Treatment of HIV/AIDS at South Africa's largest employers: myth and reality.
OBJECTIVE
To determine what proportion of employees at the largest private-sector companies in South Africa have access to HIV/AIDS care and treatment, including antiretroviral therapy (ART); how many employees are enrolled in disease management programmes; how many are receiving ART; and which approach to the financing and delivery of care is proving most successful at reaching eligible employees.


METHODS
All 64 private-sector and parastatal companies with more than 6000 employees in South Africa were identified and contacted. Those that agreed to participate were interviewed by telephone using a structured questionnaire.


RESULTS
Fifty-two companies agreed to participate. Among these companies, 63% of employees had access to employer-sponsored care and treatment for HIV/AIDS. However, access varied widely by sector. Approximately 27% of suspected HIV-positive employees were enrolled in disease management programmes, or 4.4% of the workforce overall. Fewer than 4000 employees in the entire sample were receiving ART. In-house (employer) disease management programmes and independent disease management programmes achieved higher uptake of services than did medical aid schemes.


CONCLUSIONS
Publicity by large employers about their treatment programmes should be interpreted cautiously. While there is a high level of access to treatment, uptake of services is low and only a small fraction of employees medically eligible for ART are receiving it.
Center for International Health and Development, Boston University School of Public Health, USA. pcon@bu.edu
Patrick
P
Connelly
Sydney
S
Rosen
D000163:Acquired Immunodeficiency Syndrome / Q000191:economics / Q000628:therapy*; D004651:Employment; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D009786:Occupational Health Services / Q000379:methods*; D012189:Retrospective Studies; D013019:South Africa