The number of people living with HIV continues to grow and in 2008 an estimated 33.4 million people worldwide are living with HIV. There is still no cure for the disease and pharmacological approaches to prevention as used in post-exposure prophylaxis or prevention of mother to child transmission are still not feasible on a large scale. Thus, prevention of HIV transmission still relies on promoting the uptake of specific prevention or health-seeking behaviour such as Voluntary Counselling and Testing for HIV (VCT).
The authors of a recent Cochrane review included eight studies with 11,164 participants. One study from Africa found a strong increase in uptake of Voluntary Counselling and Testing (VCT) to 51% when delivered on-site which was 14 times more compared to a voucher for off-site testing. However, VCT did not change HIV incidence in one study among African factory workers. In another study among Hong Kong truck drivers, VCT decreased self-reported sexually transmitted diseases (STD) but VCT did not decrease unprotected sex significantly. Education was studied among soldiers in Nigeria, Angola and the US, truck drivers in India and factory workers in Thailand. Education that was modelled after a motivational theory reduced STDs with 32%, decreased unprotected sex with a small amount, and reduced sex with a commercial sex worker with 12% but did not decrease the number of partners or the habit of using alcohol before sex.
The authors concluded that workplace interventions for preventing HIV are feasible and that it is possible to study them in a randomised controlled trial. Peer influence has a positive effect on VCT uptake and workplace interventions can change risky sexual behaviour to a moderate degree. More randomised trials are needed in high risk groups or in areas with high HIV prevalence to find more effective interventions.