AEGiS-14IAC: Implementing an HIV and AIDS treatment programme at Debswana diamond company.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Implementing an HIV and AIDS treatment programme at Debswana diamond company.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. LbPeF9054)

Fantan T, Villafana T
Institution, Gaborone, Botswana

ISSUES: To determine the impact of the HIV and AIDS epidemic on its mining operations, Debswana Diamond Company undertook a voluntary and anonymous saliva screening of all employees. Information gained was used to determine the feasibility of providing anti retroviral therapy to HIV infected employees.

DESCRIPTION: Between 1996 and 1999 Debswana management documented increased HIV/AIDS related morbidity and mortality among its workforce. Ill-helath retirements due to AIDS related conditions were 40% in 1996 ad 75% in 1999. In 1996, 37.5% of the deaths were AIDS related, climbing to 59.1% in 1999. Thus a voluntary anonymous saliva test was conducted at the 5 operations including Head Office in May 1999 to establish prevalence levels by grade and age. This screening was repeated in June 2001.

ISSUES: In May 1999 HIV prevalence was found to be 28.8% across all operations surveyed, while in June 2001 the overall prevalence was 22.6% ( the significance of this decrease in unclear). Overall participation in these surveys was 74% in 1999 and 72% in 2001. In response to the results of the 1999 survey, the company established a treatment programme in May 2001 to provide triple therapy for each HIV infected employee with a CD4 count of 350 or less, or an AIDS defining illness as well as treatment of one legally married spouse. This is the first programme of its kind in Sub-Saharan Africa. Currently, 212 patients are registered in the antiretroviral programme, 156 patients are on triple therapy, the rest are being monitored. 72% of those registered are male, 20% are spouses (male and female).

RECOMMENDATIONS: The company is seeking to improve the uptake of the antiretroviral treatment programme and to encourage voluntary counseling and testing among employees. Employees have also expressed the need for management to offer new strategies to help HIV negative employees remain negative.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, HIV Infections, HIV Seropositivity, CD4 Lymphocyte Count, Prevalence, Antiretroviral Therapy, Highly Active, Counseling, Disease Outbreaks, Africa South of the Sahara, Female, Male, Human, therapy, drug therapy

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