Overview
Policy is an important field that dictates the framework within which HIV services and practices occur—a coordinated reaction toward potential, anticipated, or actual events.
HIV-related service and practices can be affected by policy on many levels—within workplaces, governments, health institutions, and schools. Investigation into policy must examine not just the formal policy output, such as documents and legislative decrees, but also examine how policy operates as practice. For instance, while government policies may have the potential to change the provision and reach of health services, an innovative ground-level health provider's policy may itself be more effective in producing results. Successful community-level policy may also influence larger-scale policies on a regional or national level, demonstrating that policy fields are often inter-linked or dependent on each other.
This section has been divided into three areas where policy can influence responses to the HIV/AIDS epidemic: government, business, and health care and services.
Government
The field of public policy involves the study of specific policy problems and government responses to them. Government policy and legislation regarding AIDS and allowing for prevention education are vital in many developing countries where services are often monopolized by the government. Some efforts to measure the reach and impact of government programs may involve questions regarding impact of political support and the legal/regulatory environment on the HIV epidemic.
Business
Instrument questions may also inquire about the impact of business or company policies (or lack thereof) on HIV in the workplace. Such questions can ask respondents if their workplace has discriminatory hiring practices, carries out screening tests, requires mandatory blood tests, provides sick leave, or provides medical insurance. Company managers can be asked if HIV-related issues are included in their health care and safety policies, and if the company makes an effort to spread information on HIV-related issues at worker-accessible locations—including health education trainings or sessions. Stigma in the workplace can also be addressed.
Health care services
Inquiries into health facility/organization policies can take the form of interviews of health care workers. Such questions may inquire about HIV safety/protection policies for the health care workers, as well as precautions and treatment given to patients—both with and without HIV. It can also be helpful to interview the patients as well, to help determine if those affected by AIDS are stigmatized by the health care system, and also if they have been given proper treatment in accordance with policy guidelines. A checklist of department- and hospital-level observations and documentation is also useful when inquiring into health care services policies.
Examples of questions relating to policy issues have been selected from the questionnaires below:
- Government
- The Futures Group International, POLICY Project—AIDS Program Effort Index (API)
- Business
- Horizons—Evaluating and Accrediting Workplace AIDS Programs
- Health care and services
- Horizons—Improving the Hospital Environment for HIV-positive Clients in India
- UNAIDS—Tools for Evaluating HIV Voluntary Counseling and Testing
