HIV-Related Stigma and Discrimination in Small Enterprises: Employers’ and Employees’ Knowledge and Attitudes about HIV workplace Policy in Kabale, Uganda.
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Background: In its third decade, the HIV/AIDS epidemic continues to affect many people’s lives in affected nations. In the world of work, the epidemic has brought about loss of productivity, increased labour costs, and loss of employment due to stigma and discrimination. Many people in the affected countries have lost their jobs due to their HIV positive status. HIV-related effects like stigma and discrimination lead to its denial. HIV-related stigma and discrimination present barriers to HIV prevention and treatment in different settings including the workplace. HIV stigma affects both large and small enterprises. However, small enterprises are more affected by stigma than large enterprises. Less attention has been paid to small enterprises in the fight against HIV/AIDS and its related effects. In an effort to mitigate HIV stigma at the workplace, integrating effective HIV workplace programmes plays a big role. These programmes are enhanced by a clear and effective HIV workplace policy. However, many affected countries have not been successful in implementing these programmes due to unclear policies. Uganda is one of the African countries without a clear national HIV policy, an environment that may account for the lack of a clear national HIV workplace policy. Nevertheless, in Uganda a few large organisations have their individual HIV workplace policies. There is no either published information that shows any small enterprise with a HIV workplace policy in place or any research study about HIV- related stigma and small enterprises in Uganda. These are some of the factors behind this study’s rationale. This study sought to explore employers’ and employees’ knowledge and attitudes about HIV workplace policy and its impact in reducing HIV-related stigma in small enterprises in Uganda. To obtain the expected data, the following main research question was asked: how can small-scale entrepreneurs and their employees overcome the challenge of HIV-related stigma and discrimination at the workplace according to their knowledge and attitudes about HIV workplace policy? The following sub research questions were also asked in an effort to obtain enriched and diversified data: - How can employees’ and employers’ knowledge and attitudes about HIV/AIDS help them in dealing with HIV-related issues at the workplace? - What is the effect of integrating HIV workplace policy in the fight against HIVrelated stigma among small enterprises? - Which approaches do small-scale entrepreneurs and their employees use in managing HIV-related stigma and discrimination at the workplace? - What are the challenges faced by both employers and employees due to HIVrelated stigma and discrimination at the workplace? Methods: The study employed a qualitative study design utilising a collective case study approach. Data were collected using in-depth interviews and observation. The transcribed data were analysed by coding it into themes from which units of meaning were derived. Results: This study has confirmed the lack of HIV workplace policy in the participating small enterprises. There were few cases of HIV/AIDS denial in the visited small enterprises. Employees in small enterprises have limited knowledge about HIV workplace programmes. Some small-scale entrepreneurs do not bother to find out health-related problems from their workers. The majority of HIV support organisations have not reached out to small enterprises. Counselling and guidance, cautioning stigma perpetrators and cooperation are some of the approaches to stigma confirmed by this study. Unexpectedly, findings of this study have indicated that employees in the visited work sites do not fear HIV testing and disclosing their HIV status at the workplace although their perceptions towards HIV testing and disclosure are theoretical. Conclusion: There is a need for effective HIV workplace programmes among small enterprises in an effort to mitigate HIV-related stigma. In this era of HIV/AIDS, enabling small enterprises to integrate a clear HIV workplace policy is one way of empowering small-scale entrepreneurs and their employees with skills and knowledge in the fight against HIV-related stigma at the workplace.