Establishing HIV - AIDS Programs in The Workplace - Outreach To Factories in Pathum Thani Province

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ASEAN Institute for Healih Development Maliidol University and Provincial AIDS Committee, Pathum Thani Province
Supporting Agency
The European Communiryt Program on HIV/AIDS in Developing Countries
Establishing HIV/AIDS Programs in the Workplace: Outreach to factories in Pathum-Thani province.
Yawarat Porapakkham Wilaiwan Koykaewpring Varaporn Pinitpwadol
Hatairat Suda
With support of the European Community's Programme on HIV/AIDS in Developing Countries

Contract number
EC/AIIID
96106
ASEAN Institute for Health Development

Mahidol University, Salaya
Thailand
July 1999
Establishing HIV/AIDS Programs in the Workplace: Outreach to factories in Pathum-Thani province. Yawwat Porapak*lnm Wilaiwan Koylaewpring Varaporn Pinitpwadol Hatairat Suda
With zupport of the European Community's Programme on HIV/AIDS in DeveloPing Counties Confract number EC/AIHD 96/06
Publishedby ASEAN Institute for Health Development Mahidol University, Salaya

Thailand
July
1999
Fint published: 500 Copies

176 Pages
Cataloguing in Publication Data
Estab[;hing-Hry/AlDs Programs in the Workplace: Outreach to factories in PathumThani province I Yanarat Porapakffitam". [et al.J
1. Acquired Immunodeficiency Syndrome
'- Prevention & Control
2. AIDS (Disease)
I.Title
wc
503 E79 1999
ISBN 974-662-939 -5
Table of Contents
Chapter
Project on the establishing HIV/AIDS Programes in a workplace.
1.1 HIV/AIDS problem in factory workers. 1.2 National Plan for HIV/AIDS prevention and care.
AIDS situation in Pathum-Thani. 1.4 AIDS and Navanakorn. 1.5 Establishing HIV/AIDS Programs in the Workplace: Outreach to factories in Pathum-Thani province.
1.3 I .6 Project assessment.
Chapter
II Project strategies. .....................................................-..........-.--.....--....
l4
2.1 Strategy for sustainability. 2.2 Outreach communication strategy. 2.3B&rcation for behavioural change strategy.
Chapter
III
Strategies and results...............................................,.-...............-......25
3.1 Management ofthe project. 3.2 Preparation before full operation. 3.3 Working process in the target workers. Chapter [V Results of the factory intervention........'..........................................'49 4.1 Participation of the partners in the project. 4.2The success of potential development of personnel in the workplace. 4.3 Results of implementing HIV/AIDS prevention education. 4.4 Cost investrnent analvsis. Chapter V Result of the project.... 5.1 Result ofthe project on workers. 5.2 Result of the project on AIDS policy in the factories.
Establishing HIV/AIDS Programs in the Workplace
Page
6.1 Studies on the results and impact. 6.2 Operation model. 6.3 ksson leamed. 6.4 Policy suggestion for economic crisis.
Annex.
Al. Evaluation
....107
.............107 AQ.Datafrom interviewing survey of male and female workers afterthe completion of the ...1l l ,4'3. Group - discussion and in depth ...........120 ,4'4. Results from the qualitative study among women workers: Final project evaluation results ..........I42 A5. A case study: Rohm Apollo ..................157 Name of Personnel Participating in the Factories...
process. project.
interview... (Post-intervention)........... company...
ll
Establishing HIV/AIDS Progrms in the Workplace
Preface
AIDS is one of the crisis in this globalization era. To solve AIDS
problems, one has to understand the sensitivity and the depth of human behavior and life style, which are closely associated with social, economics and culture. These factors influence the rapid change of AIDS problems. It is not sufficient to solve AIDS problems base only on science a technology, arts and other disciplines of knowledge should be applied. It is a challenge to seek the answer, which will lead to problem solving in all dimensions, which are variable and dynamic other than the dimensions of the disease and the virus.
The outreach program on AIDS prevention in Nava Nakom Ind'ustrial Park conducted by the ASEAN Institute for Health Development, M-ahidol University is one part of the role of academic institution gathering experience and lesson leamed is an attempt to help solving AIDS problem is the environment of
production factories and to present other aspect of problem-solving to the society.
The major objective of the project is to develop a suitable model for sustainable preventive activities in the factories. This report presents an education intervention program in the 12 taryet factories. The process, the products and the results of the project comparing the efficiency of the program in medium and large size factories, including suggestion obtained from the lesson learned are presented. Handbook and education curriculum for training ofAIDS educators and volunteers including techniques to educate factory workers will be
presented separately.
with the support from AIDS program of the European commission, the project had been ciried out smoothly and efficiently. We hope the knowledge
gained and the model developed by the project would be usefrrl and could be applied in solving AIDS problem in other area by AIDS projects of the European Commission.
Som-arch Wongkhomthong Director The ASEAN lnstitute for Health Development Mahidol UniversitY
Julv
1999
Establishing
HMAIDS
Programs in the Workplace
l1l
Acknowledgement
The success for outreach program on AIDS education prevention in Nava Nakom Industrial Park is the result of the cooperation of all partrers, the govemment sector, the business sector, the factories, the non-government organization and the community of 12 factories in Nava Nakorn Industrial Park, The ASEAN Institute for Health Development, Mahidol University is imfressed and greatly appreciate the cooperation of all partner in carrying out the project until it is successfully completed, and reached the goal which had been set in spite of the economic crisis which had impact on every participant and every factory.
The investigators wish to express their appreciation to the following

