A win-win scenario? Employers' responses to HIV in Tanzania: A qualitative study.

Workplaces have been increasingly promoted as key sites for HIV interventions, with cost-benefit analyses employed to demonstrate the financial benefits to employers for implementing workplace HIV programmes. In these analyses, the potential costs of having HIV positive employees are weighed against the costs of the workplace programmes. Despite evidence that shows some firms have saved significant sums of money through these interventions, the general response from the private sector has been limited, with most positive case studies originating from high prevalence settings. This article reports findings from qualitative fieldwork conducted in Tanzania with private and public sector employers that aimed to understand how HIV was addressed in their organisations. Our findings suggest that HIV is not generally a serious issue, and hence HIV interventions are primarily ad-hoc with few formal HIV workplace programmes. We also found that in cases where compulsory testing programmes were implemented, employees did not turn up for testing and thus lost access to employment. Our findings suggest that relying on workplace programmes in lower prevalence settings is no substitute for investment in public health systems. Employer interventions should emphasise education and awareness, condom distribution and the promotion and provision of self-testing kits.