WORKPLACES are increasingly being targeted as fertile grounds for the fight against HIV/AIDS because workers spend most of their time there; working and interacting with their colleagues.
Because of their higher literacy levels, workers are also better placed to understand the meaning, causes, preventive measures, and other issues surrounding the epidemic, which has continued to attract the attention of governments, civil society, and other interest groups owing to its devastating effects on populations.
HIV/AIDS has many cost implications on the economy of a country as it wipes out the productive sector of the population.
Similarly, the social landscape of a country is affected. Many breadwinners die, the number of orphans escalates, and anti-social behaviour such as commercial sex work goes up.
Health experts have established an important link between poverty and HIV/AIDS.
Zambia is one of the sub-Saharan African countries worst affected by the pandemic, with a prevalence rate of about 14.3 per cent, according to the latest Ministry of Health estimates.
The 2008 Zambia Demographic Health Survey, states that 16 per cent of women and 12 per cent of men of sexually active age are HIV positive, with young people aged between 15 and 24 accounting for 6.5 per cent of the HIV statistics.
Some of the key factors in the spread of HIV are multiple, concurrent sexual partners that some people have engaged themselves in.
The relationship between HIV and poverty is well-established; poverty directly or indirectly promotes behaviour that leaves people vulnerable to HIV.
As a result of poverty, preventable and treatable diseases have taken an enormous toll on poor people who do not have access to professional healthcare information, education and secure employment.
Sexually transmitted infections (STIs) are also a major public health problem in Zambia. Up to 10 per cent of all outpatient attendances at health institutions are related to STIs; with the most affected age-group being between 15 and 44 years.
STIs are said to increase the chances of HIV transmission in cases of unprotected sex between an HIV-positive person and one who is not.
A doctor from the department of obstetrics and gynaecology at the University Teaching Hospital in Lusaka, Bwalya Nkole, says HIV 1, which is found in Zambia, causes the most serious illnesses and faster progression of AIDS.
Dr Nkole said at a Zambia Business Coalition workshop in Kitwe recently that a number of men had now resorted to circumcision, an operation that was yet to be fully appreciated.
She told the participants that circumcision was not an answer to reducing HIV, but when used with condoms effectively and consistently it reduces the chances of contracting the virus.
She said circumcision reduces the risk of HIV by 60 per cent, with condom use as an additional strategy and not a stand-alone measure.
Another doctor from Luanshya Mine Hospital, Boniface Zulu told participants that HIV is a manageable chronic disease that needs the involvement of everybody.
Dr Zulu urged the participants to encourage their male colleagues to get circumcised, saying the scientific basis for circumcision proved to be effective and that it reduces the chances of cancer of the penis in men and reduces the chances of their partners to get cervical cancer.
He said as one is entering the 40s - the age of malignancies - where cancers and high blood pressure are common due to low immunities, people should be cautious and go for check-ups.
He said it was important for people to test for the virus because if one knew their status, they would know how to take care of themselves.
Dr Zulu also challenged the participants that one is able to know how to relate with clients who are HIV positive when they know their status as most people involved in the fight against HIV/AIDS do not even know their status.
He said people living with the virus need dignity and it can be restored to them through maximum confidentiality, which has been a challenge for most counsellors and people involved in HIV/AIDS programmes.
Dr Zulu said healthcare was being affected because of the interaction of conventional and traditional remedies.
According to a Zambia Business Coalition survey, 82 per cent of the people who die in the workplace die from HIV-related illnesses.
The Zambia Business Coalition comprises public and private companies, and non-governmental organisations in Zambia, which have come together to respond to HIV/AIDS and mitigate its impact.
Currently made up of 72 member companies from various business sectors all over the country, it closely works with the Government, donor community and other entities involved in addressing issues of HIV/AIDS.
Lizzy Chanda, a facilitator from the Zambia Business Coalition said focal point persons are key leaders in the implementation of workplace policies.
She said a good workplace policy should be independent; it should not involve sister companies but employees of a particular organisation should be fully involved at all levels as that would guide them on how best to implement their programmes.
HIV/AIDS workplace programmes have at times proved to be challenging.
With the creation of multi-national companies, some organisations have adopted policies of sister companies in other countries, making local programmes difficult to sustain.
Ms Chanda said when formulating a policy, an organisation should know the prevalence rate, the level of knowledge about the pandemic, attitude and practises pertaining to the company.
She said people should be encouraged to go for testing as long as they are sexually active because "every time is a new experience".
According to her, one of the obstacles to implementing HIV/AIDS programmes is financial support.
Failure to understand the importance of HIV/AIDS programmes has proved to be a big challenge. Some organisations perceive issues of HIV/AIDS as belonging to employees outside management.
Additionally, Ms Chanda said workplace policies cannot be separated from the community within which an organisation operates.
Copperbelt Provincial AIDS co-ordinating advisor, Violet Mongeza said generally, workplace HIV/AIDS programmes, especially in line-ministries on the Copperbelt, had not been doing well due to factors such as inadequate funding.
Ms Mongeza said focal point persons do not have enough time and support to carry out their activities.
Some supervisors do not support financing of HIV/AIDS activities because of "thin" budgets and prefer giving prominence to other areas.
For most focal point persons, it is basically a volunteer arrangement and they cannot be held accountable for not pushing the programmes forward.
