1Pirie.qxd HIV/AIDS and its impact on South African Organisations The HIV/AIDS pandemic threatens the welfare of between 4 to 6 million South Africans (Garbus, 2002), of which an estimated 4, 7 million people are between the age of 15–49 years (http://hivinsite.ucsf.edu). Furthermore, it is assumed that 25% of South Africa’s economically-active individuals are believed to be HIV positive (Human Science Research Council, 2002; Pangaea Global AIDS Foundations HIV/AIDS Statistics, 2004). This implies that the HIV/AIDS pandemic has dramatically changed the environment in which organisations operate. As indicated in Figure 1, HIV/AIDS undeniably impacts on organisations and workplaces. Barrows, Gallow and Mulleady (1996) argue in this regard that the effect of HIV/AIDS manifests itself in the workplace through increased absenteeism, increased salaries, lower employee morale and higher staff t urnover. HIV/AIDS also significantly impacts on organisational goals when investing resources in Black Economic Empowerment and upliftment programmes. Not only has the pandemic a significant impact on an organisation’s profits through direct costs and declining economies, but the pandemic deters investment and decreases output which could earn foreign exchange (http://www.corporateleadershipcouncil.com). A study in several Southern and East African countries has estimated that the combined impact of AIDS-related absenteeism, decline in productivity, health care expen- ditures and recruitment and training expenses could cut profits by at least 6 – 8% and that absenteeism can account for as much as 25 – 54% of a company’s total cost structure (Garbus, 2002). Despite the mentioned economic challenges, HIV/AIDS- related stigmatisation, discrimination and denial have characterized the disease for the past twenty years and offered additional challenges for organizations in terms of prevention, care and treatment programmes (Lim & Loo, 2000). Linking to the previous, HIV/AIDS-related discrimination, stigmatisation and denial have been cited at all stages of the employment relationship (Connors & Heaven, 1995) and it can be argued that these impact negatively on the psycho-social contract bet ween employer and employee. Regarding the psycho-social contract Veldsman (1996, p. 14) emphasises that the psycho-social contract focuses on the reciprocal expectations of co-responsibility for organizational success and serve as a source of security and legitimacy between the parties, providing stability and predictability to their interactions over time. It can therefore be argued that HIV/AIDS–related discrimination and stigmatization could destabilize the reciprocal expectations in the employee/ employer relationship and could impact negatively on organisational effectiveness. HIV/AIDS discriminatory behaviour manifests itself in the workplace in different ways. Authors such as Aggleton, Whitty, Knight, Prayle, Warwick, and Rivers (1998) state in this regard that stereotyping, exclusion from social events, pre-employment HIV testing, denial of employment to people who test positive or who are suspected to be infected, dismissal, pressure to resign and harassment, employees’ refusal to work with infected co- workers or refusal to share communal facilities, exclusion or denial of certain benefits and lack of confidentiality regarding an employee’s health status could be regarded as examples of discriminatory practices. Chandra, Deepthivarma and Manjula (2003) state in this regard that the internalization of these responses on an individual level may result in non-disclosure of HIV/ AIDS stat us, self-exclusion from information, treatment and care programmes. This presents a major barrier to the effectiveness of educational programmes. Training is generally regarded as an important determinant in creating HIV/AIDS awareness and reducing risk behaviour (Jourdan & Etkind, 2004). However, training is expensive in terms of production and wages, and much investment in training is wasted because the training is not underpinned by effective models for behavioural change or by a learning environment (Holton & Baldwin, 2000). Relating to this, the present st udy seeks to determine if there is a relationship between increasing levels of knowledge about HIV/AIDS and perceptions of discriminatory behaviour toward people with HIV/IADS. M PIRIE WJ COETSEE jc@rau.ac.za Department of Human Resource Management University of Johannesburg ABSTRACT The primary objective of this study was to assess whether there is a relationship between increasing levels of knowledge about HIV/AIDS and perceptions of discriminatory attitudes and behaviour towards people with HIV/AIDS. Employees (3662) from a large accounting firm were exposed to a survey and a response rate of 41% or 1532 was received. The secondary objective of the study was to determine whether there were any statistically significant differences in the mean difference of knowledge scores of groups created in terms of the different biographical variables. ANOVA’S (to determine the significance of differences between the means), t-tests (two groups only) and F-statistics were used for the analysis. Given the large sample size an F-test is not conclusive and the effect of the difference in sample size needs to be taken into account. For this reason it was also necessary to look at the Partial Eta Squared. Results indicate that respondents are generally knowledgeable about the prevention and transmission of HIV/AIDS and that respondents’ level of knowledge correlates negatively with discriminatory practices. Key words Knowledge levels regarding HIV/AIDS, discriminatory attitudes, HIV infected people THE EFFECTIVENESS OF HIGH LEVELS OF KNOWLEDGE REGARDING HIV/AIDS IN REDUCING DISCRIMINATORY ATTITUDES AND BEHAVIOUR TOWARDS HIV-INFECTED PEOPLE 1 SA Journal of Human Resource Management, 2006, 4 (1), 1-11 SA Tydskrif vir Menslikehulpbronbestuur, 2006, 4 (1), 1-11 HIV/AIDS-related Attitudes Attitudes, has been variously defined as, stable predispositions (Cox & Cox, 1991) a general and enduring positive or negative feeling about some person, object, or issue (Arnold, Cooper & Robertson, 1995; Worchel, Cooper & Goethals, 1991) a mental state of readiness, learned and organized through experience (Ivancevich & Matteson, 1996) and consisting of three distinct components i.e. 1. Cognitive component (consists of a person’s perceptions, opinions and beliefs); 2. Affective component (consists of the feelings, emotions a person has toward an object); and 3. Behavioural component (refers to the tendency of a person to act in a certain way). The relationship between the three components is illustrated in Figure 2 and from this it is clear that the components are directly related and dependant upon each other (Lewis, 1990). The creation of knowledge (i.e. cognitive component) can be understood as the cognitive activity that determines individual understanding and sense making of environmental stimuli. Weick (1995) and Dougherty, Borelli, Munir and O’Sullivan (2000) regard sense making as the process through which people reduce the complexity of their environment and by means of which different information, insight and ideas come together in a meaningful way. This means that information is gathered (through environmental scanning), interpreted and meaning is assigned to the information (Thomas & Pollock, 1999). Adding to this, Lewis (1990, p. 41) argues that, associated with cognition, is the concept of perception i.e. “…a cognitive process by which an individual gives meaning to the environment and it includes the interpretation of