HIV+ employees was 71, which implies a program uptake of 87.1% (62/71) in this group. Of the identified 109 HIV+ beneficiaries, 42 were on highly active antiretroviral treatment (HAART). In November 2003 a qualitative study of awareness and health-seeking behavior of the Heineken Rwanda beneficiaries identified key principles contributing to the success of this program.

Towards Universal Voluntary HIV Testing and Counselling: A Systematic Review and Meta-Analysis of Community-Based Approaches

“…61 studies reported uptake of different community-based testing approaches among 713,632 participants: seven studies evaluated index testing among 12,052 participants [29],[30],[41]–[46], three evaluated self-testing among 1,839 participants [47]–[49], 14 evaluated mobile HTC among 79,475 participants [26],[28],[50]–[59], 28 evaluated door-to-door testing among 555,267 participants [24],[25],[28],[30],[60]–[81], six evaluated workplace HTC among 62,406 participants [22],[82]–[86], and three evaluated school-based HTC among 2,593 participants [87]–[89] (Figure 2). The percentage of participants accepting HTC was 88.2% for index testing (95% confidence interval [CI] 80.5%–95.9%; I 2 99.7%, 95% CI 99.7%–99.8%; Figure 3), 87.1% for self-testing (95% CI 85.1%–89.0%; I 2 28.8%, 95% CI 0%–92.6%; Figure 4), 86.8% for mobile HTC (95% CI 85.6%–88.1%; I 2 99.9%, 95% CI 99.9%–99.9%; Figure 5), 80.0% for door-to-door HTC (95% CI 76.9%–83.1%; I 2 99.9%, 95% CI 99.9%–99.9%; Figure 6), 67.4% for workplace HTC (95% CI 32.8%–100.0%; I 2 100%, 100.0%–100.0%; Figure 7), and 62.1% for school-based HTC (95% CI 39.6%–84.5%; I 2 99.0%, 95% CI 98.5%–99.4%; Figure 8).…”

“…18 studies reported the CD4 counts of 8,993 participants found to be HIV-positive using point-of-care or standard lab diagnostics [29],[30],[51],[55],[56],[60],[61],[74],[76],[82],[110],[121],[124]–[127]. 56.7% (95% CI 49.6%–63.9%; I 2 97.6%, 95% CI 97.0%–98.1%; Figure 14) of participants testing positive had CD4 counts above 350 cells/µl.…”

Utilization of HIV and Tuberculosis Services by Health Care Workers in Uganda: Implications for Occupational Health Policies and Implementation

“…The preference to access HIV care outside their workplace is contrary to the recommendation to provide such care at the workplace, which has been found to be cost-effective [36], [37]. Offering HCWs a package of services not only for HIV and TB but also for infectious and non-communicable diseases may be the way to go.…”

From policy to action: how to operationalize the treatment for all agenda

“…Men – who access the health system less frequently than women – are tested in higher numbers when HIV testing is offered at work sites as compared to HIV testing clinics (e.g. 51.1% vs. 19.2%) [7, 8]. And, although the evidence is limited, provider-initiated testing and counselling of children in key health service entry points have shown an average yield of 16.6%, with paediatric inpatient units showing 22.5% [9].…”