The impact of and responses to HIV/AIDS in the private security and legal services industry in South Africa potx

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Compiled by the Social Aspects of HIV/AIDS
and Health Research Programme of the HSRC
Funded by and prepared for the Safety and
Security Sector Education and Training Authority
The impact of
and responses
to HIV/AIDS in the

private security
and legal services
industry in
South Africa
S A F E T Y S E C U R I T Y
&
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Funded by and prepared for the Safety and Security Sector Education and Training
Authority (SASSETA).
Published by HSRC Press
Private Bag X9182, Cape Town, 8000, South Africa
www.hsrcpress.ac.za
First published 2007
ISBN 978-0-7969-2205-2
© 2007 Human Sciences Research Council
Copy-edited by Laurie Rose-Innes
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Suggested citation:
Simbayi LC, Rehle T, Vass J, Skinner D, Zuma K, Mbelle MN, Jooste S, Pillay V, Dwadwa-
Henda N, Toefy Y, Dana P, Ketye T & Matevha A (2007) The impact of and responses to
HIV/AIDS in the private security and legal services industries in South Africa. Cape Town:
HSRC Press.
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
List of tables and figures v
Foreword ix
Contributors x
Acknowledgements xii
Abbreviations and acronyms xiv
Executive summary xv
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1.1 Background 1
1.2 Literature review 1
1.3 Epidemiological model 6
1.4 Objectives 6
1.5 Conceptual framework of the project 7
1.6 Scope 8
1.7 Overview of the report 10
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2.1 Introduction 11
2.2 Overall research approaches 11
2.3 Study 1 (HIV prevalence, HIV incidence and KABP survey):

the formative research phase 11
2.4 Study 1 (HIV prevalence, HIV incidence and KABP survey):
the main study 12
2.5 Study 2 (Business impact and response):
the formative research phase 20
2.6 Study 2A (Employer survey of business impact and response):
the main study 20
2.7 Study 2B (Employee survey of business impact and response):
the main study 21
2.8 Study 2C (Review of HIV/AIDS policies) 21
2.9 Ethical considerations 23

3.1 Introduction 25
3.2 Response analysis 25
3.3 HIV prevalence 29
3.4 HIV incidence 31
3.5 Behavioural and social determinants of HIV/AIDS 33
3.6 Voluntary counselling and testing 43
3.7 Substance use 46
3.8 Self-reported behaviour change 47
3.9 Male circumcision 48
3.10 Communication about HIV/AIDS and related issues 48
3.11 Associations between HIV prevalence and sexual behaviour indicators 50
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4.1 Introduction 55
4.2 Response analysis 55
4.3 HIV prevalence and HIV incidence 60
4.4 Knowledge, attitudes, perceptions and behaviour 62
4.5 Awareness and use of VCT services 67
4.6 Self-reported behaviour change 68

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4.7 Substance use 69
4.8 Communication about HIV/AIDS and related issues 70
4.9 Associations between HIV prevalence and sexual behaviour indicators 72
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
5.1 Introduction 73
5.2 Response analysis 73
5.3 Perceptions of general HIV/AIDS impact 78
5.4 Impact on employee profile 78
5.5 Impact on employee costs 80
5.6 Impact on demand and supply of skills 81
5.7 Business response 83
5.8 Employee perceptions of HIV/AIDS impact 85
5.9 Discussion 87
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
6.1 Introduction 91
6.2 Response analysis 91
6.3 Perceptions of general HIV/AIDS impact 96
6.4 Impact on employee profile 97
6.5 Impact on employee costs 98
6.6 Impact on demand and supply of skills 100
6.7 Business response 101
6.8 Employee perceptions of HIV/AIDS impact 103
6.9 Discussion 105


7.1 Introduction 107
7.2 Background 107

7.3 Commentary on policies 108
7.4 Gaps and general problems with the policies 110
7.5 Key issues not included in the policies 114
7.6 Areas requiring improvement 120

8.1 Introduction 133
8.2 Summary of main findings for Study 1: HIV prevalence,
HIV incidence and KABP survey 133
8.3 Perceptions of business impact and responses 138
8.4 Recommendations 144
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Appendix 1 Nurses who were trained as fieldworkers 153
Appendix 2 Terms of reference for policy experts 154
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Tables
Table 1.1 Crude and adjusted company-level HIV prevalence in 22 South African
workplaces 3
Table 2.1 Overview of employees and companies in the sub-sectors from various
sources 12
Table 2.2 Policy reviewers 22
Table 3.1 Individual response rates for interviews and testing by background
characteristics 25
Table 3.2 Characteristics among respondents interviewed and tested for HIV 26
Table 3.3 Profile of respondents compared to the national profile of employees
in the private security sector 28
Table 3.4 Profile of study participants from the private security firms vs. national
profile of employees in the private security sector 28

Table 3.5 HIV prevalence among respondents by demographic characteristics 30
Table 3.6 HIV prevalence among respondents by occupational category 30
Table 3.7 HIV incidence among respondents by demographic characteristics 32
Table 3.8 Responses to individual HIV/AIDS knowledge items by sex 33
Table 3.9 Attitudes towards HIV/AIDS (N = 2 787) 35
Table 3.10 Perceived seriousness of HIV/AIDS by sex and race 36
Table 3.11 Perceptions of personal risk of HIV infection by sex 37
Table 3.12 Reasons for believing that one did not have a high risk of HIV infection 38
Table 3.13 Sexual activity of respondents in the past 12 months by sex and race 39
Table 3.14 Number of sexual partners in the past 12 months by sex and race 39
Table 3.15 Age mixing among sexually active respondents by sex and race 40
Table 3.16 Condom use during last sexual intercourse by demographic characteristics 41
Table 3.17 Condom use during last sexual intercourse in different age groups by
marital status and number of partners 42
Table 3.18 Awareness of where to access VCT services 44
Table 3.19 Alcohol use as measured using AUDIT scores by demographic
characteristics 46
Table 3.20 Self-reported behaviour change by sex 47
Table 3.21 Communication messages/slogans about HIV/AIDS recalled by
respondents by sex 49
Table 3.22 Comfort in communication with others about sex and HIV/AIDS-related
issues by sex 49
Table 3.23 HIV prevalence and key sexual behaviour practices 51
Table 3.24 HIV prevalence and age mixing by sex 52
Table 3.25 HIV prevalence and perceived personal risk of HIV infection 52
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Table 3.26 HIV prevalence and awareness of HIV status 53
Table 3.27 HIV prevalence and recency of HIV test 53
Table 4.1 Individual response rates for interviews and testing by background