objects, symbols and people in the light of pertinent experiences” (Ivancevich et al., 1996, p. 121; Cook & Hunsaker, 2001). Dixon (1999) postulates that individuals create meaning structures (intentionally or unintentionally) when they are purposefully trying to understand or learn. The new meaning structures may corroborate or modif y existing meaning structures that the individual has, and when existing meaning structures conflict with new meaning struct ures, individuals experience an internal sense of uneasiness or dissonance. Closely related to perception is the concept of stereot ypes. Stereot yping is the process employed to assist individuals in dealing with information processing demands. This means individuals make assumptions about people solely on the basis of their belonging to a certain race, group or gender (Hellriegel, Jackson & Slocum, 1999). Attitudes (as illustrated in Figure 2) originate from human cognit ions and are closely linked and inf luenced by perceptions. Prejudice and stigmatisation normally refers to a specific attitude – a combination of hostile feelings, negative emotions and hostile behaviour towards others (Lewis, 1990; Ivancevich et al., 1996). Authors such as Goffman (1963), and PIRIE, COETSEE2 Figure 1: The impact of HIV/AIDS on organisations (UNAIDS, 200) Figure 2: Relationship between cognitive, affective and conative components (Figure taken and adapted from Lewis, 1990) Parker and Aggleton (2002) describe stigmatisation as a significant discrediting attitude, a process of devaluation or a perceived flaw which allows for its bearer to be treated in a dehumanized way or to reduce the stat us of the person who possesses it, resulting in a “spoiled identit y” (Parker et al. 2002). It is important to note that, apart from beliefs, perceptions and attitudes (which are critical for successful change (i.e. behaviour), there are individual difference variables (e.g. personalit y traits) that differentiate bet ween individual responses to change (Schalk, Cambell & Freese, 1998; Weber & Weber, 2001). The last component illustrated in Figure 2 namely the conative component refers to the likelihood of an individual behaving in a certain way. Given the focus of the study, the term discrimination can be defined as the unfair and unjust treatment of an individual based on his/her real or perceived HIV stat us, and discrimination is usually seen to follow stigmatisation (U NAIDS, 2003). Linking to the above, Dixon (1999) argues that individual actions are mediated by meaning structures. This means that stigmatisation and discriminatory behaviour is seen to be a function of the individual’s current meaning structures. It can therefore be speculated that those who stigmatise do not understand the condition, lack a relevant frame of reference/meaning structure and that this is supported by inappropriate knowledge of the condition. It is further speculated that other variables that could impact on an individual’s abilit y to construct or reconstruct meaning structures are demographic factors such as age, gender and educational level as well as perceived vulnerabilit y to becoming infected (Norman & Carr, 2003). According to Chiliaoutakis et al. (1996) the initial characterization of AIDS as being the result of clandestine, immoral and antisocial behaviour as well as the stereotyping of ‘high risk’ groups on this basis, paves the way to a ‘full blown’ AIDS social epidemic of stigmatisation and discriminatory practices. It can therefore be argued that HIV/AIDS-related stigmatisation builds upon and reinforces prejudices that already exist and strengthen existing social inequalities. Attribution theory (Ferris, Bhawuk, Fedor & Judge, 1995; Cook et al. 2001) gives a further explanation of this phenomenon. Martinko (1995) argues in this regard that when an individual’s behaviour is observed the observer attempts to determine whether the behaviour was internally caused by the individual or externally by the context or the sit uation. Three criteria namely distinctiveness (explain whether a person’s behaviour fits with other behaviour), consistency (explain the degree of variance in behaviour over time) and consensus (how others behave in similar situations) are used in the attribution process (Cook et al., 2001). This means that society is likely to attribute the cause of HIV/AIDS infections to either internal or external factors and thereby feel that stigmatisation and discriminatory practices are justified. This also illustrates the fact that the behaviour of people is continuously inf luenced by perceptions and attributions. Figure 3 not only indicates the link bet ween HIV/AIDS and pre-existing sources of stigmatisation and discrimination but also links to factors used in the attribution process. Furthermore, it can be argued that by stereotyping certain individuals or groups, and through attribution, society can excuse itself from the responsibility of caring for and looking after infected populations. Stereotypes also enable people to justif y to themselves why they personally will never be likely to become infected, which leads to a state of denial. Some of the most common forms of denial are to ignore the existence of HIV and AIDS, neglecting to respond to the needs of those infected and failing to recognize the growing epidemic in the belief that HIV/AIDS ‘can never happen to us’. Denial fuels AIDS stigmatisation by making those individuals who are infected appear abnormal and exceptional (http://www.avert.org). Figure 3: The link between HIV/AIDS and pre-existing sources of stigmatisation and discrimination (Figure taken from Horizons, 2004, p. 3) HIV/AIDS knowledge and discriminatory behaviour The majority of HIV/AIDS interventions have the common goal of educating employees regarding HIV/AIDS transmission and prevention so as to reduce the number of new infections, i.e. change individuals’ at risk behaviour (Sixsmith, Kelleher & Crangle, 2000). Organisations therefore need to provide continuous and strategic HIV/AIDS awareness, education and prevention activities integrated into ongoing communication, education and training activities. Despite the importance of continuous HIV/AIDS education and preventative programmes, the impact and effectiveness of these programmes remain questionable (Grunseit & Aggleton, 1998). From the literature it is clear that research conducted is inconclusive with regard to whether increases in knowledge alone is sufficient in changing discriminatory attitudes toward people infected with HIV/AIDS. Research conducted by Chiliaoutakis et al. (1996) showed that the higher the level of accurate knowledge about AIDS, the less discrimination and stigmatisation would occur. Unlike the findings of Chiliaoutakis et al. (1996), De Bruyn (1998) found that education will not change everyone’s attitudes or prevent stigma and discrimination in every instance. Stigmatized attitudes toward people with HIV/AIDS persist in a minority of the general population and research has demonstrated that negative attitudes toward, for example, homosexualit y contribute significantly to such stigmatizing attitudes. Quah (1998) found that the image of HIV/AIDS sufferers is moulded by a person’s age and level of information (outcome of formal education and knowledge) on the disease. Ragan and Bowen (2001) found that the provision of information can improve negative attitudes however, the new attitude may be lost without reinforcement for change. Bhate (1999) adds another level of complexity to the debate by stating that when attempting to change attitudes, it is important to know which cognitive