The company had long realised that the health and well being of its employees contributed to efficient production and a caring ethos in the workplace. Located in Industria, west of the Johannesburg CBD, the 250 employees in a manufacturing environment had access to a full-time on-site nurse and a visiting doctor once a week. At the time of this study less than 25% of staff were members of a formal medical aid plan.

HIV/AIDS related deaths, while not confirmed, had started to increase in the past two years, when in late 2001 management believed that a proactive strategy beyond education and counselling was required to address the problem.

The increasing awareness of the rising impact in the workplace spawned an informal workers’ HIV/AIDS Committee which encouraged all employees to voluntarily contribute R10 or more per month from their pay towards a fund that was supporting colleagues who needed vitamins and nutritional supplements. The company had a blood donation drive and donated R50 to the fund for every pint of blood donated by employees on an on-going basis. The clinic sister, while maintaining confidentiality, managed the distribution of nutritional supplements and supportive medication employees.

Surveillance initiative

The company commissioned a saliva prevalence test process in February 2002. Following talks and education, 227 employees from the 250-strong workforce were tested with 23 (10.1%) testing positive. The prevalence in the 20 to 40 year age band was 17,5% with other age groups accounting for the balance.

The results were published in the workplace and the company offered VCT. To date 38 staff members have received VCT with 13 testing positive.

Anti-retroviral (ARV) drugs offered to employees

The proposal was made to the overseas shareholders to provide ARV drugs at the appropriate time to all employees who come forward for VCT and request ARVs. The budgets showed that the related costs are affordable to the company, and the Board of Directors approved the proposal.

The company formed an HIV/AIDS Committee to manage the funding of the ARV initiative, set policy and drive the HIV/AIDS Strategy in the company. With prevalence levels that are manageable within reasonable budgets, the HIV/AIDS Strategy is focussed on prevention, peer educators, healthy lifestyle and nutrition. The following points highlight some interesting aspects of the ARV initiative, and its impact on participating staff:

•    All 13 individual employees who tested positive and registered with the programme have regular CD4 and viral load checks. Three employees have low CD4 counts and are receiving ARV therapy.

•    A charge of R25 per week is levied to recipients receiving ARV therapy primarily to introduce a “sense of value” to the privilege.

•    The company expects a strong reciprocal responsibility from the HIV-positive employee to comply with ARV protocols and reserves the right to withdraw therapy if the CD4 counts show that the employee is not compliant.

•    Two of the five employees on the ARV programme have volunteered to become peer educators and help drive the HIV/AIDS campaign.

•    Two cases have shown CD4 counts raised from under 50 in March 2002 to over 100 by July 2002 and viral loads dropping from over 20 000 to undetectable levels after one month, and remaining there.