characteristics 55
Table 4.2 Profile of respondents by demographic characteristics (N = 421) 56
Table 4.3 Profile of respondents by employment category and situation, and
household economic situation (N = 421) 57
Table 4.4 Characteristics among respondents interviewed and tested for HIV 58
Table 4.5 HIV prevalence among respondents by demographic characteristics 60
Table 4.6 HIV prevalence among respondents by occupational category 61
Table 4.7 Responses to individual HIV/AIDS knowledge items by sex 62
Table 4.8 Responses to individual attitudinal statements about HIV/AIDS 64
Table 4.9 Perceptions of personal risk of HIV infection by sex 64
Table 4.10 Reasons for believing that one did not have a risk of HIV infection 65
Table 4.11 Age mixing among sexually active respondents by sex 66
Table 4.12 Awareness of where to access VCT services 67
Table 4.13 Self-reported change of behaviour by sex 69
Table 4.14 Alcohol use as measured using AUDIT scores by demographic
characteristics 70
Table 4.15 Communication messages/slogans about HIV/AIDS recalled by
respondents by sex 71
Table 4.16 Comfort in communication with others about sex and HIV/AIDS-related
issues by sex 71
Table 4.17 HIV prevalence and perceived personal risk of HIV infection 72
Table 5.1 Profile of employer respondents 73
Table 5.2 Profile of employees by occupational category, population group and
sex (N = 14 105) 75
Table 5.3 Profile of employees by age group, population group and sex (N = 972) 76
Table 5.4 Employment status of employees 77
Table 5.5 Perceptions of past and future impact of HIV/AIDS on operations and
profits (N = 13) 78
Table 5.6 Perceptions of the HIV/AIDS impact on employee profile 79
Table 5.7 Reported number of employees (n) who may have died due to AIDS or

AIDS-related causes, 2003–2006 79
Table 5.8 Reported number of employees (n) who may have left due to health-related
causes, 2003–2006 80
Table 5.9 HIV/AIDS impact on increasing employee benefit costs (N = 12) 81
Table 5.10 Impact on expenditure on HIV/AIDS services (N = 12) 81
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vii
Table 5.11 Perceived impact of HIV/AIDS on the demand and supply of
skills (N = 12) 82
Table 5.12 HIV/AIDS impact on investment in training by occupation (N = 12) 82
Table 5.13 HIV/AIDS impact on output, service delivery and consumer demand 83
Table 5.14 Awareness and implementation of HIV/AIDS policies 83
Table 5.15 Implementation of HIV/AIDS programmes (N = 12) 84
Table 5.16 Employee perceptions of HIV/AIDS impact on employees and
the company 85
Table 5.17 Awareness of HIV/AIDS policies and their implementation 85
Table 5.18 Employee knowledge about content of and gaps in company
HIV/AIDS policies 86
Table 5.19
Reported employee access to HIV/AIDS interventions in company 86
Table 5.20 Perceived gaps in company HIV/AIDS interventions (N = 732) 87
Table 6.1 Profile of employer respondents 92
Table 6.2 Profile of employees by occupational category, population group
and sex (N = 417) 93
Table 6.3 Profile of employees by age group, population group and sex (N = 417) 94
Table 6.4 Employment status of employees (N = 416) 95
Table 6.5 Perceptions of HIV/AIDS as a business concern and the measurement
thereof 96
Table 6.6 Perceptions of past and future impact of HIV/AIDS on operations and
profits (N = 20) 97

Table 6.7 Perceptions of the HIV/AIDS impact on employees by occupational
category (N = 19) 97
Table 6.8 Reported number of employees who may have died due to
AIDS or AIDS-related causes, 2003–2006 (N = 15) 98
Table 6.9 Reported number of employees who may have left due to health-related
causes, 2003–2006 (N = 15) 98
Table 6.10 HIV/AIDS impact on increasing employee benefit costs (N = 19) 99
Table 6.11 Impact on expenditure on HIV/AIDS services (N = 18) 99
Table 6.12 Perceived HIV/AIDS impact on the demand and supply of skills (N = 19) 100
Table 6.13 HIV/AIDS impact on investment in training by occupation (N = 18) 100
Table 6.14 Potential HIV/AIDS impact on supply of critical skills and strategies for
skills turnover (N = 20) 101
Table 6.15 HIV/AIDS impact on output, service delivery and consumer
demand (N = 20) 101
Table 6.16 Awareness and implementation of HIV/AIDS policies 102
Table 6.17 Implementation of HIV/AIDS programmes (N = 20) 102
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Table 6.18 Employee perceptions of HIV/AIDS impact on employees and the
company 103
Table 6.19 Awareness of HIV/AIDS policies and their implementation 104
Table 6.20 Employee knowledge of contents and gaps in company HIV/AIDS
policies (N = 101) 104
Table 6.21 Reported employee access to HIV/AIDS interventions in company 105
Table 6.22 Perceived gaps in company HIV/AIDS interventions (N=134) 105
Table 7.1 Coverage of key issues in the HIV/AIDS policies of SASSETA and private
security companies 109
Table 7.2 Coverage of key issues in the HIV/AIDS policies of the legal firms 109
Figures
Figure 1.1 Epidemiological model of the impact of HIV/AIDS in a workplace 7

Figure 2.1 HIV testing strategy 17
Figure 3.1 Profile of respondents by employment benefits (N = 2 787) 29
Figure 3.2 HIV test history, participation in VCT and awareness of HIV status 45
Figure 4.1 Profile of respondents by employment benefits (N = 421) 58
Figure 4.2 Sexual activity and number of partners in the past 12 months by sex 66
Figure 4.3 HIV test history, participation in VCT and awareness of HIV status 68
Figure 5.1 Profile of employees by occupational category (N = 14 105) 75
Figure 5.2 Employees by age group (N = 972) 76
Figure 5.3 Number of companies with health-related benefits (N = 11, 8, 8, 11 & 9) 80
Figure 6.1 Profile of employees by occupational category (N = 417) 93
Figure 6.2 Employees by age group (N = 417) 94
Figure 6.3 Number of companies with health-related benefits (N = 16, 10, 12 & 11) 99
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
When sector education and training authorities (SETAs) were established in 2000 and we
drafted the first sector skills plan, the consultation process with stakeholders contained
one constant input: HIV and AIDS may have an impact on our sector and we should be
doing something about it. At the time, the Police, Private Security, Legal, Correctional
Services and Justice (Poslec) SETA realised that it had an important contribution to make
towards the fight against AIDS with a distinct training perspective. However, nobody
could give direction in respect of what the SETA should focus on. While the majority of
interventions generally seemed to focus on prevention awareness, some employers were
raising questions around succession planning and maintaining a healthy workforce.
Others were raising questions about the cost to their companies.
It was very clear that the scope and impact of the HIV and AIDS problem in the then
Poslec sector was not understood, and that interventions from a SETA perspective would
be short-sighted if they were not designed and specifically targeted to meet the sector’s
needs. Thus, the idea of this research project was born.
Now, seven years later, SASSETA is proud to present the results of the first survey into the