benefactors:
l.
The governor of Pathum Thani Province especially Khun Ying
Charatsri Teepeerach, who had graciously predicted over the opening ceremonies and awarding the certificate to the factories. 2. The Provincial Health Officer of Pathum Thani, Doctor Veerchai Pitawan who participated in the planning of the project and Doctor Wiwat Thiarawiboon who efficiently coordinated the project. Mrs.Kruetip Chaudrathawivat, Mrs.Kanakpom Trusbanfong who served as members of the working group as resource persorn leoturers
and management.
3.
The Provincial Welfare and Labor Protection Officer of Pathum Thani who serve in the administrative committee and supported the activity of the project by sending Mr.Neatit Prasertwongse to participate in the working group of resource persons and to coordinate the exchange of information between the project and Nava Nakom Labor Welfare and Welfare for the infected workers.
4. Representatives
5.
from PATH, CLIST, ACCES, CARE, TBCA and Dr.Alisara Chuchart from the Faculty of Education, Chulalongkorn University who participated in the development of the training curricula and serve as AIDS lectuer Chairman of the Navanakom Personnel Management Forum, Mr.Samark Songswang and Security Forum of Nava Nakorn, Mr. Sattaphol Wittayapak, Mr.Supan Pongpaew, Nh.Samart klinkajom
and others involved who contributed to the efiicient activities later
6.
Chairman ofNavanakorn Personnel Management Forum, 1998, Mr.Jongkol Kaewkumsen and the Forum members who carried out the coordination and collaboration effectively.
Establishing Hw/AIDS Pmgrams in the Worlglace
7.
cooperate
Personel managers of the 12 Factories who contributed to the success of the project and the community ofthe activities efficiently.
The investigation team is impressed with the enthusiasm and willting to in the activities on AIDS prevention education in the factories of the workers in the 12 target factories, the volurteers who form the forurn and network especially the AIDS resource persons who cooperated during the 12 months of the activities and who are ready to carry on the activities is order to help the society. Without the participations of the officers and workers in factories, the project could not achieve the goal set by the project organizer,
The outreach project on AIDS preventions is an operation research to test the model for AIDS education intervention there must be supervision, monitoring and assessment during the operation, the supervisors, evaluators and outside advisors were important mechanism in oarrying out the activities to achieve the
objective efficiently. We wish to express our appreciation to Mrs.Rajitta Na Patalung and team from OPTA and associate professor Pramoj Prasatkul from the Institute of Population and Social Research, Mahidol University who served as constrltant and Peer Review of the Project report and Mrs.Chongkolnee Chutimatawin who participated in the supervising team.
This report will not be completed without the assistance of Assistant Professor Linda Wongsanuphat, Faculty of Graduate Studies, Iv{ahidol
University.
Appreciation is expressed for Dr.Alessio Panza, Coordinator of the EC AIDS programme in S.E. Asia and Archarn Somjai Pramanpol, the manager of EC/AIHD AIDS Project for her valuable advice and financial support to the project.
Last but not least, the team wishes to extend the merit to the late Assistant Professor Boongium Tragoolvongse, the past manager of EC/AII{D AIDS Project for his sincere interest and support that lead to the success ofthe project.
Yawarat Porapakkham Wilaiwan Koykaewpring Varaporn Pinitpuvadol Hatairat Suda

