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Saving lives, protecting jobs: new horizons in the fight against HIV/AIDS at work

HIV is having a devastating effect on the world of work. The majority of the 33.2 million people worldwide living with HIV/AIDS are working and have skills and experience their families, workplace and countries can ill afford to lose. As the UN’s lead agency in HIV/AIDS workplace interventions, the ILO is launching a new report highlighting strategic responses to HIV/AIDS in enterprises worldwide. ILO Online spoke with Dr Sophia Kisting, Director of the ILO/AIDS.

Article | 14 April 2008

ILO Online: Seven years after the adoption of the Code of Practice on HIV/AIDS and the world of work by the ILO Governing Body, much has been done to implement it. The SHARE (Strategic HIV/AIDS Responses in Enterprises) programme is in full swing. What is SHARE and how does it work?

Dr. Sophia Kisting: The workplace offers distinct opportunities and advantages as a key delivery point for HIV prevention, treatment and care programmes on an on-going basis. Using a combination of dialogue, training and facilitation methods, the SHARE programme aims to increase the capacity of government, employers’ and workers’ organizations in participating countries to protect working people from HIV and help to reduce its impact on the world of work. The main thrust of the SHARE programme is action at the enterprise level. The programme financed by the United States Department of Labor is now reaching more than a million workers.

ILO Online: What are its key components?

Dr. Sophia Kisting: SHARE aims at reducing employment-related discrimination against PLHIV; maintaining employment for workers living with HIV; reducing high-risk behaviour; and facilitating access to voluntary and confidential testing, treatment, care and support.

National ownership of the SHARE initiative is essential to the project’s success and sustainability. While there is a generic approach, this is adapted to be country specific on the basis of dialogue and collaboration with key stakeholders. Most countries now have national HIV initiatives in place, and SHARE’s role is to strengthen the world of work component at national level and introduce programmes at the enterprise level.

We work in the framework of the “decent work” agenda which is threatened in many ways by HIV.

ILO Online: Where does SHARE work?

Dr. Sophia Kisting: Five years since its inception, the SHARE programme is now collaborating with 650 enterprises, reaching an estimated one million workers in 24 countries. The first programmes set up under SHARE in Belize, Benin, Cambodia, Ghana, Guyana, India and Togo, are now well established and turning into sustainable national programmes.

As a result of positive achievements and effective programme implementation, SHARE projects are attracting increasing attention and their scope is expanding with additional funding becoming available. Chief among the new donors is the President’s Emergency Plan for AIDS Relief (PEPFAR), which has funded extensions to SHARE projects in Botswana, Guyana, India, Lesotho and Swaziland.

ILO Online: What impact has SHARE had?

Dr. Sophia Kisting: During the last four years, SHARE has been systematically gathering data from its first six country projects to measure the impact of its interventions. In Belize, Benin, Cambodia, Ghana, Guyana and Togo, workers demonstrated an informed attitude towards people living with HIV over the project implementation period.

In Cambodia for example, the proportion of workers who reported having a positive attitude towards condom use increased from 34 per cent to 68 per cent.

In Ghana, the percentage of workers who reported a supportive attitude towards co-workers living with HIV increased from 33% to 63%.

What’s more, only 14 per cent of the partner enterprises in the six countries had written HIV policies when the programme started. The figure rose to an average 76 per cent when final surveys were conducted.

Overall, 16 of the 24 countries where SHARE is implementing projects have adopted a national tripartite policy or declaration on HIV and the world of work. A total of 3,978 government officials, 1,238 employers’ organizations representatives and 5,077 representatives of trade unions have been trained on HIV in the workplace.

The data show that SHARE has made a significant contribution to the creation of an enabling and supportive workplace environment, and to a change in attitudes and behaviour.

ILO Online: Is changing attitudes and behaviour key to successful workplace interventions?

Dr. Sophia Kisting: Behaviour change programmes are an essential and central element in enterprise-level initiatives within SHARE. Many workers do not know enough about HIV to protect themselves, while others do know but still don’t change their behaviour to reduce the risk of infection.

Behaviour change is a form of participatory education that encourages people to understand their own attitudes to HIV, assess their own risks, and motivate them to change behaviour. The programme uses targeted messages and approaches and is implemented through a system of peer education. This is based on the idea that individuals are most likely to change their behaviour through the support of people they know and trust. Positive individual behaviour change in turn encourages and motivates more collective behaviour change.

ILO Online: What are the next steps in the fight against HIV/AIDS at the workplace?

Dr. Sophia Kisting: Some countries offer outstanding examples of how they address HIV/AIDS using the workplace for prevention, care and support, and to tackle stigma and discrimination. It is time to look at what has already been done in pioneer countries and build on good practices. We wish that the stories in the new ILO report will convince and inspire more ministries of labour, employers, and trade unions to intensify their efforts in addressing HIV.

The Recommendation on HIV and AIDS in the World of Work to be discussed at next year’s International Labour Conference would provide a framework for national policy development and action in this respect. The March 2007 session of the ILO Governing Body tabled the recommendation on the agenda of the International Labour Conference in June 2009 following wider demand for a new international labour standard by SHARE countries and ILO members in general.