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Voluntary testing the key to control
by Business Day
2001-12-06

Voluntary counselling and testing is central to business strategy in addressing HIV/AIDS, but it has to be accompanied by an appropriate treatment programme for people to come forward, says Clem Sunter, chairman of the Anglo American Chairman's Fund. Sunter says voluntary counselling and testing is particularly valuable for people who are HIV positive because it makes them aware of the need to change their behaviour so as not to pass the virus on to other people, as well as giving them the opportunity to stave off illness by living more healthily. Sunter says while there is some highly successful treatment available in SA, it is usually accessible only to people on medical aid schemes. Sunter says companies have to decide how far they can afford to go with treatment and whether they want to address it in-house or outsource to specialist disease management companies. Stephen Laverack, consultant for Aid for AIDS, a disease management programme for HIV/AIDS, says voluntary counselling and testing should be incorporated in a company's AIDS awareness programme. Laverack says by having the correct policies and procedures in place a company can convey the message that people will not be discriminated against if they test positive, and that when they become sick their illness will be treated in the same way as any other life-threatening condition. Laverack says peer educators have an important role to play in raising awareness and providing support. (Source: Business Day, 30 November 2001)

Voluntary counselling and testing is central to business strategy in addressing HIV/AIDS, but it has to be accompanied by an appropriate treatment programme for people to come forward, says Clem Sunter, chairman of the Anglo American Chairman's Fund.

If people test positive they can be put on a treatment programme, maintain a reasonable level of health at work and live longer, he says.

If they test negative, they can have a renewed incentive to remain negative.

Sunter says voluntary counselling and testing is particularly valuable for people who are HIV positive because it makes them aware of the need to change their behaviour so as not to pass the virus on to other people, as well as giving them the opportunity to stave off illness by living more healthily.

There is plenty you can do for a person who tests positive prior to his CD4 count falling to between 250 and 350, at which stage highly active antiretroviral therapy should begin, he says.

These programmes should include nutritional advice and prophylactics to pre-empt AIDS related opportunistic diseases like TB, pneumonia and thrush.

What could be added to the pre-therapy treatment are drugs that strengthen the immune system generally, some of which are still undergoing clinical trials.

Sunter says while there is some highly successful treatment available in SA, it is usually accessible only to people on medical aid schemes.

Drug companies haven't yet agreed to the kind of prices that make it a cost-effective form of treatment for many companies.

Sunter says companies have to decide how far they can afford to go with treatment and whether they want to address it in-house or outsource to specialist disease management companies.

Companies that opt to offer treatment in-house have to set up a medical delivery system that gets the right medication to the patient, ensures compliance, monitors the side-effects and resistance and makes adjustments when necessary, he says.

There are outsourcing organisations that offer an entire package. Companies don't have to do anything: they will test the people in confidence as well as offer pre- and post-test counselling.

Stephen Laverack, consultant for Aid for AIDS, a disease management programme for HIV/AIDS, says voluntary counselling and testing should be incorporated in a company's AIDS awareness programme.

Even if they don't have the facility in-house, they should promote the advantages of being aware of their HIV status. AIDS is largely a silent killer because people aren't aware of their status.

Laverack says by having the correct policies and procedures in place a company can convey the message that people will not be discriminated against if they test positive, and that when they become sick their illness will be treated in the same way as any other life-threatening condition. 

At the same time as conveying a message of confidentiality, companies can tell people it is the aim to keep them productive and healthy as long as possible. 

Laverack says peer educators have an important role to play in raising awareness and providing support. 

They can sit with their colleagues and explain what is involved in being tested and their right to receive pre-test and posttest counselling.

Source: Business Day, 30 November 2001

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