Feedback from HIV Positive Employees of the Automotive Industry in Nelson Mandela Bay, South Africa

Martin Weihs1, Anna Meyer-Weitz2, Keith Appolis3, Friederike Baasner-Weihs,1 Sihle Ntlangu 1
1

Automotive Industry Development Centre Eastern Cape, GIZ, 2 University of KwaZulu-Natal, 3 Independent Researcher

Background
The AIDC EC has been implementing HIV&AIDS workplace programmes (WPP) in more than 15 supplier companies of the Nelson Mandela Bay automotive sector. An average HCT uptake of more than 80% was achieved in all companies. Employees tested HIV positive in the workplace are normally directed to access treatment, care and support services. Often, only assumptions could be made that HIV positive employees access these services and little is known of their experiences after testing.

Results

Figure 1: Identified disclosure categories

Aims
The primary aim of the study was to investigate the experiences of employees once tested HIV positive in the workplace with regard to the various challenges they face and ways of coping pertaining to psychological support, regular medical follow-up and ART adherence where relevant.

Methodology: Sampling
A qualitative in-depth study was conducted amongst 66 HIV positive employees in 6 automotive supplier companies in the Nelson Mandela Bay in which workplace programmes and HCT initiatives have been implemented by the AIDC EC during 2011 and 2012. Convenience sampling was used by the nurse responsible for the HCT to recruit HIV positive employees for participation in the study.

Demographic characteristics of the sample

Table 1. Characteristics interviewees (N= 66) Characteristic % Age in years 18-29 22.03 30-39 42.37 40-49 28.81 50-64 6.78 Sex Female 58.3 Male 41.7 Employment status Contractor 31 Permanent 41.4 Unemployed 27.6 Marital status Married 31 Unmarried 58.6 Living with a partner 10.3 Highest education reached High school 44.1 Matric 39 College 11.9 University 5.1 Medical aid membership Yes 32.2 No 67.8

Preliminary results from the forced disclosure category

Conclusion
The preliminary results of the forced disclosure category show how vulnerable some employees are once tested HIV positive in an environment that is not sufficiently prepared to guarantee confidentiality of HIV status. The results strongly indicate that HIV&AIDS workplace programmes efforts and investments are undermined by forced disclosures . Demeaned and enraged do not fully capture the extend of participants experiences and the length of therapy needed to get them to a wholesome resolution of their experienced trauma due to forced disclosure.

P1: I could die of embarrassment at being so brutally exposed. I felt naked, stripped of my pride.
Situation: Nursing staff loudly announce the HIV patients to their queue in

Those in need of CD4 checks or ARVs queue here. P1 avoids clinics and reneges on treatment protocols.
the public clinic:

P2: I felt discriminated by the nurses in the clinic and the general lay out at the clinic creates that, for example, people who are HIV sit on one side thats obvious that people would know that we are HIV positive. P3 was forced to disclose HIV status to this committee or lose the job. Situation: At the resumption of 2012,
P3 experienced health problems, which culminated in several short periods of hospitalization and minor surgeries. Towards the end of 2012 a pattern of absenteeism seemed to emerge which had P3 monitored for a behaviour of absenteeism. With the medical staff not consulted by management, as P3 was medically booked off, P3 was summoned for disciplinary discussions followed by termination of employment. P3 was reinstated after disclosure.

Recommendations for the AIDC ECGIZ programme

WPP implementers need to consider that the success of a WPP also strongly depends on the environment HIV positive employees have to interact with. Clear procedures and control mechanisms need to be in place in the workplace to guarantee confidentiality of employees HIV status. Feedback from HIV positive employees to identify challenges needs to be integrated into WPP monitoring systems. WPP implementers together with all stakeholders that are linked to the WPP need to make sure that identified challenges are addressed.

Methodology: Measures
A semi-structured interview schedule with open ended questions was used. Participants were interviewed at least twice. Ethical approval was obtained from the University of KwaZulu Natal.

Methodology: Analysis
All interviews were transcribed verbatim for the purpose of data analysis. The computer software package Atlas.ti was used to manage and code the data. No specific research question informed the data analysis, instead thematic analysis was conducted (Braun & Clarke, 2006). The entire data set was systematically processed and any interesting aspects were identified so as to form the basis for repeated themes across the data set. Direct quotations illustrated these identified themes and analysis was then conducted on a purely semantic level. Analysis was conducted within realistic/essentialist paradigms and motivations: experience and meanings were thus theorised in a straight-forward way because a largely unidirectional relationship was assumed between meaning, experience and language (Potter & Wetherell, 1987).

P4 was forced to disclose HIV status at P4s childs school. Situation: Forced disclosure of childs status at school so as to
inform teacher.

The companys wellness officer had to disclose P5s HIV status to three police officers. Situation: P5 had to work
overtime over weekends, the end results of which was protracted argument with physical overtones. The police were called in and P5 was taken into custody from Sunday to Tuesday. I had not taken my meds for two days when I reached the (companys) wellness officer.

Acknowledgements
This work was conducted in 2012-2013 during a project run by the Automotive Industry Development Centre Eastern Cape (AIDC EC) and the German Development Cooperation (GIZ) in cooperation with the UKZN. Many thanks to the AIDC EC and GIZ.

P6: I had disclosed my status without my consent to the (new) boyfriend I recently broke up with, I sometimes feel lonely as if no one cares, I do not trust certain people in my life. Situation: P6s former partner
disclosed P6s status to the family of P6s new partner. The new partner left P6 being pregnant.