MOTIVATION FOR PREVENTION:

You realise that, given national seroprevalence estimates from antenatal clinics of 10% and upward, it is likely that far more than 3 of the workers at the factory have HIV. This number is likely to increase as the epidemic expands. If you are going to provide a comprehensive and ethical service, it seems imperative that you will have to provide a service, not just for management of HIV positive workers, but also a service aimed at prevention.

However, you know that management will resist the introduction of any activities that will pose further costs to the company. For this reason, you decide to do a cost-benefit analysis (CBA) of the introduction of an HIV-prevention programme at the workplace to convince management that it is worthwhile.

Use the data presented below to develop your CBA for the Programme, which consists of the following:

• A series of workshops run with all health and safety representatives (total of 50 people) in groups of about 10. The groups are homogenous for language and job grading. The workshops each last 2 hours and 5 workshops are run over the full programme. The workers are trained to act as facilitators of training for other workers in the factory. They are then meant to run similar workshops for co-workers, but only 3 workshops are planned for the "final recipients" of the training.
• The workshops are run by Wola Nani, a non-governmental HIV project that charges R500 per workshop. The primary aims of the workshops are to increase knowledge and understanding about HIV, as well as to improve workers self-awareness and practice of behaviours that reduce HIV transmission. The workshops then go on to train participants to act as trainers of other workers, on the basis that the most effective trainers are peer educators.
• From previous experience, Wola Nani claim that their programme is able to reduce the incidence rates of HIV by about 50% in similar urban workforces.
• The workshops may also encourage participants to become more involved in HIV education amongst their peers, and may also encourage workers to seek HIV testing.
• In addition to the workshop, the programme includes the production of a series of posters (1 poster for every 25 employees) and pamphlets (ratio of 2 pamphlets for every one employee) providing information on HIV, and on testing for HIV, both at the plant and outside the plant, as well as services for people with HIV or wanting to be tested. To prepare the media materials, the safety representatives will need two meetings of an hour long each.