Boston University Center for Global Health and Development
Abstract
This repository item contains a single issue of the Health and Development Discussion Papers, an informal working paper series that began publishing in 2002 by the Boston University Center for Global Health and Development. It is intended to help the Center and individual authors to disseminate work that is being prepared for journal publication or that is not appropriate for journal publication but might still have value to readers.BACKGROUND: In the past three years, many large employers in South Africa have announced
publicly their intention of making antiretroviral treatment (ART) available to employees.
Reports of the scope and success of these programs have been mostly anecdotal. This study
surveyed the largest private sector employers in South Africa to determine the proportion of
employees with access to ART through employer-sponsored HIV/AIDS treatment programs.
METHODS: All 64 private sector and parastatal employers in South Africa with more than 6,000
employees were identified and contacted. Those that agreed to participate were interviewed by
telephone using a structured questionnaire.
RESULTS: 52 companies agreed to participate. Among these companies, 63% of employees had
access to employer-sponsored care and treatment for HIV/AIDS. Access varied widely by
sector, however. Approximately 27% of suspected HIV-positive employees were enrolled in
HIV/AIDS disease management programs, or 4.4% of the workforce overall. Fewer than 4,000
employees in the entire sample were receiving antiretroviral therapy. In-house (employer)
disease management programs and independent disease management programs achieved higher
uptake of services than did medical aid schemes.
CONCLUSIONS: Publicity by large employers about their treatment programs should be interpreted
cautiously. While there is a high level of access to treatment, uptake of services is low and only
a small fraction of employees medically eligible for antiretroviral therapy are receiving it
