November 2003

The Role of Incentives in Promoting Workplace HIV/AIDS Policies and Programs

Key Findings

Managers were more motivated by social responsibility to improve their policies and programs than by incentives. The most important reason cited by company managers for joining ASO and subsequently implementing HIV/AIDS policies in the workplace was an altruistic one: the opportunity to act in the best interests of their employees. Nearly 60 percent of the 125 company managers choosing to join ASO decided to participate because they felt a sense of responsibility to their workers and the wider community to do something about HIV/AIDS.

"The incentive...to be involved in the fight against AIDS is not simply about money or certificates, but about us giving our workers greater knowledge and providing them with additional training."
Manager, ASO participant

Other motivations to join the initiative reported by managers were that ASO would allow them to find out how their HIV/AIDS policies and programs compare to those of other companies, and to better understand the disease and how employees may be at risk due to their behavior.

Only 11 percent of managers who participated said that they had joined ASO for its financial benefits, while the rest—particularly smaller companies with fewer resources—did not perceive the premium reduction as being enough to justify the additional costs of introducing the policies and activities. With life insurance coverage costing employers an average premium of 250 baht (US $5.85) per employee, the maximum reduction available was 25 baht (US $0.60) per employee.

"To be honest, it is only a small amount. Seeing that we would have to invest time, it would be time consuming and complicated."
Manager, non-participating company

Neither did company managers value the certificate nor attach much importance to receiving it at a public ceremony. They indicated that the certificate would have had greater value if it had been endorsed by a well-known international organization or the Thai royal family; or if the initiative itself had been better known in the first place, thereby making achievement of the certificate a significant accomplishment.

“Our hotel has so many [certificates] that I do not know where to put them. I am not interested in the certificate unless it came from someone really important.”
Manager, ASO participant

Researchers also discovered that some managers declined to join because the sign-up process appeared very complicated or because they suspected the incentive scheme was an AIA marketing ploy since only AIA clients were entitled to the insurance discount.

HIV/AIDS educational workshop activity with employees. Photo credit: TBCA

Managers with pre-existing connections to the initiative were more likely to participate. Overall participation in the initiative was 15 percent of the 857 companies originally invited. Participating companies included factories, hotels, and commercial and professional firms, and companies of diverse size and ownership characteristics. Company characteristics associated with higher levels of participation in the initiative included a history of previous involvement in HIV/AIDS activities and the manager’s personal commitment to the issue. The most successful contact method of recruiting companies was approaching companies and individuals already known to TBCA. Locally-owned and -headquartered companies had significantly higher participation levels than those in which the locus of decision-making was physically more distant. Larger companies, to whom the fixed costs of the required policy changes represent a proportionately smaller burden, were slightly more likely to sign up to the initiative.

Most participating companies improved their HIV/AIDS policies and programs. ASO had a marked impact on the workplaces of participating companies, with 82 percent of companies improving their accreditation score between the two rounds. Overall, the mean total accreditation score increased from 37 to 51 points out of a maximum of 100 (p < .001).

Broad policy improvements were not associated with specific changes at the employee level. The self-administered questionnaires completed by employees indicated very limited impact on the HIV/AIDS knowledge and risk behavior of individuals. This is not surprising since an intervention designed for impact on individual risk behaviors must go beyond the policy level to directly and consistently reach employees over a significant time period.

Among companies that joined ASO, financial incentives were associated with greater policy improvements. Although the financial incentive was perceived to be insufficient to motivate many companies to join ASO, it likely played a positive role once companies had already signed up. About a third of 125 companies that joined ASO (34 percent) held AIA group life insurance policies and were eligible for premium reductions. AIA member companies showed greater improvements in their policies and spent more to improve their programs than did non-AIA member companies that joined ASO and were ineligible for financial benefits.

	Print this page
@	E-mail this page

This page updated
19 Oct 2007