According to a US National Intelligence Council report, there will be 20 to 25 million HIV positive people in India by 2010, and statistics suggest most will be in the most economically productive age group, 18 to 40. A Confederation of Indian Industry (CII) estimate puts the cost to business of one HIV-infected employee at about INR 1,00,000 annually. Businesses are now realising that it is cheaper to provide preventative measures than meet the costs incurred by dealing with workforce problems arising out of HIV/AIDS. As a result, a number have initiated programmes aimed at raising HIV/AIDS awareness among their workforce. The following is one drawn up by Larson and Toubro (L&T), one of the biggest private companies in India. A long established engineering firm with plants across India, L&T employs a total of around 23,000 employees.
In 1985, L&T launched an awareness programme at its Powai works, by collaborating with an NGO, the Dilip Kumar Tyagi Trust. Through lectures, counselling and discussions by the company’s Employee Welfare Department, employees and their families were given a comprehensive overview of the infection, modes of transmission, prevention and treatment. Young people, including graduate trainees, employees’ children and local students were a particular focus of the programme.
In 1995, a 10 month baseline study was also conducted in a targeted intervention programme to give more structure. These initiatives were then taken up in the other plants and incorporated into their training calendars.
Orientation on HIV/AIDS awareness is now part of the L&T induction programme. In addition the company undertakes the following:
i) Awareness Generation
Through posters and information booklets; street plays; lectures and discussions, and in partnership with NGOs (for a list of NGO partners please see References below).
Peer educators are seen as one of the most important links in the prevention chain. ‘Training of trainers’ sessions are conducted quarterly among employees.
Community-based training programmes are offered for employees’ wives. A 2003 programme covered all the contract workmen and another covered about 70 bus drivers of L&T, Powai.
iii) Condom Distribution and Sexually Transmitted Disease (STD) Treatment:
Free condoms are provided at all medical centres on the plant sites and through vending machines at public places. Free medicines are provided for treatment of STDs as well as information and counselling on ‘risky behavioural practices’, HIV and its impact. Compliance to treatment and recurrence of STDs are also monitored.
Professionally trained counsellors offer information on prevention of HIV, pre-testing counselling and referrals to Voluntary Testing Centres. Counselling is also given to HIV-positive employees and their families. Workers and staff trained on HIV issues act as peer counsellors to their co-workers.
v) Care and support to HIV positive employees:
L&T counsellors and doctors liaise closely with doctors at external hospitals to ensure access to services without discrimination. The company runs a scheme for reimbursement and hospitalisation benefits, and appropriate work adjustment is carried out if a worker is not fit for a certain period. Group counselling is arranged to ensure support from colleagues and avoid discrimination.
Since 1997, 140 peer educators have been trained. At Powai between 1995 and 1998 more than 10,000 employees, 4500 family members and 1600 local children have received HIV awareness education.
No figures are available regarding the number of employees going for voluntary testing since this information is confidential.
However the company reports that:
i) No employees have quit their jobs or been terminated since the policy came into force.
ii) There has been a reduction in the number of HIV cases reported amongst employees.
iii) Since December 2003, the voluntary testing and counselling services have been utilised 573 times.
The following are some of the lessons learnt from L&T’s experience:
i) A multi-layered response is necessary in large companies with several plants.
ii) Education and prevention have to be built into the training strategy of the company.
iii) Peer educators play a key role in both prevention and care.
Involvement of trade unions: Failure to include unions in the planning and implementation of programmes could lead to friction and delays.
Ensuring multicultural material: Education materials should be multicultural and multilingual, and appropriately directed at specific target groups. Failure to do so could exclude certain groups
Approachability: The company’s programme implementation department should be positioned as a professional, neutral and non-threatening body. Any member percieved as judgemental could lead to intimidation amongst employees
Many other companies, either on their own or with NGO or government participation, have opened counselling centres, provided medical cover for workers, and are working to eradicate the social stigma attached to HIV carriers from the workplace. See References for other examples.