Although the official data for Guatemala are unreliable, showing only 2548 AIDS cases by June 1998, the epidemic has spread through the heterosexual population in the last 10 years. A 1995 socio-economic impact study showed that the epidemic will greatly affect private enterprises due to: 1) the absence of employees when a family member is sick; 2) an increase in employee turnover; 3) difficulty in replacing welltrained personnel; 4) increasing costs of health insurance; 5) flagging employee morale; and 6) a decrease in net earnings as more money goes towards the cost of AIDS. Given the serious impact on the private sector, the Guatemalan Association for the Prevention and Control of AIDS (AGPCS) developed an innovative training programme for employees within the private sector.

The project began with high expectations. The first step involved creating an awareness of the need to set up AIDS prevention programmes in the workplace; this work was done together with the Fundación Preventiva del SIDA Fernando Iturbide. They stressed the socio-economic impact that AIDS would have on companies in future if they would not dedicate efforts to prevention today. The two NGOs thought that the information from the impact study would suffice to persuade companies to educate their personnel about AIDS, thus increasing awareness and reducing the number of infected employees.

The workshop designed by AGPCS for companies is divided into 11 two-hour modules offered each week for up to 30 participants: this requires that employees be away from their jobs for a total of 22 hours. The modules offer comprehensive information about STDs, AIDS and related aspects such as alcohol and drugs, communication skills, sexuality, power and gender relations.

As part of a new flexible approach, AGPCS began to explain to businesses that the ideal would be for them to receive all 11 modules. However, if companies feel they can only afford five modules, for example, they are now given five sessions on topics that they choose themselves. Representatives of staff and management work out the precise content together. If they can only accommodate two hours or less, AGPCS offers them a general informative talk on STDs and HIV/AIDS. One business, McDonalds, hired AGPCS to give 20 workshops in 1998 to all their employees because they felt that it was important for each person to receive the training firsthand.

This new approach has allowed many employers to include time in their schedules for the employees to attend the workshop. Despite the programme's initial slow start, 31 workshops were held in 1997 and 28 up to August 1998. Large local and multinational companies form the majority of programme collaborators. They include food service businesses, manufacturers of cereals and agricultural chemicals and breweries.

AGPCS then offers workshop participants and their employers some follow-up. Once the participants and companies receive the information about AIDS and the workplace, they decide for themselves how they will implement prevention activities, based on their own time and needs.

Some companies have produced pamphlets for distribution among employees; others created several onehour presentations to give to all their workers. One company created a 20minute play that they presented to their employees during lunch hours, while still others distributed information through their newsletter, etc.

Peer education, including formal and informal replication of the information within and outside the workplace, is an important part of the programme. We originally envisioned that 2530 employees per company who had attended the workshop would themselves become workshop facilitators and peer educators.

This plan, too, had to be modified because most workshop participants felt unprepared to act as facilitators without assistance. Our team now provides them  with a manual, an extra training session to help them become more experienced in replication, follow-up visits, sporadic supervision of their presentations, and materials upon request (videos, pamphlets, etc).

AGCPS recognized that there might be some danger in motivating businesses with the argument that their productivity could be affected if many employees become HIV-positive. However, our approach is not so direct. Companies are informed that if something is not done now, in the long run many employees could become infected. The training has helped firms realize that dismissing PHAs will not solve the problem. Indeed, we have been able to show companies that had a policy of mandatory HIV testing for everyone that the money spent on testing would be better spent on other things such as education, training, offering opportunities for free confidential testing and help for those already infected. Based on the workshops, many companies have now developed workplace AIDS policies. Of the companies that participated in 1997, 50% established continuing peer education.

An evaluator has been hired to follow up the workshops' long-term impact. This includes assessing responses to questionnaires from employees who received the worshop, other employees in collaborating companies who did not receive the workshop, and company directors. The evaluation process allows us to measure after one year what actions have been taken at the company and individual levels with regard to knowledge about AIDS, attitude changes and prevention. We hope to use the information gathered in this way to approach health officials and policy-makers in order to influence the passage of laws to protect workers from HIV/AIDS-related discrimination.

The AGPCS private enterprise programme that began in 1996 with a small amount of seed funding (US$ 6300) is still going strong today. The programme pays for its staff, all materials and other projects costs through the payments that the companies make for the workshop. Monitoring has shown that more than 90% of all workshop participants have increased their knowledge and changed their attitudes about AIDS and condom use. The programme has thus become a sustainable project within a short time that is having an impact on the young men and women who are the economically active workforce and the people most affected by the AIDS epidemic.