The Role of HIV focal Persons in HIV and AIDS Education And Service Delivery; A Study of The Focal Person in Enterprises in Accra Ghana

 ABSTRACT

People living with HIV and AIDS are likely to experience stigmatization and ostracism when they open up about their sero-status at work. The HIV Focal Point is a system where a staff member, referred to as a focal person is assigned to deliver HIV related services. It offers distinct opportunities and advantages as a key delivery point for HIV prevention, treatment and care programme for specific groups of people. Yet, many programmes do not explain the operational issues concerning it. The study examined the formation and operation of workplace HIV focal persons and the influence of their services on the workforce. Methods: A descriptive study using a mix methods approach. The quantitative aspect employed a survey with close ended questions administered to 428 workplace respondents. The qualitative aspect used open-ended and semi-structured interview guides for five Focus Group Discussions and fifteen in-depth/Key Informant Interviews. Qualitative data was analysed by coding and condensation of data; identification of significant text and recording and grouping of emerging themes whilst quantitative data was analysed using the Statistical Package for the Social Sciences (SPSS) version 16. Results: The results indicate that there was no evidence of a standard criteria for the selection of focal persons. The focal person selection process varied among enterprises: the selection were at times made in cognisance of government policy; by reasons unknown to workers; or by default appointment, if health workers were present in the enterprises’ clinics. The roles and responsibilities of the HIV focal person was not a construct of their job description and specification but emanated from their respective company’s HIV and AIDS policies. Focal persons’ saw themselves as ill-equipped for iv their role and this inadequacy was both operational and logistical. In instances where the focal person did not have a health background, there were also technical knowledge deficits. Using the parameters of ‘comprehensive HIV knowledge’, for example, knowledge of content of HIV policies; condom use and HIV risk perception as a proxy for measuring the influence of focal person exposure on the workforce, exposed workers reported significantly higher ‘comprehensive HIV knowledge’. When parameters were compared between exposed and non-exposed workers, knowledge of the content of HIV and AIDS policies was 64.5%:0%; condoms use was 65%:24.8%; perception of a moderate to small risk of acquiring HIV was 100%:76% with 24% of non-exposed workers reporting no risk at all in comparison with none among the exposed. Stigmatizing behaviour was also significantly reduced in the exposed workers in contrast to the non-exposed (68.7%:7%) Conclusion: Workplace HIV focal persons influenced positively HIV behaviour outcomes of workers and the availability of HIV services at the workplace. Workplace HIV focal persons assured the availability of HIV services at the workplace and the ability of workers to respond positively to HIV. It is therefore recommended to scale up and institutionalize the focal person services; expand services to include other diseases of public health importance; incentivize private sector with tax rebates to support the position through monies thus saved; mainstream the focal person’s job description within the public /civil service and private sector and enjoin (charge) government to enforce a minimum standard for the operations of focal persons.