styles one is dealing with (adaptors versus innovators) as they follow different patterns in changing attitudes as a result of exposure to negative and positive sources. Recent international and local research regarding HIV/AIDS knowledge showed that respondents who were younger and had a higher formal education attainment (de Bruyn, 1998; Garbus, 2002; Norman et al., 2003; Steward, 1993) lived in urban rather than rural areas; were employed and had higher household socioeconomic status (Garbus, 2002); had better HIV/AIDS knowledge. No significant gender differential regarding HIV/AIDS knowledge was found (Garbus, 2002). KNOWLEDGE REGARDING HIV/AIDS 3 With regard to denial and fear, Garbus (2002) found that only 0.5 percent of South Africans believed that there was someone infected with HIV in their families and that up to 92 percent of persons who tested positive for HIV were not able to tell their partners their serostatus. International research shows that stigma, fear of discrimination (http://www.avert.org; Chandra et al., 2003), disgrace to family and self (Lau, Tsui, Li, Chung, Chan & Molassiotis, 2003), were reported as the main reasons for non disclosure. The majority of subjects (73%) reported anticipation of negative societal reaction as the main concern following disclosure (Chandra et al., 2003). The conviction of individuals that they will be discriminated against is confirmed by various studies that show that people would resist working alongside, avoid, or even dismiss an employee if the person was found to be HIV-positive (Barrows, Gallo & Mulleady, 1996; Lau et al., 2003). Results of a study conducted by Lim and Loo (1999) indicated that respondents view the employing of people with HIV/AIDS as holding adverse consequences for the organisation. A number of studies have shown a positive correlation between perceived personal risk of contracting the disease and knowledge of the disease. The Kaiser Youth Survey undertaken in 2000 showed that 54% of respondents indicated that they are afraid they may contract HIV and that 66% agreed with the statement “I could die of AIDS” (Garbus, 2002). A study in Trinidad of 1 351 adults showed that knowledge was associated with concern about personal risk of HIV (Quah, 1998) and that the image of HIV/AIDS is less important than the joint impact of accepting personal responsibility and the perceived seriousness of the disease (Norman et al., 2003). The finding is that research is inconclusive and lacking with regard to the link between the extent of HIV/AIDS knowledge, attitude towards infected and affected people and resulting behaviour (discriminating, indifferent or accepting). Although knowledge appears to be a very important variable in reducing stigma and discrimination, it is clearly not the only variable. Existing studies looking into the role that a supportive, protective and caring environment plays in reducing HIV/AIDS discrimination can also be expanded on. To date only a limited amount of research has examined working adults’ attitudes towards infected colleagues in the workplace. It would appear that research in South Africa regarding mechanisms involved in the stigmatisation of risk behaviours, the socio-cultural construction of risk, attitudes of discrimination, and attitudes based on fear, have not received much scientific attention at all. The research that has been conducted on the last mentioned issues has also mainly been of international origin. Bearing in mind that cultural differences may influence people’s attitudes (Quah, 1998) towards having to work with an HIV-infected colleague, a case can be made that it is worthwhile examining individuals’ attitudinal and intended behavioral responses towards infected people in the organisational setting within the South African context. The problematic nature of stigmatisation and discrimination as social processes or phenomena are summarized by Parker et al. (2002, p14): “Much of what has been written about stigma and discrimination in the context of HIV and AIDS has emphasised the complexity of these phenomena, and has attributed our inability to respond more effectively to both their complex nat ure and their high degree of diversit y in different cultural settings”. Objectives of the study The primary objective of the study was to determine if there is a relationship between increasing levels of knowledge about HIV/AIDS and perceptions of discriminatory attitudes and behaviour towards people with HIV/AIDS. The secondary objective of the study was to determine if there are any statistically significant differences in the mean difference scores between levels of knowledge with regard to educational qualifications, sex, age and high-risk behaviour. This comparison would assess whether different comparison groups have different mental models regarding positive HIV/ AIDS employees. The previously mentioned objectives have been implemented by utilizing exploratory means, including a questionnaire that was compiled with the aim of measuring knowledge levels of the respondents regarding HIV/AIDS. The research design is further explained and developed in the next section. RESEARCH DESIGN Research Methodology This study is a quantitative study and a cross-sectional survey design was used to describe the information on the population collected. The study is also exploratory and descriptive as well as retrospective in nature (i.e. it was done on retrospective data). Elements of the research design are predetermined and in addition it is ex post facto and attempts to show causes and consequences after they have occurred. Respondents Due to the inherent educational value that knowledge, attitude, practices and behaviour (KAPB) surveys have, all 3662 employees of a large accounting firm situated in nine regions (See Table 1) were exposed to the survey. TABLE 1 GEOGRAPHIC REGIONS Region of work Count % Eastern Cape 92 6,0% Free State 72 4,7% Gauteng 763 49,8% Kwazulu Natal 136 8,9% Limpopo 16 1,0% Mpumalanga 20 1,3% North West 36 2,4% Northern Cape 43 2,8% Western Cape 353 23,1% Total 1531 100,0% A response return rate of 41% (N = 1532) was achieved. Employees from offices situated in Gauteng, Kwa-Zulu, Free State, Western Cape, Northern Cape, North West, Mpumalanga, Limpopo participated in and responded to the survey. The employment setting was predominantly white collar and participants operated in diverse functional areas e.g. from professional staff such as accountants to support and administrative personnel. Table 2 gives an indication of the ages of the respondents. TABLE 2 AGE OF RESPONDENTS Age Count % 19 and younger 8 0,5% 20 - 24 287 18,7% 25 - 29 496 32,4% 30 - 34 277 18,1% 35 - 39 150 9,8% 40 - 44 123 8,0% 45 - 49 80 5,2% 50 and older 110 7,2% Total 1531 100,0% PIRIE, COETSEE4 Respondents ages ranged from as young as 19 (0,5%) to age 50 and older (7%) with the majority of employees (32%) in the 25 – 29 year age category (N = 496). The sample indicated a leaning towards female respondents (N = 902), with male respondents accounting for 41% of the sample (N = 627). The educational level of the sample varied between high school, college and university, with the majority of respondents (63%) reporting a university degree (N = 963). See Table 3 in this regard. TABLE 3 EDUCATIONAL LEVELS Highest educational level Count % College/Technikon 267 17,4% High school 284 18,5% Primary school 17 1,1% University 963 62,9% Total 1531 100,0% More than half of the respondents (52%) indicated that they were in a relationship with the remaining 48% indicating that they were single at the time. Measuring Instrument In the research, a questionnaire consisting of 32 items and comprising three sections was utilized. Section A recorded the demographic data of the various respondents. Section B (22 items) measured the level of knowledge of the respondents regarding HIV/AIDS and Section C (10 items) measured discriminatory practices regarding an HIV-positive individual. Various literature sources were used in the compilation of the questionnaire. In this regard the ILO Code of Practice on HIV/AIDS and research done by the World Health Organisation refer. Following the study of different knowledge domains, it appears that information regarding HIV/AIDS is centered around the following themes: 1. How is the virus contracted? 