Public Health Department, The University of Zambia, School of Medicine, P.O Box 5110, Lusaka, Zambia.
Zambia Federation of Employers, plot 6662 Mberere Road Olympia extension, PO Box 31941, Lusaka, Zambia.
BMC Public Health. 2018 Jan 25;18(1):180. doi: 10.1186/s12889-018-5072-y.
HIV workplace policies have become an important tool in addressing the HIV Pandemic in Sub-Saharan Africa. In Zambia, the National AIDS Council has been advocating for establishing of HIV/AIDS workplace policies to interested companies, however no formal evaluation has been done to assess uptake and implementation. The study aimed to establish the existence of HIV/AIDS policies and programs in the private sector and to understand implementation factors and experiences in addressing HIV epidemic drivers through these programs.
A mixed method assessment of the availability of policies was conducted in 128 randomly selected member companies of Zambia Federation of Employers in Lusaka. Categorized variables were analysed on Policy and programs using Stata version 12.0 for associations: Concurrently, 28 in-depth interviews were conducted on purposively sampled implementers. Qualitative results were analysed thematically before integrating them with qualitative findings.
Policies were found in 47/128 (36.72%) workplaces and the private sector accounted for 34/47 (72.34%) of all workplaces with a policy. Programs were available in 56/128 (43.75%) workplaces. The availability of policy was 2.7 times more likely to occur with increased size of a workplace, P value = 0.0001, (P < 0.05). Management support was 0.253 times more likely to occur in workplaces with policy, P value = 0.013, (P < 0.05) compared to those without. Having a specific budget for programs was 0.23 times more likely to occur in workplaces with a policy (P < 0.05) than those without a policy. Implementation was hindered by reduced funding, lack of time, sensitisation and lack of monitoring/evaluation systems. HIV awareness (56/56, 100%) and HIV/AIDS/Stigma (47/56, 83.93%) were the most addressed epidemic drivers through programs while Mother to Child Transmission (30/56 53.57%) and Males having sex with males were the least addressed (18/56, 32.14%).
HIV/AIDS policies exist in the private sector at a very low proportion but policy translation was very high suggesting that workplaces with polices are likely to implement programs. The eradication of HIV/AIDS by 2030, requires addressing epidemic drivers with a focus on marginalised populations, gender integration, a wellness and rights based approach within the context of the legal framework.
艾滋病毒工作场所政策已成为解决撒哈拉以南非洲艾滋病毒大流行的重要工具。在赞比亚，国家艾滋病委员会一直在倡导为感兴趣的公司制定艾滋病毒/艾滋病工作场所政策，但尚未进行正式评估以评估采用和实施情况。本研究旨在确定私营部门中艾滋病毒/艾滋病政策和方案的存在，并了解通过这些方案解决艾滋病毒流行驱动因素的实施因素和经验。
在卢萨卡的赞比亚雇主联合会的 128 家随机选择的成员公司中，对政策的可用性进行了混合方法评估。使用 Stata 版本 12.0 对政策和方案进行分类变量分析：同时，对有针对性抽样实施者进行了 28 次深入访谈。对定性结果进行主题分析，然后将其与定性结果整合在一起。
在 128 家工作场所中发现了 47 家（36.72%）有政策，私营部门在有政策的工作场所中占 34/47（72.34%）。在 128 家工作场所中，有 56 家（43.75%）有方案。工作场所的政策可用性增加一倍，发生的可能性增加 2.7 倍，P 值=0.0001（P<0.05）。有政策的工作场所发生管理支持的可能性是没有政策的工作场所的 0.253 倍，P 值=0.013（P<0.05）。有专门预算用于方案的工作场所发生政策的可能性是没有政策的工作场所的 0.23 倍（P<0.05）。资金减少、缺乏时间、宣传和缺乏监测/评估系统阻碍了实施。通过方案，艾滋病毒意识（56/56，100%）和艾滋病毒/艾滋病/耻辱感（47/56，83.93%）是最受关注的流行驱动因素，而母婴传播（30/56，53.57%）和男性与男性发生性关系则是最不受关注的（18/56，32.14%）。
艾滋病毒/艾滋病政策在私营部门中的存在比例非常低，但政策的转化程度很高，这表明有政策的工作场所可能会实施方案。要在 2030 年之前消除艾滋病毒/艾滋病，就需要在法律框架内，针对边缘化人群、性别平等、健康和权利，重点解决流行驱动因素。
