What can companies do to support HIV-positive workers? Recommendations for medium- and large-sized African workplaces

Abstract

Purpose -The purpose of the paper is to provide recommendations for medium-and large-sized workplaces on how to support HIV-positive employees. Supporting HIV-positive workers is an issue of social responsibility and an economic necessity for employers. HIV-positive workers can remain productive and healthy for many years if able to access appropriate HIV management support. Design/methodology/approach -Recent (2000-2010) academic and grey literature on HIV workplace management was reviewed and a qualitative study of nine workers receiving antiretroviral treatment (ART) in Zimbabwe was conducted by the authors. Results from both the literature review and qualitative study were used to develop recommendations. Findings -Carefully considered organizational support is of primary importance in the following areas: workplace HIV policy, voluntary testing and counselling, HIV management, HIV treatment uptake and adherence, day-to-day assistance, peer education, nutrition support, opportunistic infection (OI) monitoring and support to temporary/contract workers. Confidentiality is a key element in achieving positive outcomes in all areas of organizational support for HIV-positive workers. Practical implications -The paper provides a source of information and concrete advice for workplaces seeking to implement or augment HIV management and support services for their employees. The paper offers vital insight into workplace intervention strategies shown work best for workplaces and employees. Originality/value -The paper fills a need for comprehensive documentation of strategies for effective HIV management at medium-and large-sized workplaces.

Exploring HIV-Related Stigma and Discrimination at the Workplace in Southwestern Uganda: Challenges and Solutions

“…In one of the studies conducted in Australia, increased social support was associated with less HIV centrality, less internalised stigma, and less psychological distress [67]. Studies conducted among medium and large sized African workplaces demonstrated that employees will be more interested in taking up HIV testing if they know there is support available in case they are found to be HIV positive [18,68]. As a result of HIV-related stigma and discrimination, some individuals are denied necessary social support [44,69].…”

“…A study carried out in South India established that some people lose jobs after being screened and found to be HIV positive [43], implying that any job applicant who tests HIV positive would be denied employment opportunities. It is unfortunate that, to date, such discriminatory behaviours still exist in some enterprises [68]. However, according to the Uganda National Policy on HIV/AIDS and the World of Work, employees or prospective employees should not be subjected to personal discrimination on the basis of real or perceived HIV/AIDS status [77].…”

Employers’ responses to the HIV epidemic in sub‐Saharan Africa: Revisiting the evidence

“…As Scott et al. () note, supervisors and lower level managers may have other imperatives and may not understand the overall benefits of ensuring that workers have time to take their drugs or go to the clinic, and this can lead to uneven implementation, sometimes reliant on the attitudes towards the issue of individual supervisors (Scott et al., ). While their recommendations to improve this include better training for supervisors on company policy, they also acknowledge that lower level managers are under significant pressure to deliver results and hit targets.…”

“…In this study, these benefits are due to significant and sustained improvements in patients who were enrolled in an ART programme, with regard to the fatigue they suffered, their ability to perform normal tasks, increased rates of employment, and reductions in difficulties with job performance experienced by those in work (Rosen et al., ), reflecting both increasing workforce participation and, crucially, improved productivity at work. As a result, there is an increasing emphasis on more precisely quantifying the economic benefits of workplace programmes, accounting for the significant impact on productivity observed in HIV positive workers who have access to treatment and thus going beyond the standard framework which concentrates on costs “avoided,” documenting the challenges and barriers to the uptake and success of workplace programmes, as well as identifying best practice to support expanded implementation across the private sector (AIDS Accountability International & Rosencrantz and Co, ; George, ; ILO, ; Scott et al., ; UNAIDS, ). With ARVs increasingly (though in some cases intermittently) provided free at the point of access in many sub‐Saharan countries, the business case may be further enhanced if costs of treatment are removed from estimates of the costs of workplace programmes.…”

A win-win scenario? Employers’ responses to HIV in Tanzania: A qualitative study

“…Most studies that take the business case approach utilise human resources records to calculate the costs outlined above, whilst the evidence regarding the alternative ways that employers seek to shift the burden is largely anecdotal [25] and is not incorporated into the standard cost-benefit approach. The small body of literature that exists emphasises the challenges of implementing workplace programmes from the perspective of employees and lower level managers highlighting issues such as confidentiality and HIV stigma as key factors that influence the operational success of workplace programmes [30]. This article addresses this lack of research by reporting findings from a qualitative study that explored how employers (both private sector and public sector) viewed and responded to the issue of HIV in the workplace in the Tanzanian context.…”