2. What is the cause of HIV/AIDS? 3. Employees concerns, myths and fears; 4. Prevention and control of the spread of the virus; 5. Testing for HIV/AIDS; 6. Discriminatory practices. The abovementioned themes served as point of departure in formulating the questions. Each of the items in the HIV/AIDS Knowledge Questionnaire is presented in the form of a three- point scale namely Agree, Uncertain, and Disagree. This format is most appropriate, given the objective of the study, i.e. to assess the level of knowledge of the respondents. For the purpose of this study all questions answered as Uncertain were considered to be incorrect answers, which indicated a lack of knowledge. An example of the item construction is included. “Do you believe HIV/AIDS can be cured?” Agree Uncertain Disagree “Do you believe that you can prevent becoming infected by wearing a condom during intercourse?” Agree Uncertain Disagree Procedure A pre-survey distribution, meeting was held with the participating organisations stakeholders. The aim of the workshop was to familiarise stakeholders with the HIV/AIDS Knowledge Questionnaire content and with the procedures of distribution to ensure buy-in into the process, efficient survey delivery and minimizing possible misunderstandings. Surveys were distributed amongst all of the participating organisations’ employees. Although the majority of surveys were distributed electronically a small number of hard copies were distributed to employees who were not able to obtain them or did not have access to the electronic version. Employees also received an email or letter from the Deputy Chief Executive Officer of the participating organisation that explained the objectives of the survey and encouraged participation. Employees were asked to either return the survey electronically or to place completed questionnaires in the collection boxes provided. Employees were assured that the data would be kept confidential and anonymous. RESULTS The secondary objective of the study was to determine whether there were any statistically significant differences in the mean difference of knowledge scores of groups created in terms of the different biographical variables. ANOVA’S (to determine the significance in difference between the means), t-tests (two groups only) and F-statistics were used for the analysis. Given the large sample size, an F-test is not conclusive and the effect of the difference in sample size needs to be taken into account. For this reason it was also necessary to utilize the Partial Eta Squared. HIV/AIDS Knowledge Questionnaire The items utilized in the questionnaire are indicated in Table 4. Given the purpose of the investigation, namely to determine the relationship between increasing levels of knowledge about HIV/AIDS and perceptions of discriminatory attitudes and behaviour towards people with HIV/AIDS, items were included that are considered by inspection to have face validity. The pilot questionnaire can therefore serve as point of departure in compiling and refining a subsequent questionnaire. It is apparent from Table 4 that questions 1; 6; 7; 9; 11; 12; 15; 16 possess a relatively low discriminatory value and it is recommended that the items be excluded from any subsequent questionnaire. TABLE 4 KNOWLEDGE QUESTIONS AND DISCRIMINATORY PRACTICES SECTION B: KNOWLEDGE Agree Uncertain Disagree 1. A blood test can show whether Count 1480 28 21 someone has HIV/AIDS % 96,8% 1,8% 1,4% 2. It is possible to have a negative Count 1251 178 94 HIV blood test in the first couple % 82,1% 11,7% 6,2% of months after becoming infected with HIV 3. An HIV-positive mother who is Count 1127 207 195 breast-feeding can pass the HIV % 73,7% 13,5% 12,8% virus on to her baby 4. HIV/AIDS can be cured Count 204 193 1132 % 13,3% 12,6% 74,0% 5. The presence of a sexually Count 1175 192 164 transmitted disease can increase % 76,7% 12,5% 10,7% the risk of HIV transmission 6. A pregnant woman who has Count 1437 42 52 HIV/AIDS can pass the HIV virus % 93,9% 2,7% 3,4% on to her unborn baby 7. TB can be cured if treatment is Count 1474 44 12 given early enough % 96,3% 2,9% 0,8% 8. There is a difference between Count 1317 64 149 being HIV-positive and having % 86,1% 4,2% 9,7% AIDS 9. A person can be HIV-positive for Count 1438 54 40 many years without becoming ill % 93,9% 3,5% 2,6% 10. Tuberculosis (TB) is often Count 692 225 612 considered to be an AIDS % 45,3% 14,7% 40,0% related disease KNOWLEDGE REGARDING HIV/AIDS 5 11. You can tell by looking at Count 65 71 1393 someone that they are infected % 4,3% 4,6% 91,1% 12. You can become infected by Count 35 20 1476 touching the body of a person % 2,3% 1,3% 96,4% who has HIV/AIDS 13. You can become infected by Count 214 149 1167 kissing a person who has % 14,0% 9,7% 76,3% HIV/AIDS 14. You can become infected by Count 88 82 1361 sharing food or eating utensils % 5,7% 5,4% 88,9% with a person who has HIV/AIDS 15. You can become infected by Count 1507 6 17 using Syringes/needles previously % 98,5% 0,4% 1,1% used by a person who has HIV/AIDS 16. You one can become infected Count 1518 2 11 by having unprotected (no % 99,2% 0,1% 0,7% condom) sex 17. You can become infected by Count 222 377 931 being bitten by a mosquito that % 14,5% 24,6% 60,8% previously bit an HIV-infected person 18. You can become infected by Count 57 79 1396 using the same toilet seats as % 3,7% 5,2% 91,1% HIV-infected people 19. You can become infected by Count 51 152 1327 being in contact with the % 3,3% 9,9% 86,7% perspiration (sweat) of a person who has HIV/AIDS 20. You can prevent becoming Count 1264 88 178 infected if you wear a condom % 82,6% 5,8% 11,6% 21. There are female condoms that Count 574 551 405 are effective in the prevention % 37,5% 36,0% 26,5% of HIV transmission 22. Contraceptive practices such as Count 30 56 1444 the pill etc. can also prevent HIV- % 2,0% 3,7% 94,4% transmission SECTION C: DISCRIMINATORY PRACTICES Disagree Uncertain Agree 1. If you were infected, do you Count 210 639 673 believe that your colleagues % 13,8% 42,0% 44,2% would avoid you if they found out that you had HIV/AIDS? 2. Would you feel comfortable Count 314 396 818 working with a colleague if you % 20,5% 25,9% 53,5% knew that he/she was HIV- positive? 3. Would you feel comfortable Count 356 305 868 sharing toilets with an HIV % 23,3% 19,9% 56,8% infected colleague? 4. Would you feel comfortable Count 347 252 928 sharing equipment/tools with an % 22,7% 16,5% 60,8% HIV-infected colleague? 5. Would you feel comfortable Count 417 297 814 sharing cutlery/crockery with an % 27,3% 19,4% 53,3% HIV-infected colleague? 6. Do you believe that CO. X would Count 986 426 115 attempt to dismiss you if they % 64,6% 27,9% 7,5% found out that you were HIV positive? 7. Should you become infected with Count 598 494 433 HIV /AIDS would you tell your % 39,2% 32,4% 28,4% manager/supervisor? 