1
July 1998
Abbreviations
C's
Clear, Clean, Convenience, Creating and Hygienic and Crealing
AIHD FOW GAV HEST IE & C ISO IST KABP MOPH MPA NGO OPTA PATH PHO PV PWA Q and A RP SWOP TOT
IIabit
ASEAN Institute for Health Development Factory Outreach Workers Graduate AIDS Volunteer Health Education and Support Team Information, Education, Commtmication Intemational Standard Organization In- service haining Knowledge, Attitude, Beliefs, and Practice Thailand Minisfiy of Public Health Minimum Package of Aotivities Non- Government Organization Office of Population Technical Assistance Programme for Appropriate Technology in Health Provincial Health Office Peer Volunteer Person with HIViAIDS Question - Answer
Resource Person Service Workers Outreach Project Training of Trainers
vt
Establishing HIV/AIDS hograms in the Wortglace
Abstract.
With the support from EC AIDS Program in S.E. Asia, the AIHD of Mahidol University had conducted a study on "Establishing HIV/AIDS Programmes in the Workplace Outreach to Factories in Pathum-Thani Province, Thailand" in Navanakorn Industrial Estate, Pathum-Thani Province during October 1996 to March 1998. The objective of the study was to establish a model for a sustainable program on HIV/AIDS prevention education in a workplace. A total of 12 factories, 6 medium size and 6 large size, were selected for the study. The project was 18 months operation in the fiel4 with 3 month preparation, 12 months intervention and 3 months assessment and surnmary.
Thete strategies were used in the study.
1). Strategy for sustainability. 2). Outreach communication strategy and 3). Education for behaviour change strategy.
The first stuategy was carried out by establishing parbrerships among government sector, business sector, private sector, the community and academic iqstitution and strengthening the potential of all partrrers. Parbrers involved in the project were personnels from Pathum-Thani Provincial Health and Labour Protection and
Welfare Officers, representing govemment sector; 12 intervention factories in Navanakom Industrial Estate represented business sector; NGO working on HIV/AIDS prevention invited as trainers represented private sector, AIDS volunteers from staffs and workers of the intervention factories represented the community and factory outreach workers and project staff from AIHD represented the academic instifution. Representatives from all 5 sectors were trained according to the curricula constructed appropriate to their functions. Development of a coordinating unit in each factory was achieved with the cooperation from the factory management so the activities could be canied on after the completion of the project. The outreach communication strategy was to promote volunteers of different levels, staffs and workets, in the factories and also tainers from partners in the operation area, the provincial officers and NGO, to cooperate in implementing the HIV/AIDS prevention education to workers in their factories where they worked. This led to the development of 2 Resource Persons (RP) from factory staff and 10 Peer Volunteers @V) from workers in each factory and 4 Health Education support team (IIEST) from Provincial Health Office and Provincial Labour Protection and Welfare Office, and NGO expert in HIV/AIDS education. Five Factory Outreach Workers (FOW) and Project Staff represented AIIID Matridol University. The third strategy was implementing various forms of education processes using BASNEF model and two-way communication to change attitude and behaviour of workers. By traving standard goup education, 30 workers per group, small group discussion 1-5
vll
workers per group and one to one conversation and distribution of printed materials plus other special activities suoh as exhibitions and advertisement boards in the factories, newsletters and voice mail, it was possible to create awareness of workers about HIV/AIDS problems and convinced them that those could be their problems if they were careless.
The objectives of the HIV/AIDS prevention education were to change attitude and behaviour of workers to a safei sexual behaviour and to prepare thei to live with HIV/AIDS infected persons. At the end of the project go pb cent of workers (20,000) received direct education from the projecfactivities via various processes previously described, and it was expected that up to 90 per cent would be educated though volunteer's activities. Interview of 2,000 random workers was conducted before the beginning and after the completion of the project. It was found that workers knew about the mode of HIV infection, 3 waystoirevent the infection, i.e., use of condoms avoid having risky sexual relation (visiting prostitutes) and do not used syringes. They were also able to assess their own risk and were more prepared to live with infected persons. Some workers gave up having multiple sexual partners and visiting prostitutes. The second objeJtive was- for the factory to have policy on HIV/AIDS prevention education in their workplace and to support the activities of Rp and It was found that the intervention factories had incorporated HIV/AIDS prevention education into their regular orientation for new workers and developed policy on HIV/AIDS prevention and care as part of their policy on labour pioteciion and welfare which conformed with the law on labour protection 1993. The networks for resotsce persons and peer volunteers were set up and supported by the factories. It was hoped that other factories in Navanakom tndustrial Esiate would joins such activities later on. As for the out - effectiveness, of the project, it was found that direct education cost was 233 bahts per workers. Once tle volunteer network took over the activities, the cost would be much reduce. It could be concluded that the study had established an efficient and effective sustainable outreach program on HIV/AIDS prevention and care in a workplace. This model could be adapted and used in other workplace as well.
pv.
Establishing HW/AIDS programs in the Workplace
Chapter I: Project on the Establishing HIV/AIDS Program in Workplace
Establishing HIV/AIDS Programs in the Workplace: Outreach to Factories in Pathum-Thani Province.

