HIV in the Workplace in Botswana: Incidence, Prevalence, and Disease Severity

Abstract

Few detailed epidemiologic data exist regarding the impact of HIV infection on the workplace in the developing world. In addition, most HIV surveys examine only prevalence, without data on incidence or disease severity. In June 2003, we conducted a voluntary anonymous HIV serosurvey among employees of the Debswana Mining Company, the largest nongovernmental employer in Botswana. Among the 3558 participants, annual HIV incidence was estimated to be 3.4%, and HIV prevalence was 23.8%. HIV-infected participants had a median CD4(+) lymphocyte count of 427 cells/mm(3) (interquartile range 269-642), with 13.3% of samples <200 cells/mm(3). The high incidence and prevalence of HIV, and the proportion of workers with <200 CD4(+) lymphocytes/mm(3), demonstrate the impact of HIV infection in this workplace and the potential negative impact on productivity. These results highlight the need for routine HIV testing and access to antiretro-viral treatment for workers in countries such as Botswana.

HIV epidemiology and trends in a large national manufacturing company in South Africa, 2001–2006

“…In this manufacturing company, HIV prevalence appears to be inversely proportionate to employees' job skill level. Similar findings were described in workplace studies by Evian et al (2004), Colvin et al (2007) and Riviello et al (2007). In this set of surveys, lowest HIV prevalence was found in the upper-management category and highest prevalence in the unskilled category.…”

“…For both surveys, HIV prevalence was highest in the 30-39-year-old age group, which has been commonly found for male-dominated workplaces. These patterns are similar to those found in studies by Evian et al (2004), Colvin et al (2007) and Riviello et al (2007). HIV prevalence did not increase for the 18-29-year-old age group, however significant increases occurred in the aged 30-39 and aged 40-49 groups, and possibly also in the age 50+ category.…”

“…However, the permanent and contract workforce usually differed in their skill and age profiles, which are major determinants in differences in HIV prevalence (for example, see specific HIV prevalence by job category, below). Contract employees in diamond mines in Botswana were also found to have higher HIV prevalence (32.4%) when compared to permanent employees (20.1% prevalence) (Riviello et al, 2007).…”

“…There are few published papers about HIV prevalence in workplaces in southern Africa (e.g. Evian, Fox, Macleod, Slowtow & Rosen, 2004;Colvin, Connolly & Madurai, 2007;Riviello, Sterling, Shepherd, Fantan & Makhema, 2007) and currently none on serial surveillance. In this regard the author has done serial surveillance in various companies in Evian 306 southern Africa.…”

Recipient States in Global Health Politics

“…Eventually, the country's economy would suffer dramatically with decreasing figures of growth, consumption and productivity. A 2007 published study on the labour force of Debswana, the diamond public-private partnership, concluded that 'among the 3558 participants [of the survey], annual HIV incidence was estimated to be 3.4 per cent, and HIV prevalence was 23.8 per cent' (Riviello et al, 2007). It would also scare foreign investors away.…”