Center for International Health and Development
Treatment of HIV/AIDS at South Africa's
Largest Employers: Myth and Reality
Patrick Connelly and Sydney Rosen
Health and Development
Discussion Paper No. 5
Center for International Health and Development
Boston University School of Public Health
85 East Concord St., 5th fl.
Boston, MA 02118 USA
Treatment of HIV/AIDS at South Africa's largest employers HDDP 5
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.
Keywords: HIV/AIDS, South Africa, Private Sector,Antiretroviral Therapy, Disease
Patrick Connelly and Sydney Rosen are at the Center for International Health and Development
at Boston University in the U.S. and the Health Economics Research Unit at the Wits Health
Consortium, University of the Witwatersrand in South Africa.
Correspondence to: Patrick Connelly, email@example.com.
Treatment of HIV/AIDS at South Africa's largest employersHDDP 5
Funding for this study was provided by the South Africa Mission of the U.S. Agency for
International Development through its Cooperative Agreement No. 674-A-00-02-00018 with
Right to Care. We thank our research assistants, Kay Muller and Jeremy Ogusky, who
conducted many of the interviews reported here.
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