8. Should you become infected with Count 576 474 476 HIV/AIDS would you tell your % 37,7% 31,1% 31,2% HR manager? The descriptive statistics for different educational levels are depicted in Table 5. From Table 1 it is clear that the majority of respondents are Universit y graduates. Respectively, 284 respondents (19%) are in possession of a High School diploma and 267 respondents (18%) are in possession of a college or technicon qualification. Given the sample size, statistically significant differences (Table 6) were found in the mean scores between levels of education and knowledge levels of the respondents.(F 2; 1511 = 34,776, p < 0,0005). However, based on the effect size, Partial ETA Squared (Table 2), the effect of level of education on knowledge is relatively small as ETA = 0,21 < 0,3 TABLE 5 DESCRIPTIVE STATISTICS ACCORDING TO LEVELS OF EDUCATION 95% Confidence Interval for Mean N Mean Std. Std. Lower Upper Mini- Maxi- Deviation Error Bound Bound mum mum College/ 267 82,1927 10,82341 0,66238 80,8885 83,4969 Technicon High 284 78,5851 13,19370 0,78290 77,0441 80,1262 36,36 100,00 school Univer- 963 84,4898 9,67387 0,31174 83,8780 85,1015 31,82 100,00 sity Total 1514 82,9771 10,85558 0,27899 82,4298 83,5243 31,82 100,00 TABLE 6 ANOVA: COMPARISONS OF LEVELS OF EDUCATION IN RESPECT OF LEVEL OF KNOWLEDGE Sum of df Mean F Sig. ETA Squares Square Between Groups 7845,893 2 3922,947 34,776 0,000 0,210 Within Groups 170451,376 1511 112,807 Total 178297,270 1513 ETA 0,1 – 0,3 (Small effect) 0,4 – 0,5 (Moderate effect) > 0,5 (Large effect) TABLE 7 LEVENE’S TEST OF EQUALITY OF ERROR VARIANCES Levene Statistic df1 df2 Sig. 19,994 2 1511 0,000 The results of the Levene’s test for equality of error variances are depicted in Table 3. As the null hypotheses of equal variances is rejected (see Table 7), Dunnett T3 post hoc tests are used to ascertain which of the educational groups differ significantly. TABLE 8 POST HOC TESTS: MULTIPLE COMPARISONS BETWEEN LEVELS OF EDUCATION 95% Confidence Interval (I) (J) Mean Std. Sig. Lower Upper (Recoded) (Recoded) Dif- Error Bound Bound Highest Highest ference educa- educa- (I-J) tion level tion level Dunnett College/ High 3,6076(*) 1,02552 0,001 1,1515 6,0636 T3 Techni- school kon Uni- -2,2970(*) 0,73207 0,005 -4,0523 -0,5418 versity High College/ -3,6076(*) 1,02552 0,001 -6,0636 -1,1515 school Technikon Uni- -5,9046(*) 0,84268 0,000 -7,9254 -3,8838 versity Uni- College/ 2,2970(*) 0,73207 0,005 0,5418 4,0523 versity Technikon High 5,9046(*) 0,84268 0,000 3,8838 7,9254 school *The mean difference is significant at the 0,05 level. PIRIE, COETSEE6 The results of the Dunnett T3 post hoc tests for the different educational levels are depicted in Table 8. From Table 8 it is clear that there are significant differences in mean between the groups: College/Technicon, High School and Universit y graduates. From Table 5 it is clear that respondents who have a University degree have a higher level of knowledge than respondents who have a High School or Technikon qualification. TABLE 9 DESCRIPTIVE STATISTICS ON GENDER GROUPS Gender N Mean Std. Std. Deviation Error Mean Percentage correct on Female 902 82,3523 11,16853 0,37187 level of knowledge Male 627 83,3913 10,91232 0,43580 The descriptive statistics for gender groups are depicted in Table 9 and indicate that 902 (59%) respondents are female and 627 (41%) are male. TABLE 10 T-TEST: INDEPENDENT COMPARISON OF THE MEAN DIFFERENCE SCORES OF THE DIFFERENT GENDER GROUPS Levene's Test for Equality of Variances t-test for Equality of Means F Sig. t df Sig. (2- tailed) Percentage correct on Equal variances 0,875 0,350 -1,806 1527 0,071 level of knowledge assumed No statistically significant differences (Table 10) were found in the mean scores pertaining to the level of knowledge between the different gender groups [t(df =1527) = -1,806, p =0.071 > 0,05]. Based on Partial ETA Squared (Table 11) only 4.6% of the variance in level of knowledge can be attributed to differences in gender scores. Hence the observed differences between gender groups are neither of statistical significance nor of practical significance. TABLE 11 DIRECTIONAL MEASURES Value Nominal by Interval Eta Percentage correct on level 0,046 of knowledge Dependent ETA 0,1 – 0,3 (Small effect) 0,4 – 0,5 (Moderate effect) > 0,5 (Large effect) TABLE 12 DESCRIPTIVE STATISTICS ON AGE GROUPS 95% Confidence Interval for Mean N Mean Std. Std. Lower Upper Mini- Maxi- Deviation Error Bound Bound mum mum 24 and 295 82,6502 11,66458 0,67914 81,3136 83,9868 31,82 100,00 younger 25-29 496 84,5308 9,44966 0,42430 83,6971 85,3644 31,82 100,00 30-39 427 82,7656 10,75391 0,52042 81,7427 83,7885 40,91 100,00 40 and 313 79,9303 12,87195 0,72757 78,4987 81,3618 36,36 100,00 older Total 1531 82,7356 11,12108 0,28422 82,1781 83,2931 31,82 100,00 The descriptive statistics for age groups are depicted in Table 12 and it is clear that that the majority of respondents fall in the age categories 25 – 29 (32%) and 30 – 39 (28%) years. The remainder of respondents were 24 years of age and younger (19%) and 40 years of age and older (20%). TABLE 13 ANOVA: COMPARISONS OF LEVELS OF KNOWLEDGE IN RESPECT OF AGE GROUPS Sum of df Mean F Sig. ETA Squares Square Between Groups 4064,230 3 1354,743 11,172 0,000 0,147 Within Groups 185163,763 1527 121,260 Total 189227,993 1530 ETA 0,1 – 0,3 (Small effect) 0,4 – 0,5 (Moderate effect) > 0,5 (Large effect) Given the sample size, statistically significant differences (Table 13) were found in the mean scores of the different age groups (F 3; 1527 = 11,172, p < 0,0005). However, based on Partial ETA Squared (Table 9) the effect of the level of age on knowledge is relatively small as ETA = 0,147 < 0,3 TABLE 14 LEVENE’S TEST OF EQUALITY OF ERROR VARIANCES Levene Statistic df1 df2 Sig. 8,392 3 1527 0,000 The results of the Levene’s test for equality of error variances are depicted in Table 14. As the null hypotheses of equal variances is rejected (see Table 14), the Dunnett T3 Post hoc tests are used to ascertain which of the age levels differ significantly. TABLE 15 POST HOC TESTS: MULTIPLE COMPARISONS BETWEEN AGE GROUPS Percentage correct on level of knowledge Subset for alpha = 0,05 (Recoded) Age N 1 2 Scheffe (a,b) 40 and older 313 79,9303 24 and younger 295 82,6502 30-39 427 82,7656 25-29 496 84,5308 Sig. 1,000 0,150 Means for groups in homogeneous subsets are displayed. a) Uses Harmonic Mean Sample Size = 365,538. b) The group sizes are unequal. The harmonic mean of the group sizes is used. Type I error levels are not guaranteed. The results of the Scheffe post hoc tests (for comparison between the different age groups) are depicted in Table 15. From Table 15 it is clear that the levels of knowledge of respondents in the age group 40 and older are significantly lower than that of respondents in the other age categories. However, it is important to note that, based on the Partial Eta Squared (0,147), the effect of age on the level of knowledge is relatively small. (0,147 < 0,3). See also Table 10 in this regard. The descriptive statistics for respondents’ perceived risk of becoming infected are depicted in Table 16. It is clear that the majority of respondents (62%) do not believe that it is likely at KNOWLEDGE REGARDING HIV/AIDS 7 all that they will become infected with HIV. 8% of respondents believe that they are somewhat likely and 2% believe that it is very likely that they will become infected with HIV. The remaining 27% of respondents are uncertain about their personal likelihood of becoming HIV-infected. TABLE 16 DESCRIPTIVE STATISTICS ON PERCEPTION OF CONTRACTING HIV 95% Confidence Interval for Mean N Mean Std. Std. Lower Upper Mini- Maxi- Deviation