state of HIV and AIDS in two of its constituencies – the private security industry and the
legal profession. This project, sponsored by SASSETA, was a collaborative effort between
the HSRC, SASSETA and stakeholder representatives over one and a half years. While the
process was not without stumbling blocks, we believe this to be a major step in the
direction of informed and targeted interventions for our sector.
Having covered four very important aspects, namely a policy provision analysis, a
business impact study, a knowledge, attitudes and practices (KAP) survey, and a
prevalence and incidence survey, the findings and recommendations in this report can
now be constructively be put to use in the development and implementation of HIV and
AIDS management strategies for the private security industry and the legal profession. As
is evident from the report, both groups are affected by HIV and AIDS; however, the
hesitancy to participate in this survey on the part of so many employers is a clear
indicator that the subject-matter has not crossed into the general awareness of businesses
in our constituency. We hope that this report will be useful, beyond its original purpose
of informing the SETA, in contributing to the general body of knowledge that is being
generated on the subject.
This publication is presented to the reader with the challenge to take HIV and AIDS
seriously as an individual and as a businessperson. Perhaps, if we manage to repeat a
similar study in the future, we may be fortunate enough to witness the difference we
have made.
Temba Mabuya
Acting CEO, SASSETA
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Authors are listed in order of contribution to the conceptualisation and preparation of the
proposal, the development of the questionnaire, preliminary planning, management of the
project, data collection, data analysis and report writing.
Leickness Chisamu Simbayi, DPhil
Research Director

Behavioural and Social Aspects of HIV/AIDS Section
Social Aspects of HIV/AIDS and Health Research Programme
Thomas M Rehle, MD, PhD
Research Director
Epidemiology, Strategic Research and Health Policy Section
Social Aspects of HIV/AIDS and Health Research Programme
Jocelyn Vass, MA
Senior Research Specialist
World of Work Section
Education, Science and Skills Development Research Programme
Donald Skinner, PhD
Chief Research Specialist
Behavioural and Social Aspects of HIV/AIDS Section
Social Aspects of HIV/AIDS and Health Research Programme
Khangelani Zuma, PhD
Chief Research Specialist
Epidemiology, Strategic Research and Health Policy Section
Social Aspects of HIV/AIDS and Health Research Programme
Ntombizodwa M Mbelle, MA(ELT), MPH
Senior Research Manager (Doctoral Research Trainee)
Behavioural and Social Aspects of HIV/AIDS Section
Social Aspects of HIV/AIDS and Health Research Programme
Sean Jooste, MA
Research Specialist (Doctoral Research Trainee)
Behavioural and Social Aspects of HIV/AIDS Section
Social Aspects of HIV/AIDS and Health Research Programme
Victoria Pillay, PhD
Research Specialist
Epidemiology, Strategic Research and Health Policy Section
Social Aspects of HIV/AIDS and Health Research Programme

Nomvo Dwadwa-Henda, MA
Chief Researcher (Doctoral Research Trainee)
Behavioural and Social Aspects of HIV/AIDS Section
Social Aspects of HIV/AIDS and Health Research Programme
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xi
Yoesrie Toefy, MA
Database Manager (Doctoral Research Trainee)
Social Aspects of HIV/AIDS Research Alliance (SAHARA)
Pelisa Dana, PhD
Research Specialist
Epidemiology, Strategic Research and Health Policy Section
Social Aspects of HIV/AIDS and Health Research Programme
Thabile Ketye, MA
Senior Researcher
Epidemiology, Strategic Research and Health Policy Section
Social Aspects of HIV/AIDS and Health Research Programme
Azwihangwisi Matevha, MA
Senior Researcher (Doctoral Research Trainee)
Behavioural and Social Aspects of HIV/AIDS Section
Social Aspects of HIV/AIDS and Health Research Programme
Nkululeko Nkomo, MA
Senior Researcher (Doctoral Research Trainee)
Behavioural and Social Aspects of HIV/AIDS Section
Social Aspects of HIV/AIDS and Health Research Programme
Yolande Shean
Project Administrator
Behavioural and Social Aspects of HIV/AIDS Section
Social Aspects of HIV/AIDS and Health Research Programme
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A project of this magnitude and complexity involves several people in both its planning
and execution. Therefore, we wish to thank the following people and organisations for
their meaningful contributions to this study:
The South African Safety and Security Sector Education and Training Authority •฀
(SASSETA) for awarding the tender to the HSRC to conduct this study. We especially
wish to acknowledge Ms Yvette Raphael and Mr Jens Gunther from SASSETA for
their continuous support throughout the study. Without their passion and strong
commitment, this study would not have been successfully completed.
The Steering Committee members consisting of senior staff from SASSETA, the HSRC •฀
and the various stakeholders from SASSETA for providing ongoing guidance and
oversight, which also ensured successful completion of the project.
Members of the Technical Task Team from the HSRC, SASSETA and the various •฀
stakeholders from SASSETA who tirelessly and regularly met to discuss the progress
of the study and to smooth out potential risks to the project whenever there
was a need.
We would like to thank Mr T Proudfoot and Mr E Boshoff for facilitating •฀
communication between the researchers and the large companies in the private
security and legal services sectors respectively.
The HSRC fieldwork management team and project manager, who managed the •฀
fieldwork efficiently and effectively from the beginning to the end of the study. This
team included the following:
Mr Nkululeko Nkomo and Ms Azwihangwisi Matevha, the PhD research trainees
•฀
who co-ordinated fieldwork in Gauteng.
Mr Sizwe Phakathi of Oxford University and Mrs Pavathy Anthony of the •฀
University of KwaZulu-Natal who co-ordinated the fieldwork in KwaZulu-Natal.
Dr Victoria Pillay and Mr Sean Jooste who co-ordinated fieldwork in the •฀
Western Cape, and who, together with Ms Thabile Ketye, conducted quality

