BackgroundAccording to Uganda Population-based HIV impact survey 2016-17, HIV prevalence in the most productive age group (15-49 years) is 6 percent. The epidemic continues to disproportionately affect women, who show a higher HIV prevalence (7.5 per cent) than men (4.3 per cent) in this age group.
Prevalence of HIV varies in different regions and economic sectors. According to the National Macro-Economic AIDS impact study in 2008, the HIV prevalence in the tourism and hospitality industry among workers was found to be 10.3 per cent, much higher than the then national HIV prevalence amongst adult populations. Engagement of young, mobile and migrant workers, prevalence of unprotected sex, stressful working conditions, lack of legal protection, low level of knowledge about HIV and poor access to HIV services, particularly HIV testing, were seen as drivers of the epidemic in the sector.
Promoting HIV testing and counselling is a key component of the AIDS response in Uganda. In collaboration with the National AIDS Commission, the ILO has supported the Federation of Uganda Employers (FUE), and the Uganda Hotels Owners Association (UHOA) to put in place HIV and AIDS workplace programmes for the hotel workers. Promotion of voluntary HIV counselling and testing for hotel workers under the VCT@WORK initiative has shown promising results.
Salient features of the strategyThe VCT@WORK Initiative focuses on seven high HIV prevalence districts, particularly those having cross boarder high-ways running from the eastern Uganda to Western Uganda, connecting Kenya, Rwanda and Democratic Republic of Congo.
Advocacy was conducted with the senior management of hotels in collaboration with FUE and UHOA. Communication messages were developed around the benefits of early HIV testing. Peer educators were trained by the ILO for giving information on HIV and AIDS and creating demand for HIV testing.
The ILO developed an HIV & AIDS Resource Guide for the Hotels sector and in collaboration with the FUE and UHOA conducted dissemination workshop in 10 selected high HIV burdened districts of Uganda.
HIV testing events were planned in consultation with the peer educators, the hotel management and the health departments in the targeted districts. Testing events were organized in different locations that included hotel gardens, town parks and community centres. The workers who tested HIV positive were provided post-test counselling by the hospital counsellors and were referred for further care and treatment.
Based on the needs of hotel workers, a package of health information was offered by different service providers. Workers accessed condoms, received information on safe male circumcision, family planning methods and were able to establish contacts with different health providers in their vicinity for further counselling and treatment.
Results• Over 1000 hotel managers were reached through the advocacy and training sessions. Advocacy efforts resulted in in-kind contribution worth USD 150,000 by the hotel owners and board members to support the HIV programme in their hotels.
• Over 25,000 men and women hotel workers were reached out under the VCT@WORK Initiative in 10 hotels with HIV and other health information.
• Over 7000 workers accessed HIV Testing and Counselling. HIV positive workers were referred to the public health care facilities for initiation of HIV treatment and care.
Lessons Learned• Advocacy with top management with the involvement of hotel associations and employers’ organization at sectoral level was the key to the success of the programme.
• Offering a package of health information and participation of different service providers in the HIV testing events was found to be very strategic. Workers appreciated getting all the necessary information in one go directly from the providers in their vicinity. This also resulted in strengthening linkages with care facilities.
• Initially workers were not able to access the services due to long working hours but having the services at workplaces and getting to meet the service providers during events in hotels helped in enhancing the uptake of services.
Next Steps• Based on the success of the VCT@WORK Initiative and partnerships that have been set in place, the Uganda Hotel Owners Association is scaling up the programme through public-private partnerships.
• The HIV training programmes are being reviewed to cover other important issues such as violence, sexual harassment, occupational safety and health.
• In order to integrate HIV into collective bargaining agreement processes at the level of the hotel industry, the ILO intends to support the National Organization of Trade Unions in the development of a Collective Bargaining Guide for the hotel workers.