A model for
sustainable
A Cooperative Project between the

ASEAN Institute for Health Development, Mahidol University and the Sub-committee of the Prevention and Care of AIDS, Pathum-Thani Province. Under the support of the EC/AIIID AIDS program.
Institute for Health Development, Mahidol University and Provincial AIDS Committee, PathumThani Province.
program.
Agencies
Collaborating ASEAN
Supporting Agency Project Site
The European Community's Program on HIV/AIDS in Developing Countries.
Navanakorn Industrial Estate. Pathum Thani, Thailand.
Chapta I: Project on the Establishing HIV/AIDS hogram in Workplace
Chapter
Project on the Establishing HIV/AIDS Program in the Workplace.
University
conducting a project on o'Graduate volunteers for prevention and control of AIDS in industuial workerso' under the "Bangkok Fight Against AIDS" Program. This project aimed to develop a model for prevention and control of HIV/AIDS in medium and large size factories in Bangkok Metropolitan.
The ASEAN Institute for Health Development, (AIIID), Mahidol is an academic institute having experience in research and development of health program using graduate volunteer as an important mechanism. In 1993, the Institute had collaborated with AIDSCAP/FHI in
Lessons learned from Graduate AIDS Volurteers (GAV) project let AIIID to have confidence in using vohmteers as a mean to motivate an ouheach progam in a workplace where communities collaborate with each other and organize activities among themselves with the principle of, comnnunity
participation and organization.
Under the sponsorship from the European Community's program on HrV/AIDS in Developing counhies, AIIID had utilized the GAV model to apply for prevention and control of HIV/ArDS among factory workers under the project. "A Factory outreach project on AIDS prevention in Navanakom Industrial Estate" with an objective of developing a sustainable program on prevention and control of AIDS in factory workplace.
1.1
HIV/AIDS problem in factory workers.
During several decades Thailand has transformed herself from an agricultural society to an industrializ.ed society, resulting in migration of wrrkers from villages to city, especially those of working, reproductive ages. These people are lmprepared for a lifestyle in a densely populated urban area where there are more sexual motivation through various media. This causes them to be among a high risk group for HIV/AIDS which is rapidly spreading in the country prevention and control of HIV/AIDS among factory workers and service sectorsl'2 are of high priority because:
t
Chai Podlisita and Uwapern Pdtaravanicfr, Youth in Contemporary in Thailand, Result from the Family and yortrh survey, IPSR Mahidol, 1995. 'Yawarat Porapakkham, Graduate AIDS volunteers for prevention and contol ofAIDS in factories ofBangkok Municipalities. Bangko( AIHD, Mahidol University, 1996.
Establishing HIV/AIDS hograms in the \Vorkplace
Chapter I: Project on the Establishing HIV/AIDS hogram in Workplace
1) Most
of the workers are in reproductive age between25-35 years of age and are ready for sexual relationship. Survey conducted in 1995 indicated that the average age of first sexual relationship anong male workers was 16 years of age, and that of female workers was 17 years ofage'