Error Bound Bound mum mum Not 954 83,2762 10,47576 0,33917 82,6106 83,9418 31,82 100,00 likely at all Some 125 85,5636 11,19470 1,00128 83,5818 87,5455 36,36 100,00 what likely Uncertain 416 81,3265 11,90367 0,58363 80,1793 82,4737 36,36 100,00 Very 34 76,3369 13,27715 2,27701 71,7043 80,9695 45,45 95,45 likely Total 1529 82,7784 11,09924 0,28385 82,2216 83,3352 31,82 100,00 TABLE 17 ANOVA: COMPARISONS OF LEVELS OF KNOWLEDGE IN RESPECT OF PERCEPTION OF CONTRACTING HIV Sum of df Mean F Sig. ETA Squares Square Between Groups 3493,769 3 1164,590 9,613 0,000 0,136 Within Groups 184745,209 1525 121,144 Total 188238,978 1528 ETA 0,1 – 0,3 (Small effect) 0,4 – 0,5 (Moderate effect) > 0,5 (Large effect) Given the sample size, statistically significant differences (Table 17) were found in the mean scores between levels of knowledge and perceived perception of contracting HIV/AIDS (F 3; 1525 = 9,613, p < 0,0005). However, based on Partial ETA Squared (Table 13) the effect of level of knowledge on perception is relatively small as ETA = 0,136 < 0,3. TABLE 18 LEVENE’S TEST OF EQUALITY OF VARIANCES Levene Statistic df1 df2 Sig. 2,854 3 1525 0,036 The results of the Levene’s test for equalit y of error variances are depicted in Table 18. It is evident that the error variance for knowledge differences is unequal across groups (p < 0,05) and therefore the Dunnett is used to compare variances (Table 18). The results of the post hoc tests are depicted in Table 19 which shows that there are significant differences in the mean level of knowledge bet ween respondents who believe they know a great deal about HIV/AIDS and those who believe they have lower levels of knowledge. In particular, those who believe they know a great deal scored on average 86% for the knowledge test. From Table 20 it is clear that level of knowledge correlates significantly negatively (p < 0,0005) with discriminatory practices (Pearson Correlation = -0,287). Due to the actual magnitude of the correlation we, however, conclude that the effect of level of knowledge on discriminatory practices is relatively small. TABLE 19 POST HOC TESTS: MULTIPLE COMPARISONS ON LEVELS OF KNOWLEDGE (I) (J) Mean Std. Sig. Lower Upper (Recoded) (Recoded) Dif- Error Bound Bound Highest Highest ference educa- educa- (I-J) tion level tion level Dunnett A great Enough 4,5155(*) 0,75320 0,000 2,5205 6,5105 T3 deal Just a 11,6527(*) 0,93654 0,000 9,1792 14,1263 little Noth- 26,3409(*) 4,79511 0,002 10,7954 41,8864 ing Enough A great -4,5155(*) 0,75320 0,000 -6,5105 -2,5205 deal Just a 7,1373(*) 0,70684 0,000 5,2713 9,0032 little Noth- 21,8254(*) 4,75558 0,007 6,2964 37,3545 ing Just a A great -11,6527(*) 0,93654 0,000 -14,1263 -9,1792 little deal Enough -7,1373(*) 0,70684 0,000 -9,0032 -5,2713 Noth- 14,6882 4,78804 0,066 -0,8541 30,2304 ing Nothing A great -26,3409(*) 4,79511 0,002 -41,8864 -10,7954 deal Enough -21,8254(*) 4,75558 0,007 -37,3545 -6,2964 Just a -14,6882 4,78804 0,066 -30,2304 0,8541 little * The mean difference is significant at the 0,05 level. TABLE 20 CORRELATIONS: KNOWLEDGE AND DISCRIMINATORY PRACTICES Percentage correct on level of knowledge Section 4 Factor (2,3,4,5) Percentage correct Pearson Correlation 1 -0,287(**) on level of knowledge Sig. (2-tailed) 0 0,000 N 1532 1525 Section 4 Factor Pearson Correlation -0,287(**) 1 (2,3,4,5) Sig. (2-tailed) 0,000 0 N 1525 1525 ** Correlation is significant at the 0,01 level (2-tailed). There is no significant correlation between knowledge and behaviour; (Pearson’s Correlation = 0,012, p = 0,679 > 0,05) DISCUSSION The main objective of this study was to determine if there is a relationship between increasing levels of knowledge about HIV/AIDS and perceptions of discriminatory attitudes and behaviour towards people with HIV/AIDS. From the findings it is evident that respondents are generally knowledgeable about the transmission and prevention of HIV/AIDS. The results of this study indicate that respondents are PIRIE, COETSEE8 knowledgeable about the four main methods of HIV transmission, namely through sexual contact, through transfusion of contaminated blood, through the sharing of contaminated needles among HIV drug users and from an infected mother to her baby during pregnancy. Results of the survey also suggest that the majority of respondents were clear that HIV cannot be transmitted through casual contact such as sharing of communal toilets, sharing of cutlery and crockery and sharing of tools and equipment. A greater uncertainty was expressed regarding whether HIV can be contracted via exposure to an infected person’s bodily fluids such as saliva and whether mosquitoes could transmit the virus. Specifically, a total of 23% were not sure as to whether one can be infected with HIV after kissing an infected person. 24% did not know about the likelihood of transmission of HIV through mosquitoes, while 14% believed incorrectly that one could be exposed to HIV from mosquitoes. Although all scientific data available leads to the conclusion that HIV cannot be transmitted through these modes, respondents appear not be convinced of this fact, as the above findings suggest. Results of this study corroborate the findings of research conducted in the Far East (Lim et al., 1999). Considering the last mentioned findings, it is not surprising to find that 46% of employees would not feel comfortable or are uncertain about whether they would be comfortable working with an infected colleague. Although employees showed a high level of knowledge and awareness that HIV can not be transmitted through the various means of casual contact, 43% were not willing to or uncertain about using the same toilets as an infected person, 46% were not comfortable or uncertain about sharing crockery and cutlery and 39% were not comfortable or uncertain about sharing tools or equipment with an infected person. Although respondents indicated that they know that HIV cannot be transmitted through casual contact (as this is what they have been told) they may remain unconvinced of scientific findings because they worry that new evidence may come to light at a later date that points to the possibility of HIV transmission occurring through casual contact. This study further highlighted that only 14% of employees believed that their colleagues would not avoid them if they found out that they had HIV or AIDS. The remaining 44% of respondents believe that they will be ostracised and 42% were uncertain about their colleagues’ reactions should their HIV status become known. The last-mentioned finding substantiates findings of Barrows et al. (1996) and Lau and Wong (2001) that individuals believe that they will be discriminated against or that others will resist working alongside or avoid them if they were found to be HIV positive. Despite the last mentioned scepticism and concern that respondents showed regarding the transmission of HIV by means of casual contact it is evident from the findings that, although the relationship between levels of knowledge about HIV/AIDS and discriminatory behaviour toward people with HIV/AIDS is relatively small, the level of knowledge correlates negatively with discriminatory practices. These findings corroborate the findings of research conducted by Chiliaoutakis et al. (1996). It would therefore appear that these results indicate that such respondents are able apply the data and information that they have received regarding HIV/AIDS in a meaningful manner which then results in non-discriminatory practices. The study further assesses whether several comparison groups created in terms of the different biographical variables had differing