control of questionnaire data.
Mrs Yolande Shean who efficiently co-ordinated and administered project •฀
meetings, data collection material and communication in general. She also
helped put the final report together by collating the sections submitted by the
various collaborators who prepared the report.
Ms Sinelisiwe Ngwenya who assisted with project administration in the project •฀
management office.
Mrs Linda Ngcwembe who diligently assisted with the project expenditure •฀
updates, report and guidance.
Ms Alicia Davids for helping with putting together the report.•฀
We wish to thank the following people for reviewing the preliminary report •฀
(especially the areas indicated) as part of the Experts’ Panel:
Dr Mark Colvin, Epidemiologist, Centre for AIDS Development Research and •฀
Evaluation (CADRE), Durban – HIV/AIDS epidemiology, especially in
workplaces.
Ms Cathy Connolly, Biostatistician, South African Medical Research Council
•฀
(MRC), Durban – HIV/AIDS epidemiology, especially in workplaces, and
behavioural and social factors driving HIV/AIDS.
Professor Kelvin Mwaba, Psychologist, University of the Western Cape (UWC), •฀
Cape Town – Behavioural and social factors driving HIV/AIDS.
Professor Carel van Aardt, Economist, Bureau of Market Research, University of •฀
South Africa (UNISA) – Impact of HIV/AIDS and response by business.
Professor Geoffrey Setswe, Public Health Specialist, Human Sciences Research •฀
Council (HSRC) – HIV/AIDS policies in workplaces.
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xiii
We thank all the nurses who undertook the fieldwork. We have come to rely on •฀
these nurses, most of whom, although recently retired, are willing to further
contribute to the development of our country as fieldworkers and supervisors. We

especially wish to acknowledge them for their patience when the project was
experiencing some problems due to poor response rates from companies in the
original sample that was chosen.
We also thank all the private security and legal services companies and their •฀
employees that participated in the study. We would like to thank the companies for
their generosity in allowing the HSRC senior managers to hold meetings and conduct
presentations, and for opening doors to fieldworkers to conduct interviews on their
premises and among their employees.
We wish to thank the staff from the National Institute of Communicable Diseases •฀
(NCID) National Health Laboratory Services in Johannesburg and the Global Clinical
and Viral Laboratory for undertaking HIV testing during the main study and pilot
studies, respectively, and the staff from Maphume for capturing data. We would also
like to thank NICD for undertaking, without charge, HIV incidence testing using the
BED technique.
Finally, we thank our individual families for their support and encouragement during •฀
the time when we undertook this study.
Prof. Leickness Simbayi Prof. Thomas Rehle Ms Ntombizodwa Mbelle
Principal Investigator Principal Investigator Project Manager

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xiv

AIDS Acquired Immunodeficiency Syndrome
ALP AIDS Law Project
AMS AIDS Management Standard
ART antiretroviral therapy
ARV antiretroviral
CDC Centers for Disease Control and Prevention
CEO chief executive officer
DBS dry blood spot

GRI Global Reporting Initiative
HIV Human Immunodeficiency Virus
ILO International Labour Organisation
KABP knowledge, attitudes, beliefs and practices
LSSA Law Society of South Africa
M&E monitoring and evaluation
PEP post-exposure prophylaxis
PLWA people living with AIDS
PLWHA people living with HIV/AIDS
SABCOHA South African Business Coalition on HIV/AIDS
SARS South African Revenue Services
SAS Statistical Analysis Systems
SASSETA Safety and Security Sector Education and Training Authority
SIRA Security Industry Regulatory Authority
SMMEs small, medium and micro enterprises
SPSS Statistical Package for Social Scientists
STD sexually transmitted disease
STI sexually transmitted infection
TTT technical task team
UCT University of Cape Town
UNAIDS Joint United Nations Programme on HIV/AIDS
USA United States of America
VCT voluntary counselling and testing
WHO World Health Organisation
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
Background
The generalised nature of the HIV/AIDS epidemic in South Africa is believed to have
uneven impacts on various business organisations operating in the country. Indeed, many

companies have responded, in different ways and means, to the challenge posed by the
epidemic to their core business. Thus, there is a need to conduct assessments of the
impacts of HIV/AIDS and responses thereto by companies. Obtaining such information
would inform the concerned organisations about, among other things, the appropriateness
of their current responses in terms of prevention and treatment interventions as well as
the suitability of their HIV/AIDS policies. This information is critical in mitigating the
impact of HIV/AIDS on productivity, economic costs, labour, and demand and supply of
skills. Prior to the present project, no such study had been conducted in the private
security and legal services industries.
In October 2005, the Safety and Security Sector Education and Training Authority
(SASSETA) put out a tender to undertake a critical assessment of HIV/AIDS in the private
security and legal services industries, in terms of the prevalence rate of HIV, its impact on
business and the responses of businesses to the epidemic thus far. Furthermore, the study
sought to establish both sufficient and reliable empirical data about the status quo, which
would then be the basis for forecasting the possible impact of HIV/AIDS on selected
indicators within the sub-sectors. Due to the availability of new laboratory-based HIV-
incidence methods, the HSRC and SASSETA agreed on the use of the BED technology to
measure incidence testing, instead of basing it on modelling.
The tender was won by the HSRC, and the contract with SASSETA was signed on 7 March
2006. The intended duration of the project was 12 months. Due to the limited funding
that was made available by SASSETA, it was agreed that the sample sizes would be
decreased and that the study would take place in only three provinces (namely, KwaZulu-
Natal, Gauteng and the Western Cape), instead of in four provinces for each sector, as
had been planned. In the original plan, the private security industry study was meant to
include Mpumalanga as the fourth province, while the Eastern Cape had been earmarked
as the fourth province in the legal services industry study. Although work started
immediately, delays were experienced as a result of a strike in the private security
industry. In addition, problems were experienced in accessing most companies in the two
sectors of SASSETA, which necessitated some changes to the sampling design, prolonging
the duration of the project by six months. The project was concluded at the end of