Ms Mongeza said focal point persons desire some incentives for the work they do.
Exchange visits, information sharing and some responsibility allowances would encourage them to press ahead with workplace policies.
However, she said not all hope was lost as the private sector was doing well in this area.
As Ms Mongeza put it, it will be important for organisations to prioritise HIV/AIDS programmes and encourage training of more peer educators this year.
Lately, most organisations have moved from concentrating on HIV/AIDS alone.
But like Dr Zulu said, with the dominance of malignances, organisations are also looking at wellness, where a general health check encompassing all health aspects is conducted.
It is common knowledge that an organisation that has healthy employees is highly-productive and is bound to meet its set targets.
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Concentrating on the workforce is like the drunk who lost his keys in an alley looking for them under a lamppost because there's more light there. It is people without jobs who are less likely to know how to protect themselves from HIV, more likely to sell sex, and less likely to be able to afford condoms.
"She told the conference that circumcision was not an answer to reducing HIV, but when used with condoms effectively and consistently it reduces the chances of contracting the virus."
A traveller came to a farmhouse and offered to make the occupants Nail Soup in return for a night's shelter. He threw a large iron nail in a pot of boiling water and said - A Magic Nail is not an answer to making delicious soup, but when used with herbs, spices, vegetables and meat effectively and consistently, it increases the chances of a succulent flavour." The farmer's wife accepted this, and In the morning the traveller went on his way, refreshed after a night in a comfortable bed, minus the Nail, with some gold coins in his pocket and the thanks of the family ringing in his ears for the wonderful Magic Nail that made such delicious Nail Soup.
In the same way, it may well be that a circumcision campaign as Dr Nkole describes will be followed by some fall in the HIV rate, and circumcision will get all the credit, but it will be the meat, vegetables and herbs of "condoms used effectively and consistently" that will have really made any difference. The money and effort spent on circumcision would be better spent on promotion of ABC - and zero grazing, one partner at a time, and testing between them.
As your figures show, women are more at risk of HIV, and a study in Uganda was stopped after 18% of the women with circumcised HIV+ partners turned HIV+ while only 12% of the women with non-circumcised HIV+ partners did. The result was not statistically significant, but if circumcision does increase the risk to women that could more than undo any benefit to men.
There is so much wrong with this article it is hard to determine where to begin.
This emphasis on the workplace is wrong. Unless sexual intercourse is a part of the employees job, it is not the domain of the employer. However, there have been attempts to enforce circumcision policies such as the attempt by a school master to require circumcision for a student to attend school. These cases have always failed in court.
Circumcision does not prevent HIV/AIDS. If it did at anywhere remotely close to the claims, it would be conspiciously absent from circumcised populations. This effect is not seen anywhere in the world.
Condoms are the "fall back." Condoms are known to be 99%+ effective and along with testing, could eliminate the disease in a single generation. By knowing your partner's HIV status and using condoms every time with the exception of when conception is desired, HIV could be virtually eliminated from the African continent in a single generation. The much trumpeted HIV studies are known to be false and fraudulent by their authors and thus the emphasis on condoms. They are desperately trying to make actual conditions on the continent match their studies with this emphasis on condom useage.
Indeed, studies have shown that circumcised men are more resistant to using condoms. The mechanics of this is the belief (backed by studies going back almost a century) that circumcision removes parts important to the sexual experience and dulls the penis to sexual sensation. Circumcised men who have used condoms will attest to the reduced enjoyment of the act. The belief is that condoms reduce the enjoyment of the act to below acceptable levels making these men less prone to use condoms and engage in risky sexual practices.
All studies purporting to show an increase in STDs are refuted by other studies contradicting the claims. By no means is the issue resolved.
Actual statistics have shown that male circumcision has virtually no effect on penile cancer. The incidence of penile cancer is 1 in 109,000 males, very rare but it is always brought up by circumcision promoters. Male circumcision has also shown to to have absolutely no effect on cervical cancer but is also used as an excuse by circumcision promoters.
I don't now where Zulu came up with the high blood pressure issue but male circumcision has absolutely no effect on blood pressure.
I can see that some over zealous employers could try to make male circumcison a requirement for employment. This is a violation of the employee's rights and dignity. Circumcision is not the business of the employer and will not affect the employer or his business.
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Circumcision is a dangerous distraction in the fight against AIDS. There are six African countries where men are *more* likely to be HIV+ if they've been circumcised: Cameroon, Ghana, Lesotho, Malawi, Rwanda, and Swaziland. Eg in Malawi, the HIV rate is 13.2% among circumcised men, but only 9.5% among intact men. In Rwanda, the HIV rate is 3.5% among circumcised men, but only 2.1% among intact men. If circumcision really worked against AIDS, this just wouldn't happen. We now have people calling circumcision a "vaccine" or "invisible condom", and viewing circumcision as an alternative to condoms. The South African National Communication Survey on HIV/AIDS, 2009 found that 15% of adults across age groups "believe that circumcised men do not need to use condoms".
The one randomized controlled trial into male-to-female transmission showed a 54% higher rate in the group where the men had been circumcised btw.
ABC (Abstinence, Being faithful, Condoms) is the way forward. Promoting genital surgery will cost African lives, not save them.