HEAIDS has identified a need to assist institutions of higher education to develop their HIV/AIDS workplace programmes. Only a few institutions have implemented such programmes despite the fact that they all have large numbers of employees.

The higher education sector employs a total of 50 000 full time staff and thousands of additional part time employees. Small institutions have several hundred employees, while at large institutions the staff establishment may run to thousands.

In the private sector, workplace HIV/AIDS programmes are accepted as a sound business investment because they conserve the company's valuable human capital and stem unacceptably high rates of attrition due to illness and death.

The imperative of conserving human capital is especially strong in the higher education sector where individual academics often represent unique, and therefore irreplaceable, intellectual resources. The need to make up the deficit in workplace interventions is, therefore, an urgent priority.

HEAIDS assistance

The national HIV/AIDS prevalence and social survey for higher education forms the foundation of HEAIDS support to institutions in the area of workplace programme development. (See Research for details of survey)

HEAIDS intends to use the findings of this study to:

• Produce a sector framework for workplace programmes.
• Develop individualised HIV/AIDS workplace programmes in consultation with individual institutions, where required.

HEAIDS aims to assist institutions to respond sensitively, appropriately and effectively to the HIV/AIDS pandemic through:

• Programmes to prevent the spread of HIV among students and staff. In South Africa, students - and particularly female students - fall into the age group that experiences the steepest rise in HIV prevalence.
• Programmes to provide treatment, care and support to students and staff who are living with HIV/AIDS. Many young South Africans are already HIV positive by their late teens. The rate is about one in 10 among young women aged 19 years.

HEAIDS' short-term support takes the form of financial grants to improve service capacity, access to training and other resources. In the longer-term, HEAIDS impact should be felt in terms of policy and planning support and advocacy for sustainable funding.

The population served

Collectively South Africa's 23 public institutions of higher education cater for about 750 000 students and employ some 50 000 full-time personnel. Ideally, HIV/AIDS interventions should reach this entire population of nearly 800 000 people. Approximately 40% of students pursue higher education through distance learning or part-time study. Their access to HIV/AIDS programmes is limited because they are not present on campus for any length of time.

Current response

The HIV/AIDS interventions undertaken by institutions include:

• HIV prevention activities, such as peer education and other educational interventions, condom distribution, and awareness campaigns.
• Voluntary counselling and testing services, usually through campus health clinics.
• Health services relevant to HIV/AIDS, including:
  • Treatment for STIs.
  • HIV prophylaxis after sexual assault.
  • Treatment for opportunistic infections. A few campuses offer TB treatment.

The range of services offered and the scale of service provision differs among institutions and even among different campuses of a single university. By the end of 2007, no institution was accredited by the Health Department to provide antiretroviral treatment (ART) for AIDS. However, most campus health clinics had well established procedures for referring students and employees in need of ART to private and public health facilities. Some were able to supervise ART once the individual had been stabilised on treatment.

HEAIDS's support

At the beginning of 2008, HEAIDS disbursed some R59 million in grants to 21 institutions. Individual allocations ranged from R1.5 million to R3 million. In most cases funding is being used to improve service provision such as building or expanding clinic facilities, introducing mobile clinics or augmenting skilled staff.

HEAIDS also concluded two important agreements that will give institutions access to resources to enhance their work:

• In terms of an agreement with the Foundation for Professional Development (FPD), the training wing of the South African Medical Association, institutional health personnel will have access to a range of training courses at no charge.
• An arrangement with the Centre for HIV/AIDS Networking (HIVAN) provides institutions easy access to an extensive database of HIV/AIDS services - HIV911 - which can be used to make effective referrals. The database can be accessed on line or by telephone on 0860 HIV (448) 911.

The HEAIDS teacher education programme aims to prepare teachers at all levels of the education system to play a central role in the country's battle against HIV/AIDS. Educators need not only to promote the prevention of HIV infection, but also to assist learners or students to cope with the wide-spread impact of HIV/AIDS.

This approach is supported by the South African Government which advocates the full integration of HIV/AIDS into education and training.

Higher education's dual responsibility

HEAIDS believes that academics at higher education institutions have a particular responsibility:

• to provide future generations of school teachers with pertinent knowledge and a whole range of interpersonal skills that will enable them to offer effective support to their learners; and
• to equip their own lecturers with a similar knowledge-base and skills set, so that HIV/AIDS interventions at school level are reinforced and extended by teaching at higher education institutions.