August 2007.
Objectives
The central objective of the present study was to conduct a critical assessment of HIV/
AIDS in the private security and legal services industries, in terms of the prevalence and
incidence rates of HIV, business impact, and the responses of businesses to the epidemic
thus far.
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
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Methods
Two research approaches were followed. Firstly, the study employed a highly
participatory approach, which our team had used successfully in similar prior research.
This entailed a significant involvement of key stakeholders in the conceptualisation and
design of the study as well as its execution. This was effected through a steering
committee and a technical task team, consisting of members of our research team and
representatives from SASSETA, as well as its stakeholder organisations, the private security
companies, legal firms and the unions, which oversaw the implementation of the project
from beginning to the end.
Secondly, we used a triangulation of several research methods, due to the complexity of
the issues that were under investigation simultaneously. This, we believe, allowed for a
deeper understanding of the issues than would have been the case if only one method
had been used.
The original overall project structure is shown in the figure opposite. In order to fulfil the
objectives of the study, two parallel sets of studies where conducted within each sector.
Study 1, which sought to address Project Outcomes 1 and 2, focused on HIV prevalence
and HIV incidence, and knowledge, attitudes, practices and beliefs, while Study 2, which
addressed Project Outcomes 3 and 4, investigated the business impact of HIV/AIDS and
responses thereto.
Both Studies 1 and 2 in each sector were preceded by a formative study involving
interviews with managers or key people involved in HIV/AIDS in a few companies and

focus groups of employees in all employment categories. The main part of Study 1
consisted of two cross-sectional surveys using the second-generation surveillance
approach, which simultaneously collects both biological specimens for HIV testing and
behavioural measures that are linked via bar codes. HIV testing was done on dry blood
spot (DBS) specimens from a finger prick with a special surgical lancet. In the private
security services sector, 2 787 respondents from 15 mainly large firms were interviewed by
trained nurses, and 2 224 of them agreed to be tested for HIV. In the legal services sector,
421 respondents from 23 legal services firms agreed to be interviewed, 341 of whom
agreed to be tested for HIV.
Study 2 consisted of three parts. The first involved surveys of employers or their
representatives from the private security and legal services sectors, who completed a
questionnaire about the impact of and response to HIV/AIDS on behalf of each company
that participated in the project. The second part included modules in the survey
conducted as part of Study 1, which asked employees in the private security and legal
services sectors about their perspectives regarding the impact of and response to HIV/
AIDS. The third and final part of Study 2 involved the use of a panel consisting of experts
who critically reviewed three HIV/AIDS policies from the private security sector, three
from the legal services sector, and the SASSETA HIV/AIDS policy.
All DBS specimens were first tested on the Genscreen ELISA, and all reactive specimens
were subjected to confirmatory tests with a second enzyme immunoassay (Vironostika
Uniform 11 + 0). For quality control, a second test was conducted for 10% of cases where
the first test was negative. Samples testing positive in enzyme immunoassay 1 and
negative in enzyme immunoassay 2 (producing discordant results) were tested further on
Western Blot (New LAV BLOT 1) for final interpretation of discordant samples.
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
Private security sector
Study 1
HIV prevalence and

incidence
(Project outcome 1)
Knowledge, attitudes,
perceptions and behaviours
(Project outcome 2)
Study 2
Business impact
(Project outcome 3)
Business response
(Project outcome 4)
Legal services sector
Study 1
HIV prevalence and
incidence
(Project outcome 1)
Knowledge, attitudes,
perceptions and behaviours
(Project outcome 2)
Study 2
Business impact
(Project outcome 3)
Business response
(Project outcome 4)
SASSETA Project
Process followed in
both sectors
Phase 1
Formative or elicitation
research: focus groups &
key informants

(Project outcome 2)
Phase 2a
Pilot study
Phase 2b
Main survey
(2 cross-
sectional
surveys)
Phase 3
HIV incidence testing
Phase 4
Analysis of test results
Phase 5
Recommendations
(Project outcome 5)
Phase 1
Formative or elicitation
research: focus groups &
key informants
(Project outcome 2)
Phase 2a
Pilot study
(in
conjunction
with Study 1)
Phase 2b
Main survey
(2 cross-
sectional
surveys, in

conjunction
with Study 1)
Phase 2c
Managers’ survey
Phase 3
Expert panel review of HIV/
AIDS policies in 16
companies
Phase 4
Synthesis of expert reviews
and policy recommendations
Phase 5
Recommendations
(Project outcome 5)
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
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The detection of recent infections (incidence) was performed on confirmed HIV-positive
samples using the BED capture enzyme immunoassay (CEIA, Calypte® HIV-1 BED
Incidence EIA, Calypte Biomedical Corporation, Maryland, USA) optimised for DBS
specimens.
Data from each study was captured and analysed using appropriate methods as described
in full in the main report.
Finally, ethical approval was obtained from the HSRC’s Research Ethics Committee.
Main findings from Study 1: The HIV prevalence, HIV incidence
and KABP survey
Private security sector
The following results were obtained:
HIV prevalence among the respondents in the private security sector is 15.9%. Other •฀
analysis showed that:

males had a slightly (although not significantly) higher HIV prevalence (17.3%)
•฀
than females (12.3%);
Africans had a substantially higher prevalence (27.3%) than other race groups •฀
(less than 1%);
respondents aged 25–49 years had a higher HIV prevalence (17.9%) than •฀
respondents aged 50 years and older (7.5%) and respondents aged 24 years and
younger (7.3%);
widows had the highest HIV prevalence (29.4%), and divorced or separated •฀
people had the lowest HIV prevalence (6.8%);
KwaZulu-Natal (22.8%) had the highest HIV prevalence, followed by Gauteng •฀
(17.8%) and the Western Cape (3.4%);
respondents who were labourers, cleaners, porters and messengers had the •฀
highest HIV prevalence (24.5%), followed by service workers, clerks and
protective service workers (21.8%), while senior officials, professionals,
managers and directors had the lowest HIV prevalence (5.1%);
HIV incidence was higher among Africans (2.5%) than other race groups; •฀
HIV incidence among respondents younger than 25 years of age (3.6%) was •฀
higher than among those aged 25–49 years (1.2%);
no new infections found among respondents aged 50 years and older; and •฀
respondents from KwaZulu-Natal had a higher HIV incidence (3.4%) than those •฀
from the Western Cape (1.1%) and Gauteng (2.0%).
The respondents in this study were generally very knowledgeable about HIV/AIDS, •฀
except for the following few misconceptions or myths:
patients with TB also have HIV; •฀
once one has started taking antiretroviral treatment for HIV/AIDS one has to •฀
take it forever;
there is a cure for AIDS; and•฀
sharing a cigarette (as well as coughing and sneezing) spreads HIV. •฀
Generally positive attitudes towards PLWHA were found on most issues, except for •฀

