Abstract
BackgroundHIV workplace policies have become an important tool in addressing the HIV Pandemic in Sub-Saharan Africa. In Zambia, the National AIDS Council has been advocating for establishing of HIV/AIDS workplace policies to interested companies, however no formal evaluation has been done to assess uptake and implementation. The study aimed to establish the existence of HIV/AIDS policies and programs in the private sector and to understand implementation factors and experiences in addressing HIV epidemic drivers through these programs.MethodsA mixed method assessment of the availability of policies was conducted in 128 randomly selected member companies of Zambia Federation of Employers in Lusaka. Categorized variables were analysed on Policy and programs using Stata version 12.0 for associations: Concurrently, 28 in-depth interviews were conducted on purposively sampled implementers. Qualitative results were analysed thematically before integrating them with qualitative findings.ResultsPolicies were found in 47/128 (36.72%) workplaces and the private sector accounted for 34/47 (72.34%) of all workplaces with a policy. Programs were available in 56/128 (43.75%) workplaces. The availability of policy was 2.7 times more likely to occur with increased size of a workplace, P value = 0.0001, (P < 0.05). Management support was 0.253 times more likely to occur in workplaces with policy, P value = 0.013, (P < 0.05) compared to those without. Having a specific budget for programs was 0.23 times more likely to occur in workplaces with a policy (P < 0.05) than those without a policy. Implementation was hindered by reduced funding, lack of time, sensitisation and lack of monitoring/evaluation systems.HIV awareness (56/56, 100%) and HIV/AIDS/Stigma (47/56, 83.93%) were the most addressed epidemic drivers through programs while Mother to Child Transmission (30/56 53.57%) and Males having sex with males were the least addressed (18/56, 32.14%).ConclusionHIV/AIDS policies exist in the private sector at a very low proportion but policy translation was very high suggesting that workplaces with polices are likely to implement programs. The eradication of HIV/AIDS by 2030, requires addressing epidemic drivers with a focus on marginalised populations, gender integration, a wellness and rights based approach within the context of the legal framework.
Highlights
human immune deficiency virus (HIV) workplace policies have become an important tool in addressing the HIV Pandemic in Sub-Saharan Africa
Distribution of policy and programs The proportion of private sector workplaces accounted for 111/128 (86.75%) of the total survey
Most respondents reported that they had difficulty in addressing this because it is a personal choice, as explained by one implementer, Addressing elements of HIV and Acquired immunodeficiency syndrome (AIDS) through programs We found that HIV and AIDS awareness was being addressed by all workplaces with programs 56/56 (100%) and that the majority of workplaces, 53/56 (94.0%) provided voluntary counselling and testing services
Summary
HIV workplace policies have become an important tool in addressing the HIV Pandemic in Sub-Saharan Africa. In Zambia, the National AIDS Council has been advocating for establishing of HIV/AIDS workplace policies to interested companies, no formal evaluation has been done to assess uptake and implementation. The study aimed to establish the existence of HIV/AIDS policies and programs in the private sector and to understand implementation factors and experiences in addressing HIV epidemic drivers through these programs. The human immune deficiency virus (HIV), the virus that causes the acquired immune deficiency syndrome AIDS, continues to be one of the major causes of death globally. Of the 1.1 million deaths attributed to HIV and AIDS in 2015, the majority, 990,000, occurred among adults [1]. Zambia is among the sub-Saharan African countries that have been heavily affected by the HIV and AIDS epidemic. Apart from having to deal with increased deaths among employees, workplaces faced increased production costs due to absenteeism resulting from sick leave and funeral attendance and increased medical costs [4, 5]
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