From late 1993 to June 1994, the US-based organization AIDSCAP undertook a needs assessment among businesses in Kenya. Our goals were to: identify what formal sector business managers and workers knew about AIDS; assess what businesses were already doing to address HIV/AIDS-related issues; and determine what types of information and communication strategies would best persuade managers to establish appropriate workplace policies and prevention programmes. Some of our findings are summarized below.

The Kenyan consulting firm HEDRA carried out the needs assessment after AIDSCAP assisted them in pre-testing the research instruments. A semi-open interview questionnaire was administered to managers in 16 organizations in three cities. They represented a diversity of business types: light industry, manufacturing companies, tourism organizations, transport firms, agro-industrial and plantation organizations and the service industry. Four companies also completed a financial/labour data survey to analyse the projected impact of AIDS on their business.

Interviews were further conducted with representatives of two trade unions. Focus-group discussions took place with workers at 13 of the companies concerning their levels of AIDS-related knowledge and perceptions of the appropriate role which their companies could play in prevention.

Six businesses had mandatory testing of applicants and/or employees. For some of them, testing upper-level employees is required by the company's insurance underwriters for life insurance policies. Nevertheless, all the managers said they would not discriminate against HIV-infected workers and would allow them to work as long as they were medically able. Many workers in the focus groups believed, however, that they would lose their jobs if they were - or were suspected to be - HIV-positive. This indicates that the lack of a formally and explicitly communicated policy of non-discrimination created worker mistrust regarding management.

Eight businesses held formal in-depth information sessions and/or had peer educator programmes while three only gave short factual presentations and/or distributed posters and pamphlets. All the programmes were "gender-neutral" in that they did not consider that men and women might have different prevention concerns and needs. However, in some companies male and female employees didn't want to participate in education sessions together so separate sessions were offered.

The companies providing education reported positive feedback from their workers. The focus-group discussions also showed that employees wanted more information and education.

Well over half the companies received their condom supplies as donations without company cost-sharing. Only two business bore the full expense of condom distribution. Nearly 50% of the respondents received financial or other external support for their education programmes.

Only one manager felt that AIDS was significantly affecting his operations but the rest who responded to this question thought this would be the case in future. Nearly all the businesses provide employees with some medical benefits (treatment at a company clinic, reimbursement of medical expenses for outside care, health insurance for senior staff). At that time, HIV-related illnesses had not significantly affected medical expenses though some firms reported increased medical and pharmaceutical costs.

Preliminary estimates of the annual costs of operating a comprehensive workplace prevention programme ranged from $18-54 per worker at one company. Corporate investment in HIV/AIDS programmes is therefore warranted in Kenya. Effective prevention will ultimately help maintain productivity and protect interests in human resources. As one manager put it: "If you lose someone you've trained for 20 years, that's a great loss. Condoms and AIDS education cost peanuts."

Matthew Roberts, AIDSCAP, and J. Wangombe, HEDRA (Nairobi, Kenya), c/o Family Health International, 2101 Wilson Blvd., Suite 700, Arlington, VA 22201, USA; Tel: 1-703-516-9779; Fax: 1-703-516-9781