An assessment of the implementation of HIV in the Workplace Policy, an anti- stigma and discrimination policy in Akwa Ibom State, Nigeria: A cross-sectional descriptive study

Abstract

Abstract Background Nigeria, like other countries in the world, has adopted policies to facilitate the implementation of HIV programs. One such policy, the HIV in the Workplace policy (HIV WPP), is an anti-stigma and discrimination policy that aims at protecting the rights of Persons living with HIV (PLHIV) in the workplace. Akwa Ibom State, one of the thirty-six states in Nigeria, adopted this policy in 2014. However, since its adoption, its implementation has not been assessed. This study aimed to assess the implementation of the HIV WPP in the state. Methods A cross-sectional study using a mixed methods approach was conducted for 591 consecutively recruited employees and 43 employers/ decision-makers across 23 organizations in Akwa Ibom State, Nigeria. The data were collected from October 2022 to February 2023. Seven criteria were used to assess policy implementation. They included policy availability, socio-economic and political contexts, stakeholders’ involvement, resource availability, leadership, operations and feedback. Scores above 70% were regarded as optimal policy implementation. Results were analyzed using SPSS 15.1 for quantitative and NVivo 10 for qualitative data. Results The study showed that 95% of organizations assessed had sub-optimal implementation (86.4% non-implementation and 9.1% poor implementation) of the AKS HIV WPP. Of the seven criteria used to assess policy implementation, the policy implementation failed on all points except one, socio-political environment. Prolonged engagement with donor agencies provided a good socio-political environment resulting in increased awareness of HIV in the state. However, only one (4.6%) organization, a private organization, fully implemented the policy on the seven domains of policy implementation. Most organizations had no HIV WPP policy (95.4%), no HIV committee (72.7%), inadequate resources (73.1%), and sub-optimal involvement of their leadership (59.2). There was a statistically significant association between the type of organization and the level of implementation of the AKS HIV WPP (p = 0.004). Conclusion The implementation of the AKS HIV WPP was poor due to many factors ranging from the unavailability of the document to lack of structures for its operationalization. It is recommended that the Akwa Ibom State Agency for the Control of AIDS (AKSACA) initiates and operationalizes the structures for its implementation through public-private collaboration. The availability of HIV-related organizational practices should provide a rationale for translating the state’s anti-stigma policy into organizational policies.