the following two, about which many respondents were either negative or
ambivalent:
having protected sex with a partner who is living with HIV/AIDS; and •฀
disclosing the status of a family member, which most respondents indicated •฀
they would want to keep a secret or were unsure about disclosing.
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
The overwhelming majority of participants (95.6%) had started taking the AIDS •฀
problem more seriously, and this was equally true for both sexes and the different
race groups. Two-thirds of respondents (60%) indicated that it was because of the
increased number of deaths due to AIDS, while almost a third (30.1%) viewed the
reality of the disease as the second main reason.
More males than females believed that they were are risk of HIV infection. •฀
Conversely, more females than males believed that they were not at risk. Most
believed they were not at risk because they were faithful to one partner/trusted their
partner, either always used condoms or were abstaining from sex, did not share
used needles or body-piercing instruments, did not have sex with prostitutes, and
knew that both they and their partner had tested HIV negative, in that order.
Of the four race groups, both males and females of African origin (95.3% and 89.7% •฀
respectively) were found to be the most sexually active in the last 12 months,
compared with their counterparts from the other race groups, especially white males
(90.8%) and coloured females (76.3%).
The large majority of respondents (86.7%) reported that they had regular sexual •฀
partners, 10.4% had non-regular sexual partners and 0.6% had had sex with
commercial sex partners. The breakdown of those who had non-regular partners
was as follows:
more African and coloured males reported having had two or more sexual •฀
partners than did their male white and Indian/Asian counterparts;
more coloured females reported having had two sexual partners than did their •฀

counterparts from the other race groups; and
more importantly, not a single Indian/Asian female reported having had two or •฀
more concurrent sexual partners.
The large majority of respondents (89%) of both sexes had partners who were •฀
within 10 years of their own ages. The breakdown was as follows:
more males (10%) than females (3.3%) reported that they had sexual partners •฀
who were 10 years younger than themselves;
more females (8%) than males (0.5%) reported having had sexual partners who •฀
were 10 years older than themselves; and
more Africans (10%) had sexual partners who were 10 years younger than •฀
themselves, when compared to other groups, with white respondents coming a
close second (6.7%).
With regard to condom use:•฀
nearly a third (32.9%) of all the respondents who agreed to be interviewed had •฀
ever used condoms;
among those sexually active, 41.9% reported having used condoms with regular •฀
partners in the past 12 months, 7.6% with non-regular partners, and 0.5% with
sexual partners who engaged in commercial sex;
both males and females below 25 years of age reported relatively high levels of •฀
condom use (62.4% and 53.6% respectively), compared to their counterparts of
50 years and above (16.4% of males and 9.1% of females respectively);
both single males and females reported higher use of condoms (57.1% and
•฀
53.0% respectively) than did those of other marital statuses;
widowed males reported the highest condom use, after single males, while •฀
none of the widows reported having used condoms in the last 12 months;
African males and females reported significantly higher use of condoms (46.0% •฀
and 49.8% respectively) than did white and coloured males (23.8% and 23.3%
respectively) and white and coloured females (22.8% and 22.6% respectively);
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
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both male (63.9%) and female (44.8%) respondents with two partners reported •฀
higher condom use than their counterparts with single partners only (37.0%
and 31.9% respectively);
single respondents across all three age groups reported significantly higher use •฀
of condoms in their last sexual intercourse, compared to their married,
widowed or divorced counterparts; in particular, respondents below 25 years of
age (65.4%) reported higher use of condoms than did respondents in the other
two age groups (53.2% for those aged 25–49 years and 50.0% for those older
than 50 years); and
respondents younger than 50 years old who had more than two partners •฀
reported the highest condom use in their last sexual encounters.
The large majority of respondents (88%) knew where to obtain VCT services. •฀
However, white respondents and those aged 50 years and older were least aware of
VCT centres. With regard to VCT use:
a slight majority of respondents (53%) had ever had an HIV test, of whom 95% •฀
had been told of their test results;
the majority of those tested (70.2%) had pre-test counselling before undergoing •฀
the test, with more men (73%) than women (64%) having received counselling;
fewer, but still a majority of the respondents (60%), had post-test counselling •฀
after having had an HIV test; and
female respondents (64%) were more likely than males (46%) to report having •฀
being aware of their HIV status.
Half of the respondents (48.2%) who knew about their HIV status had regular •฀
partners, and the large majority (78.8%) of those with non-regular partners indicated
that they had used condoms consistently in the past 12 months.
One-fifth of the respondents (18.5%) who were found to be HIV-positive in this •฀
study had been tested for HIV within the previous two years, while 16.3% had
undergone HIV testing more than two years previously.

Using a 10-item international Alcohol Use Disorder Identification Test (AUDIT) to •฀
assess alcohol use, low-risk drinking was found to be commonest among white
respondents, while high-risk alcohol use was most common among coloured
respondents and in the Western Cape.
A very low level of drug use was found in this study, with dagga (cannabis) being •฀
the most commonly used drug (and then amongst only 1.3% of respondents).
Two-thirds of the respondents (67%) reported having changed their behaviour in the •฀
face of widespread HIV infection, using mainly ABC strategies such as having one
partner only or being faithful, always using condoms, abstaining from sex, or
reducing their number of sexual partners.
Of the 1 582 males who participated in this part of the study, 40.5% reported having •฀
been circumcised. No reliable difference was found between the HIV prevalence
rates of men who had been circumcised (17.2%, 95% CI = 12.55–23.09) and those
who had not (17.4%, 95% CI = 13.05–22.84).
The most common message/slogan recalled was on condom use, followed by •฀
abstinence tied with ‘fear’, and the need for faithfulness.
The majority of respondents were generally comfortable communicating about sex, •฀
sexuality and HIV/AIDS-related issues, except for females talking with their
colleagues, presumably males, about sexual matters.
Respondents who reported having been sexually active in the previous year had the •฀
highest HIV prevalence (16.7%), followed by those who reported secondary
abstinence (10.9%) and those who claimed to be virgins (1.6%).
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
The HIV prevalence rate was higher among sexually active respondents who •฀
reported having had one sexual partner (16.4%) or multiple concurrent sexual
partners (17.0%) than it was among those who practiced secondary abstinence
(10.9%). However, there were no significant differences in HIV prevalence among
respondents with various types of sexual partnerships.