scores with regard to level of knowledge. The results of this study indicated that there is a meaningful difference between the average levels of knowledge and respondents’ education level and age. However, based on the effect size, the effect of level of education and age on knowledge is relatively small. This Survey’s findings corroborate findings of Garbus (2002) in that no significant difference was found between the knowledge of men and women. Findings of this study correspond to findings of De Bruyn (1998), Garbus (2002) and Norman et al. (2003) that AIDS knowledge is higher among people with more education and amongst younger people. In South Africa the lower knowledge of respondents 40 years and older can be ascribed to such employees having been less likely to have received sex education and HIV/AIDS education particularly in school in comparison to younger respondents. Linking findings back to earlier discussion regarding the formation of attitudes it could be argued that older respondents’ meaning structures with regard to sex and sexually transmitted diseases may differ from those of younger respondents in that meaning structures were formed in the absence of exposure to HIV/AIDS. Older employees were thus required to fit the concept of HIV/AIDS (new information) into their already existing categories at a much later stage in their lives. According to Worchel et al. (1991) all new information is distorted to some degree in order to fit into already existing categories and existing categories have to expand to accommodate such information. Depending on a number of variables, including the extent to which the individual is set in his/her ways or willingness to change existing categories, accommodation of information regarding HIV/AIDS would or would not take place. In comparison, younger respondents formed their meaning structures inclusive of HIV/AIDS due to their exposure to HIV/AIDS from a much earlier age. The same argument can be used for the findings that indicate that the higher the respondent’s level of education the higher the level of knowledge. Respondents with a higher level of education may find it less difficult to assimilate and accommodate new information into existing concepts as this is primarily what training in any field teaches and requires an individual to do. It would therefore appear that both educational level and age may be contributing factors in the formation of different mental models. Another interesting finding was that although no correlation was found between level of knowledge and behaviour that places one at risk of infection, a significant difference was found between level of knowledge and respondents’ perceived risk of becoming infected (given the large sample size the impact thereof remains small). Respondents with high levels of knowledge perceived themselves to be at lower risk of infection and respondents with lower levels of knowledge perceived themselves as having a higher probability of becoming infected. The last mentioned findings correspond with Norman et al. (2003) findings that knowledge was associated with concern about personal risk of contracting AIDS. Findings may be attributed to respondents’ (with a higher level of knowledge) understanding of the difference between putting themselves at risk for infection, thus having to make a pre-behavioral decision, and knowing when they are already at risk of being infected due to past decisions. Respondents with a higher level of knowledge are more likely to know that one increases one’s risk of infection through high-risk practices such as having unprotected sex with a partner, having unprotected sex with sex workers who are at high risk of becoming infected themselves, by sharing needles/ syringes to inject drugs/ steroids or by having unprotected sex with individuals who have previously placed themselves at high risk of becoming infected. Results of the survey show that a concerning 8% of respondents (125 employees) believed that they were “somewhat” likely to become infected with HIV and that a further 2% of respondents (34 employees) believed that they were very likely of becoming infected. It would therefore appear that these respondents are evidently aware of their previous and current “risk” practices. The 27% of respondents who stated that they are uncertain about their personal likelihood of becoming infected with HIV may not understand/be knowledgeable about at-risk practices that place them at risk of HIV infection. Despite the findings based on Partial ETA Squared that the effect of level of knowledge is relatively small, the findings of the research conducted still add value by means of determining the KNOWLEDGE REGARDING HIV/AIDS 9 various knowledge levels. Education regarding HIV/AIDS will continue to be a key component in any strategy to reduce or prevent stigma and discrimination against people with HIV/AIDS as stigma and discrimination may result in isolation and marginalization, increased vulnerability to infection and increased likelihood of general health risks (De Bruyn, 1998). The Employment Equity Act specifically protects individuals from discrimination and it is therefore important to identif y possible discriminatory attitudes and practices, which might hold Labour Relations implications for the organisation. Discriminatory behaviour not only affects the employer employee relationship but can also damage the public’s view of the organisation which will have other far-reaching negative consequences. According to Firmansyah and Kleiner (1999) AIDS discrimination in the workplace is not limited to the employer employee relationship but can also take place between business and its customers. The last-mentioned can have a further devastating impact on the organisation’s bottom line. The implications of these findings can be summarised as follows: 1. The provision of HIV/AIDS educational intervention programs are imperative in reducing discriminatory attitudes and behaviour towards people infected with HIV/AIDS. 2. By reducing discriminatory attitudes and behaviour one contributes to a milieu of acceptance and understanding which in turn assists in reducing fear and denial and thereby indirectly reduces the risk of new infections. 3. Current thinking regarding “at risk” groups such as younger age groups, should be reconsidered, since such “stereotyping of risk” can contribute to older individuals not perceiving themselves to be at risk when they may in fact be at higher risk due to their lower level of knowledge and past lack of exposure to sex and HIV/AIDS education. 