2) Most of the work force are the migrants from rural agriculture sector to r:rban industrial sector, from simple family lifestyle to a single, unskilled decision making lifestyle without influence from farnily or community. With a freedom in decision making and fin.ancial situation plus westernized culture and social value in the urban society let them to be prone to HIV/AIDS high risk group. From the Epidemiological Surveillance Report of the Ministry of Public Health (MoPlD in 1996 it was evident that the use of condom among workers either with prostitutes, with female workers or among male workers are unsatisfactory and the use of condom everytime with acquainted partners are lowa. 3) Factory workers are difficult to reach since they are productive and mobile force. It is difficult to disseminate information on HIV/AIDS. 4) Most ofthe workers migrate from rural to urban environment, they are facing problem in adjusting themselves both emotionally and physically to new environment, including drugs and family problem. If they contact HIV/AIDS, it will effect personal, family and economy resulting in loss of labour force and expense in the care of the disease and the economic growth of the country. 1.2 National Plan for
HIV/AIDS Prevention and Alleviation of AIDS.
Thailand is in a critical condition in the prevention and control of HIV/AIDS epidemics. While scientific technology has not yet been achieved in
this area, the spread of this disease is considered to be closely related to the social and cultural factors which influence human behaviour. Therefore the control of AIDS is to put an emphasis on lifestyle, human behaviour, social and environmental factors in a multidisciplinary approach with the participation of commtrnity in helping each other leading to a strong community that can solve their own problem.
To solve HIV/AIDS problem, we need a critical mass of people from all sectors, whether these people are from govemment sector, business sector, private sector, academic sector including the community itself, to work closely
Division of Epidemiology, Ministry of Public Health, Weekly Epidemiological Surveillmce for Worters in Thai
factories, first round (May 1996).
'Division of Epidoniology, Ministy of Public Healft. WeoklyreBort on Epidemiological Surveillance on AIDS among'
workers in Thai factory, second rormd, May 1996. Establishing HIViAIDS Programs in the Workplace
together, both vertically and horizontally, in order to empower a empower community in solving the problem. The national strategy for prevention and alleviation of AIDS 1997-200I outlined a working strategies that can work under the present socio-economic oondition so the problem can be effectively and sustainably solved. The emphasis are placed ont:
a.
Human development. It is important that the person is capable of protecting oneself from AIDS and other social problems and solving their own problems.
Social-environment development. It is important to develop the social environment that is conductive to prevention and alleviation of AIDS problem. The national strategy for prevention and alleviation of AIDS, 1997-2001outlined 8 important strategic plans.
b.
1)
Snategy in the development of the man, the family and the community in prevention and alleviation of AIDS.
conductive to the prevention and alleviation
2l Snategy in the development of the social environment to be