HIV prevalence was found to be higher among respondents who reported that they •฀
had used condoms during their last sex act than it was among those who reported
not having done so. More HIV-positive respondents reported that they had been
using condoms with regular sexual partners consistently over the past year,
compared to those who had not.
Respondents who perceived themselves to be at high risk of HIV had a higher HIV •฀
prevalence (19.9%) than those who considered themselves to be at low risk (9.8%).
However, the difference was not significant.
Males who had partners 10 years younger than themselves had a higher HIV •฀
prevalence (20.2%) than males who had partners 10 years older than themselves
(10%). However, females who had partners 10 years older than themselves had an
HIV prevalence of 16.3%, compared to a prevalence of 9.3% among those that had
partners 10 years younger than themselves.
Legal services sector
The main findings that emerged from this study were as follows:
HIV prevalence among the respondents was 13.8%, with the following breakdown: •฀
females had a slightly (but not significantly) higher HIV prevalence of 14.4%
•฀
than males (12.4%);
Africans had an HIV prevalence (20.2%) that was significantly higher than that •฀
of the other race groups combined (1.7%);
respondents who were 25–49 years old had a higher HIV prevalence (16.0%) •฀
than respondents in the other two age groups (5.7% for those aged 50 years
and above, and 5.3% for those aged 24 years and younger 5.3%);
respondents who had never married had a significantly higher HIV prevalence •฀
(18.7%) than married respondents (10.1%);
KwaZulu-Natal had the highest HIV prevalence (23.7%), followed by Gauteng •฀
(13.6%) and the Western Cape (2.1%); and
respondents classified as labourers, cleaners, porters and messengers had the •฀
highest HIV prevalence (21.1%), compared to respondents from other

occupational categories.
Due to the small number of respondents found to have been infected during •฀
previous six months, it was not possible to calculate a valid HIV incidence estimate.
Respondents were generally very knowledgeable about HIV/AIDS, but had many of •฀
the same myths or misconceptions as respondents in the private security industry.
The overwhelming majority of respondents generally had very positive attitudes •฀
towards HIV/AIDS-related issues including PLWHA, except for 61% of the
respondents who were either unsure or said that they would want to keep the HIV-
positive status of a family member a secret, and 50% of the respondents who were
either unsure or said that they would not have a problem having protected sex with
a partner who has HIV/AIDS.
The overwhelming majority of respondents, irrespective of gender and race group, •฀
indicated that they had started to take the problem of AIDS seriously. This
perception varied by race group, with Africans being the most concerned (98.9%)
and coloured respondents the least (83.3%).
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
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A large majority of male respondents believed that they were at risk of HIV •฀
infection, while female respondents were divided equally between those who
thought they were at risk and those who thought they were not at risk. The majority
of those who thought that they were not at risk held this view because they were
faithful to their partners (i.e. B of ABC HIV prevention strategies).
A large majority of the respondents (86.6%) reported having been sexually active •฀
during the previous year, as expected of normal adults, 9.5% of the respondents
reported that they had been sexually abstinent, and 3.8% of the respondents
indicated that they were virgins.
A large majority (86.2%) of the respondents (94.7% of the females and 67.3% of the •฀
males) reported that they had one sexual partner. Nearly one-fifth of males reported
that they had two partners (18.3%) or more than two partners (3.9%), compared to

their female counterparts (4.0% and 1.2% respectively).
About a tenth of males (8%) had a partner who was 10 years younger than •฀
themselves. The situation was the opposite among females, of whom 6% reported
that they had a partner who was 10 years older than themselves. No male
respondent had a sexual partner who was 10 years older than himself, while only
0.8% of the females had a partner 10 years younger than themselves.
Consistent condom use was higher in relationships involving either one non-regular •฀
sexual partner (55%) or more than one non-regular concurrent multiple sexual
partner (66%) than it was in regular relationships (16%).
Over the previous 12 months, the majority of respondents in casual (non-regular) •฀
relationships with one non-regular partner (55%) and two-thirds of those with two or
more non-regular partners (66%) reported consistent condom use, compared with
16% and 34% respectively for those in regular sexual relationships.
The large majority of respondents (84%) knew where to obtain VCT services, with •฀
African (92%) and coloured (80%) respondents having higher awareness of where to
access the services than white (71%) and Indian/Asian (63%) respondents.
Nearly three-quarters of the respondents (71.1%) had undergone testing, with more •฀
females than males having done so; of these, 64% had pre-test counselling and 51%
had post-test counselling, with two-thirds (66%) of them of both sexes having been
informed of the results of the tests and thus being aware of their status.
Overall, nearly two-thirds of the respondents (64%) reported having changed their •฀
behaviour in the face of widespread HIV infection. Most had done so mainly though
adopting ABC strategies.
Overall, 42.1% of the respondents reported that they had used alcohol in the •฀
previous 12 months:
nearly a third (32.2%) were classified as low-risk drinkers (AUDIT score 1–7), •฀
while a tenth (9.9%) were high risk-drinkers (AUDIT score 8+);
males (23%) were more likely than females (4%) to be high-risk drinkers; •฀
respondents aged 24 years and younger reported the highest levels of high-risk •฀
drinking (15%), compared to those older than 50 years (2%); and

across the race groups, the majority of white respondents were low-risk •฀
drinkers, while no Indian/Asian respondents were high-risk drinkers.
Overall, very low substance use was found in this study. Dagga (cannabis) was used •฀
more commonly (0.7%) than other substances.
The most frequently recalled messages were about the use of condoms (C), fear, •฀
abstinence (A), issues of support and care, and the need for faithfulness (B), in that
order.
A large majority of respondents of both sexes were generally comfortable about •฀
talking to family members, colleagues and other people about sex and HIV/AIDS-
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
related issues. As was found in the private security sector, females were not
comfortable talking to colleagues about sexual matters, while males were not as
comfortable as their female counterparts in talking about sex to at least one family
member.
Respondents who perceived themselves as being at high personal risk of HIV •฀
infection had a higher HIV prevalence (18.4%) than those who perceived themselves
to be at low risk of being infected with HIV (8.7%).
Main findings from Studies 2A and 2B in the private security sector
Employer perceptions of the impact of HIV/AIDS on business
The following main findings were obtained from the two studies:
Just over half of the employer respondents (53.8%) regarded HIV/AIDS as a business •฀
concern. Among these, the majority were large employers with 200 employees and
more.
Overall, very little was happening in terms of HIV/AIDS activities among •฀
participating companies.
Nearly half of the respondent companies (46.8%) reported a small impact on •฀
company operations. Nearly a third (30.8%) reported that they anticipated a large
impact in the next three years, with 7.7% anticipating a large impact on profits,

