After months of preparation, the HIV committee prepared a meeting room filled with hundreds of saliva sample bottles ready for use in the HIV prevalence tests and nurses ready to assist….but not a single worker appeared!

The committee (made up of representatives from the unions, staff societies and senior management including the MD) had followed all the recommendations offered at HIV conferences and in best practice guides. Senior production managers had taken each employee in the company through a personal HIV training and awareness programme. Line managers were scheduled to lead each of their teams to provide saliva specimens. The external medical team contracted to carry out the sampling had addressed all 330 employees in the previous two weeks explaining the procedure.

The issues

What became clear in the difficult discussions in the months following this abortive event, was that employees could not understand how the results would be of any benefit to them, and they were suspicious that management was trying to identify HIV positive individuals within the workforce. Employees held the perception that the disease was limited to members of the African population group, and that the management team intended to replace sick workers with recruits from other (less infected) race groups. Employee representatives had not been able to alter this perception, since they had not been adequately educated and had not been active participants in the process. Employees also feared that the infection rate within the company was extremely high, a perception gleaned from media reports from antenatal clinic surveys.

The employee-led approach

The new plan, spearheaded by a co-employee who had openly changed his lifestyle since coming to terms with the extent of the HIV epidemic in KwaZulu-Natal, involved every employee in a HIV-prevalence education programme. The initiative was positioned as an essential safety and health training programme for the workers and not for management’s benefit. The first group to pass through the programme consisted of the shop stewards and middle managers. The education programme emphasised how the information from the prevalence testing would be put to use to benefit both employees and the company. Attendees participated in many different role-play exercises and were called on to put themselves in positions such as a foreman, production manager and even a foreign shareholder in order to understand perspectives on each level.

The prevalence saliva testing was then re-launched in conjunction with a knowledge attitude and behaviour study. The success of the new communication programme has facilitated the company in collecting the anonymous prevalence results with a set of 24 responses to the KAP survey as well as the standard demographics. This level of trust between unions and management on HIV/AIDS is unprecedented in HIV/AIDS workplace activities. More than 95% of all employees provided saliva samples and KAP responses.