ofAIDS.
3) Strategy in the development of social psychology to allow the

infected and AIDS patient to live happily in the society.
4\
5)
Strategy in developing the basic social and economic services for the prevention and alleviation of AIDS.
Strategy in health promotion and services in the prevention and alleviation of AIDS.
6) Strategy in the development of knowledge

prevention and alleviation of AIDS.
and research in the
7) Strategy in the development of international cooperation in the

prevention and alleviation of AIDS.
8)
Strategy in the development of management mechanism prevention and alleviation of AIDS.
in
the
From the 8 strategies, the Factory Outreach Project on AIDS Prevention in Navanakom Industrial Estate had used the second and the eighth strategy in developing a model for a sustainable program in the prevention and control of AIDS in the factory workplace. The strategy in developing a conductive social environment in the prevention and alleviation of AIDS was carried out by
Ngtional Commias on the Prcwntion and Alleviation of AIDS, Plan on thc prewntion and Conrrol of A|DS t99?-2001
Establishing HIV/AIDS Progams in the Workplace
Chapta
Project on the Establishing HIV/AIDS Program in Wo*place
creating a social economic factor that is conductive to the development of hrnnan potential in the prevention and alleviation of AIDS, such as
a. Facilitation of industrial community potential. Create awareness among employers to realize the importance of staff and employees development in the prevention and alleviation of AIDS by
1)
Creating a supportive environment in the factory or workplace for the prevention and alleviation of AIDS by having social activities or day'care centers, etc.
employees to obtain information and training on prevention
and alleviation of AIDS.
2) Allow 3)
Encourage the factories and workplace to organized activities on prevention and alleviation of AIDS and on social value and sexual ethics by using volunteers among employees. Encourage the large factories workplace.
4)
to have consultant lervice in
the
b. Promote private business enterprise to cooperate in the prevention and alleviation of AIDS among employees and general public. The government sector support academic infonnation in the form of publication, lecfirer and other material such as condoms.
c. Support and coordinate the cooperation between labou force and the provincial social welfare office. This was done by encouragfurg the factories to organize campaign on prevention and control of venereal
diseases, AIDS and other health problem in the factories.
Important strategies on the development of management mechanism on the prevention and alleviation of AIDS.:
a)
strengthening the management system of the factories so the policy on prevention and alleviation of AIDS can be implemented successfirlly by
1)
promoting cooperation on prevention and control of AIDS starting from the local govemment and private sectors up to intemational agencies using the operation plan as guideline.
2)
Developing the potential of government sector, Non govemment development agency (NGO), local communities including private business enterprise to be able to manage the alleviation of AIDS problems at the national, regional and local levels successfully.
Establishing HIV/AIDS Progruns in the Workplace
Chaper I: Project on the Establishing HIV/AIDS hogranr in Workplace
3)
Encouraging the concerned organizations, both govenrment and private, to coordinate and include the prevention and control of AIDS as part of their working plans. By considering their major responsibilities, review and adjust their plan and direction to harmonize with the national policy on the prevention and alleviation of AIDS.
b)
Promote network on cooperation among govemment, business and NGO's and the commtmities including infected and AIDS patients. By the cooperation on prevention and control of AIDS either formal or informal and setting up organization at different levels such as setting up provincial and local commit0ees to manage the project and coordinate the collaboration with local agencies.
The higblight of the National Strategies on Prevention and Alleviation of AIDS that has been used by the Factory Outreach Project on AIDS Prevention
was the promotion
of
cooperation among govemment, academic, private,
business, and public welfare sectors and local community to collaborate on the strengthening of the people's potential in the prevention and control of AIDS and
to participate in the development of the intellectual capacity and promotion of

