BackgroundWith an estimated adult HIV prevalence of 15%, Namibia is in need of innovative health financing strategies that can alleviate the burden on the public sector. Affordable and private health insurances were recently developed in Namibia, and they include coverage for HIV/AIDS. This article reports on the efficacy of HIV workplace surveys as a tool to increase uptake of these insurances by employees in the Namibian formal business sector. In addition, the burden of HIV among this population was examined by sector.MethodsCross-sectional anonymous HIV prevalence surveys were conducted in 24 private companies in Namibia between November 2006 and December 2007. Non-invasive oral fluid-based HIV antibody rapid tests were used. Anonymous test results were provided to the companies in a confidential report and through presentations to their management, during which the advantages of affordable private health insurance and the available insurance products were discussed. Impact assessment was conducted in October 2008, when new health insurance uptake by these companies was evaluated.ResultsOf 8500 targeted employees, 6521 were screened for HIV; mean participation rate was 78.6%. Overall 15.0% (95% CI 14.2-15.9%) of employees tested HIV positive (range 3.0-23.9% across companies). The mining sector had the highest percentage of HIV-positive employees (21.0%); the information technology (IT) sector had the lowest percentage (4.0%). Out of 6205 previously uninsured employees, 61% had enrolled in private health insurance by October 2008. The majority of these new insurances (78%) covered HIV/AIDS only.ConclusionThe proportion of HIV-positive formal sector employees in Namibia is in line with national prevalence estimates and varies widely by employment sector. Following the surveys, there was a considerable increase in private health insurance uptake. This suggests that anonymous HIV workplace surveys can serve as a tool to motivate private companies to provide health insurance to their workforce. Health insurance taken up by those who are able to pay the fees will alleviate the burden on the public sector.

中文翻译：

---

匿名艾滋病毒工作场所调查作为纳米比亚负担得起的私人医疗保险的宣传工具

背景估计成人艾滋病毒流行率为 15%，纳米比亚需要创新的卫生筹资战略，以减轻公共部门的负担。纳米比亚最近开发了负担得起的私人健康保险，其中包括对艾滋病毒/艾滋病的承保。本文报告了艾滋病工作场所调查作为提高纳米比亚正规商业部门雇员对这些保险的接受程度的工具的有效性。此外，该人群中的 HIV 负担按部门进行了检查。方法 2006 年 11 月至 2007 年 12 月期间，在纳米比亚的 24 家私营公司进行了横断面匿名 HIV 流行率调查。使用了基于非侵入性口腔液的 HIV 抗体快速检测. 匿名测试结果以机密报告的形式提供给公司，并通过向管理层介绍，在此期间讨论了负担得起的私人健康保险的优势和可用的保险产品。影响评估于 2008 年 10 月进行，当时对这些公司的新健康保险使用情况进行了评估。结果 8500 名目标员工中，6521 人接受了 HIV 筛查；平均参与率为 78.6%。总体而言，15.0%（95% CI 14.2-15.9%）的员工检测出 HIV 呈阳性（跨公司范围为 3.0-23.9%）。采矿业的 HIV 阳性员工比例最高（21.0%）；信息技术（IT）部门的百分比最低（4.0%）。到 2008 年 10 月，在 6205 名以前未投保的员工中，61% 已参加了私人医疗保险。这些新保险中的大多数 (78%) 仅涵盖 HIV/AIDS。结论 纳米比亚 HIV 阳性正规部门雇员的比例与国家流行率估计一致，并且因就业部门而异。调查之后，私人医疗保险的使用量有了显着增加。这表明匿名的 HIV 工作场所调查可以作为一种工具来激励私营公司为其员工提供健康保险。有能力支付费用的人购买健康保险将减轻公共部门的负担。私人医疗保险的使用量有相当大的增加。这表明匿名的 HIV 工作场所调查可以作为一种工具来激励私营公司为其员工提供健康保险。有能力支付费用的人购买健康保险将减轻公共部门的负担。私人医疗保险的使用量有相当大的增加。这表明匿名的 HIV 工作场所调查可以作为一种工具来激励私营公司为其员工提供健康保险。有能力支付费用的人购买健康保险将减轻公共部门的负担。