Building skills among teachers

HEAIDS has focused on supporting institutions in developing the skills of future generations of school teachers to assist their learners to cope with the many challenges of HIV/AIDS.

During 2008, all education faculties are piloting a HEAIDS-generated module on HIV/AIDS among their BEd and PGCE students. HEAIDS has placed an intern at every institution to facilitate this intervention.

The module that is undergoing "testing" was developed by HEAIDS in 2005. Prior to the commencement of the pilot projects, the module was reviewed and revised to take into account existing teacher training on HIV/AIDS at various institutions. A measure of flexibility was built into the use of the module in the pilot phase to accommodate established practices at various institutions. Education faculties were fully involved in the process of planning the pilot study.

Ongoing consultation and evaluation

HEAIDS has established an On-line Collaboration Forum for educators to share experiences and to learn from expertise education faculties to deal with problems of implementing the HIV/AIDS pilot as they arise.

This dynamic method of evaluation and adaptation will inform the final design of the HIV/AIDS module for teacher training towards securing its permanent inclusion in training for educational professionals.

Transferring lessons learnt

This process of HIV/AIDS curriculum development in Education Faculties could inform the development of HIV/AIDS content for other faculties. Although most institutions support the principle of mainstreaming HIV/AIDS content in curricula across all areas of study, research conducted by HEAIDS at the end of 2007 revealed that progress in this area was very limited.

HEAIDS plays a two-fold role in relation to research.

• The programme has begun to collate the research done by individual institutions in the field of HIV/AIDS in order for all role players to have a clear picture of existing research and current gaps.
• HEAIDS has commissioned sector-wide research on aspects of HIV/AIDS that are critical to effective policy development and planning by institutions.

National campus HIV survey

The most important element in this sector-wide package of research is a national survey on HIV/AIDS across the higher education sector. This study will:

• Establish the HIV prevalence rate among students and staff.
• Investigate relevant knowledge, beliefs and practices of students and staff.

Field work for the survey started in August 2008 and will conclude in February 2009. The study involves a representative random sample of 25 000 students and staff members across all 23 higher education institutions. Results are expected to be available in May 2009.

This survey is critical in enabling HEAIDS to support the sector and individual institutions in relation to risk assessment, policy formulation, the development of budgets and funding strategies, and programme formulation.

Competencies of graduates

A focused study is being conducted to compare the actual HIV/AIDS competencies of graduates with the competencies desired by employers in a range of sectors. This is intended to inform the development of HIV/AIDS content for tertiary level curricula in various fields.

Best practice in HIV/AIDS prevention

Aspects of HIV/AIDS prevention programmes are being investigated, with a view to documenting those that represent good practice. The purpose is to provide institutions with a resource that can be used in the operational planning of prevention programmes.

The development of national policy and programme frameworks are key instruments for achieving a single approach to HIV/AIDS across the higher education sector and attaining greater equity among institutions.

Once a reliable picture of the burden of HIV/AIDS in the higher education sector is available (see Research), it will be possible to develop evidence-based policies and planning frameworks. These will set out the elements of a comprehensive response to HIV/AIDS in the context of higher education, and will determine the scope of these interventions.

HEAIDS has set in motion work to:

• Determine the HIV/AIDS risk profile for the higher education sector and for individual institutions.
• Develop an HIV/AIDS policy framework and a related framework for monitoring and evaluation of programmes.
• Establish the cost of implementing the package of interventions outlined in the policy framework to the scale required.
• Explore potential funding sources to meet the envisaged costs and ensure longer-term sustainability of HIV/AIDS programmes across the higher education sector.

Sustainability

Creating a sustainable and viable programme to tackle HIV/AIDS on every front at campus level poses a challenge. In many cases, resource constraints have limited the scope of institutional responses to HIV/AIDS and will continue to do so unless they are acknowledged and addressed.

HEAIDS has created a special working group, which includes representatives of National Treasury and the Department of Education, to find ways to provide adequate, sustainable funding for higher education HIV/AIDS programmes.

Leadership and ownership

Leadership and political will are equally critical to the sustainability of HIV/AIDS programmes at institutions. HEAIDS strives to work through the governance structures created to ensure that the programme remains responsive and accountable to the Department of Education, the higher education institutions and the students that they serve.