health, social and medical services accordingly.
1.3
AIDS Situation in Pathum-Thani.
Pathum-Thani is one of the six provinces which forms greater Bangkok which is rapidly expanding. Pathum-Thani is also rapidly growing and expanding and is highlv concentrated with factories and indushial estates.
AIDS situation in Pathum-Thani is similar to that of the national picture, that is, 75 percent of AIDS infected persons are from sexual transmission. The figure among drug addicts using syringes is rather stable, but the number of infection through sexual relation keeps increasing.
From the report, 75 percent of AIDS patients were from sexual relation and were in the working age of 2044 years old and were employees in the industrial sector and business and senrice seotors including prostitutes, whether direct or indirect.
The infected and AIDS patients in Pathum-Thani were distributed among 5 districts, these were Klong Lt ang district, Muang district, Tunyaburi district, Lard Lumkeo district and Lum Lookga District, where 2328 factoies were located. There were 259,094 workers, most of them were in the working and reproduotive age of 2040 years old. They were migrants from various parts of Thailand. After being infected, they became sick resulting in economic loss to
Establishing HIV/AIDS Progrms in the Wodplacc
Chaptcr I: Roject on the Establishing HIV/AIDS Progam in Wo*place
the patients and their families, including loss of skilled labour and work force by the iactories, especially when they become sick and cannot wo.k6.
Table 1. Cumulative Number of AIDS patients in Pathum-Thani Province during 2 years period from May 1996-May 1998
Cumulative number (patients)
No. increased withinl years

@atients)
Type
Sept, 1994-May
1996
Sept. 1994-May 1996
AIDS patients
Dead
511
930
619
67
239 304
30
t72
160
Active contact
Dead
t44 t4
t6
Table 2. Distribution of AIDS patients and HIV infected persons in dilferent districts in Pathum-Thani Province during September 1994' May 1998. Dishict
Muang Klong Luang Tunyaburi Nong Sua Lum Lumkao Lum Lookga Samkoke Total
Source: From Pathum-Thani Public Health
No. ofAIDS Patients 249

118
No. HIV of infected persons

106
29
43
235 70 44
135
t7 3l
38
79 930
36
304
Office. Summary of AIDS situdion 4:5 Msy lgg87
Campaign on behavioural changes for safer protection and preparation for living with AIDS infected persons are important strategies to be conducted in factories or workplace. The priority was placed on high risk, non-infected
persons. Navanakom Industrial Estate, located in Klong Luang district, PathumThani, was selected as the location to conduct the research to develop a morlel on outreach project for AIDS protection and alleviation.
Pa0nrm-Thani
Virachai Pitwan. [cfiire at a seminar for the Factory Management of Navanakom. hrblic Health Office "Summary of AIDS condition in Pathum-Thani hovince- (May 1998)
Establishing HIV/AIDS Progams in ihe Workplaoe
1.4
AIDS and Navanakorn.

