Eskom has helped more than 20 South African companies create their own HIV/AIDS programs. What are the most important components of an effective and sustainable testing and counseling program? Components of an effective and sustainable testing and counselling program include the following: 1. Visible and felt leadership People trust and believe what people in leadership say and do. When leadership has bought into the program they will drive it and put in the necessary resources to promote it. At Eskom, HIV/AIDS is one of the top ten priorities that are being managed for its own sustainability. For any program to work, it has to be driven from the "top." 2. Confidentiality
- The results of the HIV test are strictly confidential and cannot be shared with anyone without the client’s consent. This includes spouses/partners and employers.
- If confidentiality is not maintained the counselor could be charged legally or a complaint of a breach of ethics could be laid against the counselor.
- All our VCT is run by ICAS (an external service provider) and this has really assisted the employees to feel comfortable that the employer will not know their status.
- The counselors used by ICAS are qualified psychologists.
3. Consent
- It is crucial that the client gives consent for the test to be done and it is best if this consent is obtained in writing. It is consent that makes the ‘Voluntary" in VCT.
- Testing requires ‘informed consent’, meaning that the client has been fully informed and understands the test and its implications, giving consent with understanding.
4. Effective counselling
- Counseling is provided both before and after the test.
- During counseling the person is given as much information as possible on HIV/AIDS . Issues covered during pre and post test counseling include amongst others prevention methods available (irrespective of the outcome of the results) and disclosure. The person should feel cared for and supported at all times
5. Clear objectives for testing
- Important to share the following with people on the importance of doing an HIV test:
- It is the one time individuals are in a one-to-one situation to raise and discuss important issues regarding HIV in their own lives.
- So that people who are HIV negative will be motivated to take appropriate steps to remain HIV negative
- So that people who are HIV positive will take steps to ensure they do not infect others, are monitored and treated appropriately
- So that pregnant women who are HIV positive can decide on the options available for them to reduce MTCT
- "The sooner HIV is managed, the less costly is the treatment and the longer the person is likely to live"
6. Incorporation of VCT within the wellness program VCT should not be isolated from the components of "well being" and this will help to "normalise" HIV/AIDS within the workplace. All VCT at Eskom is done by an external service provider, ICAS, to guarantee confidentiality and ensure qualified emotional support. How does using an external service provider encourage greater uptake of VCT? Employees feel comfortable that since it is done externally the employer will not know their status. Employees fear discrimination and even if all our policies are non discriminatory, that discomfort is there all the time. Since the incorporation of ICAS as our external service provider, VCT uptake has improved and employees’ trust is enhanced. Before any VCT campaign, ICAS holds a mass briefing to explain the purpose of and the process for testing. What concerns have participantsexpressed?
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Is the rapid test used reliable?
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What test will be used? Blood or saliva?
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Reluctance to being "pricked" especially men
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Who will know the results? Is it really confidential?
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Why is Eskom concerned about HIV/AIDS as an employer?
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What are the resources available should an employee test positive?
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What will happen if the test is positive?
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How does the medical insurance assist in registering an HIV positive employee for chronic disease management and ART if need be?
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What about the spouses and dependants (VCT at Eskom does encourage spouse testing)
Stigma significantly impedes HIV testing. How is Eskom addressing this issue?
- Non discriminatory policies and procedures exist and are easily accessed by all employees.
- Discrimination and stigmatisation is not tolerated at Eskom
- We have incorporated VCT within our wellness program.
- VCT is available throughout the year versus only during annual VCT campaigns
- HIV/AIDS is discussed at staff meetings and is a standing item on most agendas at Eskom, including the "top 200 meetings"
- Eskom has a support group with employees living with HIV. This support group called ELWHA (Employees Living With HIV/AIDS) have reached out to employees that have tested positive and have assisted them greatly in coping and embarking on the "journey" with them.
- They assist them with treatment adherence and compliance and show the other employees that positive living is the way to go within Eskom. We have seen more and more employees living openly with HIV/AIDS within Eskom and not fired because of their HIV status
Eskom guarantees confidentiality and job security. What specifically does the company do to promote this message and build employee trust?
- Advocacy of our existing non discriminatory Policies and Procedures
- Available information on HIV/AIDS on all our internal communication mediums (Eskom news, intranet and the HIV/AIDS toolkit)
- Guaranteed confidentiality by incorporating ICAS as an external service provider doing the test and offering the 24/7, 365 days psychosocial support for all those affected and infected by the HIV virus.
- Eskom supports the support group (ELWHA) as these employees have disclosed and are living openly with HIV and they were not fired from work. That surely helps employees gain the trust that is so necessary for the success of the program
How does Eskom address the broader sociological issues-substance abuse, intimate partner violence- that fuel the spread of HIV/AIDS?
- The issue of Substance abuse is spoken about a lot within Eskom and is linked as well to issues around Safety.
- This month for instance communiqué was sent throughout the company, highlighting substance abuse and what employees need to watch out for and what to do is they have substance abuse issues.
- There is available 24/7, 365 days psychosocial support that is available telephonically and sessions arranged for face to face counselling for all employees who had problems that lead them to abuse substances.
- Our EAP (Employee Assistance Program) includes substance abuse management and rehabilitation. Eskom pays for the employees’ rehabilitation costs
- Gender violence issues are spoken about at formal and informal sessions.
- Eskom is one of the companies partaking in the campaign called "16 days activism against violence to women and children." Here issues on gender violence are addressed and discussed
- Courses on "anger management" are available for all to access and attend
The Eskom/SABCOHA Supply-Chain initiative helps small and medium enterprises (SMEs) in the supply-chain roll out workplace programs. Why is it important to extend services to this population? Eskom has identified HIV/AIDS as one of the risks to manage as it operates in a country that has one of the highest prevalence of HIV/AIDS in the world. Eskom has an enormous task to build more Power Stations to be able to meet the energy demands that are forever rising in South Africa. Suppliers can be worst hit by the pandemic if not properly managed and this will affect the sustainability of the supply chain to Eskom and jeopardise the Capital expansion program. BER survey 2005, did allude to the fact that most SMME (Small Micro Medium Enterprises) do not have any thing in place in the management of HIV/AIDS. Since Eskom has a comprehensive HIV/AIDS workplace program, it made sense then to extend it to the suppliers to assist them in managing HIV/AIDS within their companies. |
