An overview of HIV/AIDS workplace policies and programmes in southern Africa.
BACKGROUND
Workplace programmes refer to a range of company-based interventions including the institution of an HIV/AIDS policy, voluntary counselling and testing (VCT), and antiretroviral therapy (ART) provision.


OBJECTIVE
To review the existing information on workplace policies and programmes in southern Africa, and ascertain the common accomplishments in and challenges to implementation and efficacy.


METHODS
Given the paucity of peer-reviewed academic publications, information for this review was also drawn from working papers, symposia proceedings, and case studies. A convenience sample of 17 key informants was identified, and semi-structured interviews were conducted.


RESULTS
Workplace policies and programmes of varying sophistication are proliferating in large companies and selected sectors. Accomplishments include the institution of a legal apparatus that safeguards against discriminatory practices, the high prevalence of HIV education programmes, the growing provision of VCT, and the development of supply-chain initiatives that may enable smaller companies to develop HIV programmes. Challenges include poor recognition and monitoring of legal violations by management and unions, lack of monitoring and evaluation (M&E) methodologies for workplace HIV prevention programmes, persistent stigma in the workplace resulting in poor uptake of HIV testing, and low enrollment into workplace ART programmes.


CONCLUSIONS
The existing literature indicates a wide variation in workplace policies and programmes currently in place in southern Africa. The effectiveness of workplace interventions at the firm level, including prevention and treatment programmes is difficult to assess with currently available data. Further research on workplace programmes that addresses operational challenges to implementation and develops M&E strategies is urgently needed.
UCLA Program in Global Health, University of California, Los Angeles, California 90024, USA. anishmahajan@mednet.ucla.edu
Anish P
AP
Mahajan
Mark
M
Colvin
Jean-Baptiste
JB
Rudatsikira
David
D
Ettl
D019380:Anti-HIV Agents / Q000191:economics / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics* / Q000517:prevention & control; D006266:Health Education; D006291:Health Policy / Q000331:legislation & jurisprudence; D006801:Humans; D008297:Male; D009786:Occupational Health Services / Q000191:economics / Q000331:legislation & jurisprudence; D013019:South Africa; D017132:Workplace / Q000331:legislation & jurisprudence
D019380:Anti-HIV Agents