Evaluating the outcome of voluntary counselling and testing for HIV at the workplace : a Namibian case study

[摘要] ENGLISH ABSTRACT: In Namibia the HIV prevalence rate in adults (15 to 45 years of age) is estimated at 18.1%. The firstHIV infection in Namibia was reported in 1986 and the epidemic constitutes the biggestdevelopmental challenge for Namibia. Approximately 39 new infections occur every day andapproximately 28% of deaths in the country are AIDS-related.The majority of Namibia's workforce is in the age group of 15 years to 45 years and it can beanticipated that HIV and AIDS will have a major disruptive effect on the country's workforce as wellas its economy over the next two decades. According to the Namibian government, voluntarycounselling and testing (VCT) for HIV is one of the most effective methods to prevent the spread ofthe epidemic. With this in mind, this study aims to evaluate the outcome of voluntary counsellingand testing at one workplace in Windhoek, Namibia, to see whether VCT provides education as wellas whether VCT is a vehicle to promote awareness, good attitudes, intentions and behaviourchange. The main purpose of this outcome evaluation is to determine to what extent voluntarycounselling and testing at the workplace has led to HIV-related changes in knowledge, attitudes,behaviour and practises.Although the majority of respondents indicated that their knowledge of HIV had increased after theirparticipation in the VCT programme, upon closer analysis it was evident that participants who had asecondary or higher level of education had more knowledge, or had had more of a knowledgeincrease, than participants with a primary or lower level of education. From the research findings, itappeared that the voluntary counselling and testing had helped participants to identify theirindividual risks, as their self-reported risk perceptions with regard to becoming infected with HIVand/or a sexually transmitted disease increased after their participation in the VCT. There was alsoevidence that participants implemented risk reduction plans after the voluntary counselling andtesting, as the percentage of participants who had casual sex partners decreased while thepercentage of participants who had not had casual sex partners in the previous six monthsincreased.It can be concluded that the general attitude amongst employees towards HIV-positive people isrelatively non-discriminatory. However, it seems that the VCT was not as successful in transferringinformation and education on HIV amongst employees with lower education levels than amongsttheir peers with higher levels of education, and employees with primary or lower education levelsappear not to have benefited much from the intervention in terms of an increase in knowledge.It is recommended that voluntary counselling and testing be provided to the employees at thecompany on a regular basis, not only because employees have requested it, but also to monitorwhether the voluntary counselling and testing for HIV at the company has had the desired effects onthe employees, especially with regard to effecting an increase in knowledge, a reduction of stigmaand discriminatory attitudes, and the desired behaviour change amongst participants.

[发布机构] Stellenbosch University