4. HIV/AIDS intervention programs should have the dual aim of providing information, according to Bellinger et al. (2004) information is data that has been given meaning by way of relational connection, this meaning can be useful, but does not have to be, and education (knowledge and understanding). People first need information i.e. the facts, which will help to lay the foundation for health education. Shortcomings of the study are the following: 1. It is focused mainly on knowledge of transmission, few questions regarding knowledge of prevention e.g. effectiveness of latex condoms vs. nat ural membrane condoms, the effect of oil based lubricants on condoms etc. 2. Fear and denial were not a main focus of the survey 3. The sample group is not representative of the general South African population (high educational levels) 4. Findings may be limited to the specific organisation due to its specific environmental setting 5. Cannot ascribe high level of knowledge to educational and other interventions offered by the organisation only. Other sources of information e.g. mass media campaigns, community-based and interpersonal interventions, informal networks e.g. friends and family may also have played a role. 6. Although it has been noted that both knowledge and a supportive and caring environment is required to adequately reduce stigma and discrimination, this study focused only on the link between knowledge and attitude towards those infected, and disregarded the structural components. REFERENCES Aggleton, P., Whitty, G., Knight, A., Prayle, D., Warwick, I. & Rivers, K. (1998). Promoting young people’s health: concerns and needs of young people. Health Education, 98, (6), 213-219. Arnold, J., Cooper, C. & Robertson, I. (1995). Work Psychology: Understanding human behaviour in the workplace. London: Pitman Publishing. Avert.Org. (2004). HIV & AIDS stigma and discrimination: Attitudes towards HIV & AIDS. Retrieved February 17, 2004 from http://www.avert.org/aidsstigma.html. Barrows, C.W., Gallo, M. & Mulleady, T. (1996). AIDS in the US hospitality industry: Recommendations for education and policy formulations. International Journal of Contemporary Hospitality Management, 5, (1), 5 – 9. Bhate, S. (1999). Cognitive style differences and their impact on responses to message sources. Marketing Intelligence and Planning, 17, (6), 280 – 287. Chandra, P.S., Deepthivarm, A.S. & Manjula, V. (2003). Disclosure of HIV infection in South India: Patterns, reasons and reactions. AIDS Care, 15, (2), 207 – 215. Corporate Leadership Council. (2002). Strategies for HIV/AIDS Management. Retrieved April 21, 2004 from http://www.corporateleadershipcouncil.com. Connors, J. & Heaven, P. (1995). Health beliefs and attitudes towards people living with HIV/AIDS. Journal of Applied Social Psychology, 25, (10), 922-931. Cook, C.W. & Hunsaker, P.L. (2001). Management and Organizational Behaviour. New York: McGraw-Hill. Cox, S. & Cox, T. (1991). Structure of employee attitudes to safety: A European example. Work and Stress, 48, (3), 93-106. De Bruyn, T. (1998). HIV/AIDS and Discrimination: A discussion paper. Canadian HIV /AIDS Legal Network and Canadian AIDS Society, Montreal. Dixon, N.M. (1999). The organizational learning cycle. USA:Gower. Dougherty, D. Borelli, L., Munir, K., & O’Sullivan, A. (2000). Systems of Organizational sense making for sustained product innovation. Journal of Engineering and Technology Management, 17, 321-355. Ferris, G.R., Bhawuk, D., Fedor, D.F. & Judge, T.A. (1995). Organizational politics and citizenship: Attributions of intentionality and construct definition, In Martinko, M.J., Attribution theory: an organizational perspective, (231-251). Delray Beach: St Lucie Press. Firmansyah, S. & Kleiner, B.H. (1999). New developments concerning discrimination against workers with HIV or AIDS. Equal Opportunities International, 18, 2 – 4. Garbus. L. (2002). UCSF: Country AIDS Policy Analysis Project. Regents of the University of California. Goffman, E. (1963). Stigma: Notes on the Management of a spoiled identity. New York: Simon & Schuster. Grunseit, A.C. & Aggleton, P. (1998). Lessons learned: An update on the published literature concerning the impact of HIV and sexuality education for young people. Health Education, 2, 45 – 54. Hellriegel, D., Jackson, S.E. & Slocum, J.W. (1999). Management. Cincinnati, Ohio: South-Western College Publishing. HIVInSite. (2004). Center for HIV information. Retrieved March 31, 2004 from http://hivinsite.ucsf.edu/global? page=cr09-sf-00. Holton, E.F. & Baldwin, T.T. (2000). Making transfer happen: an action perspective on learning transfer systems. Advances in Developing Human Resources, 8, 1-6. Horizons. (2004). HIV/AIDS related stigma, pp.13 – 15. Retrieved February 17, 2004 from http://www.popcouncil.org/ horizons.html. Human Sciences Research Council of South Africa. (2002). Research programmes: Social aspects of HIV/AIDS and health (saha). Retrieved March 23, 2004 from http://www.src.ac.za/ research/npa/SAHA/news/news20021205.html. Ivancevich, J.M. & Matteson, M.T. (1996). Organizational Behaviour and Management. USA: Irwin. Jourdan, J., & Etkind, P. (2004) Enhancing HIV/AIDS and STD prevention through program integration. Public Health Reports, 119, (1), 4-11. Lau, J.T.F., Tsui, H.Y., Li, C.K., Chung, R.W.Y., Chan, M.W., & Molassiotis, A. (2003). Needs assessment and social environment of people living with HIV/AIDS in Hong Kong. AIDS Care, 15, (5), 699 – 706. Lau, J.T.F & Wong, W.S. (2001). AIDS related discrimination in the workplace – the results of two evaluative surveys carried out during a three year period in Hong Kong. AIDS Care, 13, (4), 433 – 440. PIRIE, COETSEE10 Lewis, M.H. (1990). An Investigation to predict the extend of discrimination based upon the existence of stereotypes and prejudicial attitudes against woman in managerial positions. For partial fulfillment of the requirements for the degree “Master of Personnel Guidance”. University of the Orange Free State, Bloemfontein. Lim, V.K.G & Loo, G.L (1999). HIV and the workplace. Organisational consequences of hiring persons with HIV and attitudes towards disclosure of HIV related information. International Journal of Manpower. 21, (2), 129 – 140. Martinko, M.J. (1995). The nature and function of attribution theory within the organizational sciences. In Martinko, M.J. Attribution theory: an organizational perspective. (7-14). Delray Beach: St Lucie Press. Norman, L.R. & Carr, R. (2003). The role of HIV knowledge on HIV related behaviors: A hierarchical analysis of adults in Trinidad. Health Education, 103, (3), 145 – 155. Pangaea Global AIDS Foundation. (2004). South African HIV/AIDS Statistics. Retrieved March 31, 2004 from: http://www.pgaf.org/pressreleases//south_africa_stats.html. Parker, R. & Aggleton, P. (2002). HIV/AIDS-related stigma and discrimination: A conceptual framework and an agenda for action. Horizons Program and Population Council. Quah, S.R. (1998). Ethnicity, HIV/AIDS Prevention and Public Health Education. International Journal of Sociology and Social Policy, 18, 7- 8. Ragan, A.M & Bowen, A.M. (2001). Improving attitudes regarding the elderly population: The effects of information and reinforcement for change. The Gerontologist, 41, (4), 511 -515. Schalk, R., Cambell, J.W. & Freese, C. (1998). Change and employee behaviour. Leadership and Organization Development Journal, 19, 157-163. Sixsmith, J., Kelleher, C.C. & Crangle, E. (2000). Impact evaluation of an HIV screen educational advertisement. Health Education, 100, (1), 42-49. Thomas, H. & Pollock, T. (1999). From I-O economics’ S-C-P paradigm through strategic groups to competence-based competition: reflections on the puzzle of competitive strategy. British Journal of Management, 10, 127-140. UNAIDS. (2000). Report on the global HIV/AIDS epidemic 2002. Retrieved January 8, 2003 from: http://www.unaids.org/ barcelona/presskit/barcelona%20report/chapter3.html. UNAIDS. (2003). Fact Sheet: Stigma and discrimination. Retrieved February 17, 2004 from http://www.unaids.org. Veldsman, T.H. (1998). Exploring the living organization: the concept organizational culture. In J.A. Slabbert; J.J. Prinsloo; B.J. Swanepoel; W. Backer (Eds). Managing Employment Relations in South Africa, (8-1-18-25). Durban: LexisNexis Butterworths. Weber, P.S. & Weber, J.E. (2001). Changes in employee perceptions during organizational change. Leadership and Organization Development Journal, 22, 291-300. Weick, K.E. (1995). Sense making in organizations. London: Sage. Worchel, S., Cooper, J. & Goethals, G.R. (1991). Understanding social psychology. New York: Wadsworth, Inc. KNOWLEDGE REGARDING HIV/AIDS 11