23.1% a moderate impact and 30.8% a small impact.
Most employer respondents reported that HIV/AIDS had no impact on their •฀
employee profile. However, a few indicated otherwise, and the impact varied by
occupational category, especially among service workers, security guards and
labourers.
Many AIDS or AIDS-related deaths were reported to have occurred in 2003 and •฀
2004.
Turnover was mainly among service workers and security workers, and a fair •฀
number was reported among labourers.
Most companies provided a company retirement benefit, whereas only half provided •฀
either a medical aid or funeral benefit. Very few reported the provision of HIV/AIDS
coverage or an occupational health clinic, the latter in lieu of medical coverage.
Most companies did not anticipate that HIV/AIDS would have much of an impact on •฀
increasing employee benefit costs. On average, 66.7% reported that there would be
no impact on benefit costs.
Companies spent very little on HIV/AIDS services in the period prior to the survey. •฀
However, there does appear to have been some expenditure on HIV/AIDS education
and awareness services and VCT.
Most companies felt that HIV/AIDS had no impact on skills demand and supply •฀
across all occupational categories. Overall, it appears that there had been relative
stability in the companies in regard to the demand and supply of skills, irrespective
of occupation; consequently, very few companies had strategies in place to deal
with potential labour and skills turnover.
Most companies felt that HIV/AIDS had no major impact on investment in training. •฀
Among those that indicated otherwise, increases had been among labourers (33%),
followed by service workers and learners (20% each), the occupational categories
reported by companies as being severely impacted on by HIV/AIDS.
While some companies reported that there had been no HIV/AIDS impact on output •฀
and service delivery, some indicated that there had been increases in sickness-
related absenteeism and funeral attendance (38.5%) and health-related turnover

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
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(25%), while others (23.1%) reported decreases in the availability of critical skills or
experience and declines in workforce morale. Also, declines in labour productivity
appeared to be slight (15.4%) in these companies. Finally, consumer demand
appeared to have experienced no impact.
Employer perceptions of business response
The following four main findings were obtained:
Most companies had very little knowledge or awareness of industry-wide or union-•฀
based HIV/AIDS policies.
Nearly a third of the companies, in particular the larger ones, had a written HIV/•฀
AIDS policy, and two-thirds of these had implemented the policy in their
workplaces.
In spite of the absence of HIV/AIDS policies, some companies, nevertheless, were •฀
implementing HIV/AIDS programmes or elements thereof, such as the replacement
of staff that became ill (50%), condom provision (41.7%), job security for HIV-
positive staff (41.7%), prevention and awareness education (38.5%) and provision of
protective equipment (33.3%).
Most companies were not aware of the reasons for poor implementation, while •฀
some cited the nature of the ‘unskilled’ workforce and ‘long distances’ or multiple
worksites as obstacles in conducting education and awareness programmes in the
sector.
Employee perceptions of HIV/AIDS impact
The following findings about employees emerged from data collected as part of Study 1:
Very few employee respondents displayed knowledge about colleagues living with •฀
HIV/AIDS (4.1%) or having died of HIV/AIDS-related illnesses (9.6%).
In spite of this lack of knowledge about colleagues living with HIV/AIDS or having •฀
died of HIV/AIDS-related illnesses, more than half of all respondents reported that
employees had been affected in terms of taking over the tasks of colleagues who

were ill (64.9%), a shortage of employees (58.4%) and decreases in effective
functioning (58.7%).
Most employees displayed very low levels of awareness of HIV/AIDS policies, with •฀
only 8.5% aware of an industry-wide policy, which was considerably higher than the
2.5% awareness of a trade union policy. Interestingly, two-thirds of those who were
aware of an industry-wide policy indicated that it had been implemented in their
companies.
The most commonly cited contents of company HIV/AIDS policy (among those few •฀
respondents who were aware of it) were non-discrimination, confidentiality, safety in
the workplace, counselling, support of employees living with HIV/AIDS, and
prevention programmes.
Very few of the respondents were able to identify gaps in the HIV/AIDS policies, •฀
which included counselling and support of PLWHA, workplace HIV/AIDS prevention
programmes, and HIV testing of employees.
With regard to reported employee access to HIV/AIDS interventions, the most •฀
commonly cited interventions were the provision of equipment to protect staff from
blood infections, condom provision, prevention programmes and replacement of
staff when ill.
Amongst the key programmatic gaps identified were lack of education and training •฀
about HIV/AIDS (42.1%), followed by the absence of VCT programmes (28.7%) and
programmes to address stigma (14.2%).
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xxv

Main findings of Studies 2A and 2B in the legal services sector
Employer perceptions of impact of HIV/AIDS on business
The following main findings emerged:
HIV/AIDS was not regarded as a business concern by most of the respondents •฀
(70%). Consequently, most employers had not made any attempt to measure the
potential impact of HIV/AIDS, while a few companies had conducted a quantitative

assessment of HIV/AIDS impact, focusing mostly on cost analysis.
Most of the participating companies reported no HIV/AIDS impact on operations •฀
during the three years preceding the survey, while only a few reported that there
had been a moderate impact.
A few companies foresaw either a moderate or a small future HIV/AIDS impact. •฀
While more than half of the companies anticipated no HIV/AIDS impact, a few •฀
anticipated a moderate to small future impact on profits. A third of respondents
could not predict what the future impact might be.
Most of the companies that believed that HIV/AIDS would have a small or no •฀
impact on profits over the following three years thought so because of the small size
of the company, low risk among employees or no illnesses thus far, and a degree of
awareness among staff about HIV risk factors.
Most respondents reported that HIV/AIDS had no impact on their employee profiles, •฀
irrespective of occupational category. However, where a small impact was perceived,
it was indicated that this would have occurred mainly among labourers, followed by
support and clerical staff, then among professionals and associate professionals, and
learners/candidate attorneys, in that order.
Very few employees were reported to have died due to AIDS or AIDS-related causes •฀
during the preceding four years. Those who had were mainly among support staff,
labourers and learners.
Turnover rates due to health-related causes were very low but had increased each •฀
year, with many participating companies indicating that the overall AIDS-related and
health-related attrition levels were very low.
Some of the companies provided health-related benefits such as a medical aid/•฀
insurance or an employer contribution to a medical aid fund, while a few provided
HIV/AIDS coverage, retirement benefits and funeral benefits.
Most companies reported that there had been no HIV/AIDS impact on increasing •฀
employee benefits, as expenditure on HIV/AIDS services had no effect on costs
because of the low level of provision of such services.
Nearly all companies reported that there had been no change in the demand and •฀

supply of skills as a result of HIV/AIDS; a few mentioned a shortage of associate
professionals.
Nearly all companies expressed the belief that their investment in training would not •฀
change as a result of HIV/AIDS, because they did not foresee a negative impact on
the supply of critical skills, nor did they have strategies in place to deal with HIV/
AIDS-related skills turnover.
Nearly all companies reported that there had been no change in output and service •฀
delivery, although a few reported that where there had been an impact, it reflected
sickness-related absenteeism, funeral attendance and health-related labour attrition.
Interestingly, the companies reported having experienced an increase in consumer
demand for services related to assistance with welfare grants, estate administration
and similar concerns.