AIDS interventions typically fail to address the disjuncture between private behaviors and the social determinants of HIV infection. Data from a telephone survey of manufacturing companies and a postal survey of occupational health nurses in the Western Cape, South Africa, were used to explore the possible role of occupational health services in prevention and control of AIDS. The author found limited evidence of worker involvement in AIDS programs, particularly in companies with occupational health professionals. The management of sexually transmitted diseases was incomplete. Mandatory pre-employment testing of workers for HIV was not widespread. Respondents' opinions on priorities for AIDS prevention and control reflected a preoccupation with knowledge transfer. To ensure their effectiveness, workplace AIDS programs must improve worker participation and integrate AIDS prevention in general workplace health and safety programs. In addition, education programs must develop objectives within a critical theoretical understanding of the behavioral issues relevant to AIDS prevention, and must emphasize the empowerment of women in the workplace. In the context of the present restructuring of health services in South Africa, occupational health services, using the strategies outlined, can make a major contribution to national AIDS prevention and control.
PIP: The potential role of occupational health services in AIDS/HIV control in South Africa is examined. This is done by identifying the characteristics of AIDS problems in the workplace, assessing what has been done about AIDS in the workplace by drawing out empirical data to illustrate key issues that should guide the implementation and evaluation of workplace AIDS programs, and contextualizing these issues within some of the current policy changes in South Africa and within the experiences of primary care services linked to organized labor. The occupational health services are increasingly being viewed as a key component of primary health care in South Africa. Industry has a huge opportunity to contribute significantly to AIDS control. Moreover, the imminent restructuring of the fragmented South African health care system into a comprehensive service based on primary health care greatly enhances the potential role of occupational health services in AIDS control. However, if occupational health services are to have an effective AIDS program, attention must be given to integrating AIDS prevention in the planning, management, and implementation of activities using appropriate teaching methods. Furthermore, effective education programs need to develop objectives within a critical understanding of the behavioral issues relevant to AIDS prevention. Occupational health services must also put the empowerment of women in the workplace on their agendas.