‘Health management’ in the private sector in the context of HIV/AIDS: progress and challenges faced by company programmes in South Africa

Abstract

'Health management' of employees is becoming a common imperative for companies that do business in regions where there is an HIV epidemic. Private sector initiatives in South Africa have evolved considerably. However, core components of HIV/AIDS-oriented workplace programmes, voluntary counselling and testing and anti-retroviral treatment, are not as effective as expected, despite considerable investment in them. There is some evidence to suggest gradual improvement in employee participation, yet this is coupled with employees defaulting from treatment programmes. This article explores reasons for these developments, the focus being on the economic and fi nancial challenges facing private sector workplace health programmes.

Psychosocial and behavioural correlates of attitudes towards antiretroviral therapy (ART) in a sample of South African mineworkers

“…An average of 20% of employees who tested HIV-positive during the VCT campaigns over that period were registering with the company-sponsored treatment programme. Even so, this rate resembles established trends in the private sector in South Africa (George & Quinlan, 2009). …”

“…Research has demonstrated that workplace HIV/AIDS programmes can provide rapid and widespread provision of ART and may indeed be effective in promoting treatment uptake and maintaining individuals on antiretroviral (ARV) medication (Charalambous et al, 2007). According to George and Quinlan (2009), the provision of ART to employees is largely motivated by the economic objective of preserving worker productivity in the hope that recruitment, training and absenteeism costs may be contained.…”

HIV/AIDS stigma at the workplace: Exploratory findings from Pakistan

“…An important question at this point is why organisations are forced to take discriminatory actions against employees with HIV/AIDS. Since HIV/AIDS-related health care programmes are a 'costly exercise' (George and Quinlan, 2009) organisations are reluctant to spend huge amounts on treatment of employees with HIV/AIDS as their chances of survival are quite low. Organisations must take steps to reduce this feeling of breach of psychological contract to enhance desirable outcomes like commitment (Raja, Johns & Ntalianis, 2004), organisational citizenship behaviour (OCB) (Robinson, 1996) and to reduce undesirable outcomes like cynicism (Johnson & O'Leary-Kelly, 2003).…”

Incentives for HIV testing at the workplace in the automotive industry in the Nelson Mandela Bay Municipality: Ethical considerations

“…Some studies and grey literature suggest that when lottery incentives were offered to employees, the workplace HIV-testing intention significantly improved, [11] or HIV-testing behaviour increased. [3,10] This suggests that some employees would probably not participate in workplace HCT if lottery incentives were not offered. Therefore, making use of lotteries allows the company to capture more reliable and muchneeded data about their company's HIV prevalence rates, as more employees are ready to test.…”

“…[1,2] Health management of employees is therefore a common imperative for companies that do business in regions where HIV impacts employees and communities. [3] No accurate estimates exist about the extent of the current HIV prevalence within the South African (SA) workforce, but the Health and Sciences Research Council (HSRC) has estimated that 6.4 million people were living with HIV in 2012 in SA, and that only 44.8% were aware of their HIV status. [4] Therefore, it can be assumed that many of those currently infected are not yet seeking treatment.…”