The Navanakorn Industrial Estate occlryies 6,000 Rai (2,400
acres),
situated in Klong Luang district. This industrial estate had received support from the Board of Investment (BOD to develop the industial estate for export BOI promotion. There are 163 factories located within 3 zones of the estate. ln t996
there were 72,260 workers working in the estate. There are 3 important characteristics that favours the selection ofthe estate for the site ofproject for sustainable AIDS prevention and alleviation. These are:
1) Being industrial estate which is the center for export promotion with
workers in reproductive age from various parts of Thailand ooming to live in dormitories and housing within the estate. These people are facing new way of life, new culture, freedom from family and ftaditional community influences in their decision making and with more ptuchasing power to spend and buy the service. Relaxation are done through the material and service from entertainment facilities wttich are abundant arormd the industrial estate. AIDS is one of the problems which comes into their way of life.
2)
Structure of the organization. There was organization in the form of networking of the management in order to share and learn from each other's experiences called 'T.{avanakom Personnel Manager Forum' The fonrm facilitates exchange of knowledge and informations on personnel aspect. The forum composed of honorary number wtrich are academics, administrators and experts frorn government and private sectors that the forum agreed upon, the regular and the special members who are personnel managers from factories within or outside the Navanakorn hrdustrial Estate. The organizing committees are selected by the members. The term of references of the committees are to organize monthly meetings in order to develop strategies and knowledge on personnel aspect, organize special seminar and activities on welfare for the workers such as firnd raising for Navanakom worker's social welfare, set up day care center for workers, pre-school children in the estate, etc. structure of the management in the factories. The universal structure of personnel management of the factories makes it easy for the setting up of welfare for workers. There are various sections such as the welfare and workers relation section, the education and taining section, the health service section and the safety section. Each section has responsible staffs with funding. Therefore it is appropriate to
3)
Establishing HIV/AIDS hograns in the Workplace
introduce activities on AIDS into the welfare structure of the factories of Navanakorn Industrial Estates.
The rate of AIDS infection among workers in Navanakorn Indushial Estate was 0.2 percente which is considered to be low when compared with the national rate. The workers in the estate have lifestyle which renders high tisk to AIDS infection, it was therefore chosen for the study on "Establishing HIV/AIDS Program in the Workplace: Outreach to factories in Pathum-Thani Protdnce" under Thai title "Outreach Program on AIDS Prevention in Navanakorn Industrial Estate" for a better understanding of the counterpart. This program has an objective in testing the method of education in changing the behaviow and establishing a sustainable activity on AIDS prevention and control in the workplace. The program has received support from the European Community's Program on HIV/AIDS in Developing Countries, through EC/AIHD AIDS
project.
1.5 Establishing HIV/AIDS Programs in the Workplace: Outreach to Factories in Pathum-Thani Province.
r r
To maintain, and further reduce, the prevalence of HIV/AIDS. To increase safer sex behaviour and HIV/AIDS risk reduction in Pathum-Thani.
Objectives:
1) To increase safer sex behaviour and decrease HIV/AIDS risk, and increase aoceptance, support and care of people with HIV/AIDS
among factory workers at project sites.
2) To institutionalize HIV/AIDS prevention education into

employees support structure at project site.
the
3)
To establish a Health Education Support Team (HEST), of provincial government staff to provide on going support to factories' HIVTAIDS prevention program.
size factories interms of cost-effectiveness and workers; KABP and managerial adoption of Minimum Package of Activities.
4) To compare the efficacy of the project model in large and medium
Baseline of Reports from "Establishing HIV/AIDS hograrn in the Workplace: Oufieach to Factories in Pahum-Thari hovincc, November | 996. e Summary on AIDS, !, No 5 May 1996 by the Public Health Offrce of Pathum-Thani Province.
Establishing HIViAIDS hograms in the Workplace
Chapter I: Projeot on the Establishing HIV/AIDS Program in Workplace
Project
site:
group:
Factories in Navanakom Industrial Estate located at Klong Nung sub-district, Klong Luang District, Pathum Thani Province. Six medium size and six large size factories. October 1996 to March 1998
Target
Duration:
1)
Expected Results:
20,000 factory workers from 12 factories will receive large group (30igroup) or one to one, and small goup (l-5lgoup) education. In addition, all workers in intervention sites will receive mass media education through campaign, exhibition, bill board and other activities. Resource Persons (RP) identified, trained and supported in 12 factories. RP plan and conduct activities on HIV/AIDS prevenfion and control and support activities ofVolunteer Corps.
10 per factory, received education and training. Peer volunteers plan and implement HIV/AIDS education activities.
2)
3) volunteer corps of peer@v) and formal leaders established,
4) Health Education
Support Team GIEST) forrred from staff of Provincial Health office, Labouu Protection and welfare office, all together 4 members, support HIV/AIDS activities in the factories.
5) Target factories establish wqtten policy and procedure regarding HIV/AIDS in the workplace consist of Minimum Package of
Activities containing.
r r
o
6)
Policy on HIViAIDS
Set up group ofpersonnels to coordinate and support
HIV/AIDS activities.
Support education program conducted by volunteer corps.
Demonstrate sustainable model problem workplace.
of activity to alleviate Hry/AIDS
Supervision and Monitoring Strategies:

Since 'Establishing HIV/AIDS Program in the Workplace: Outreach to
Factories in Pathum Thani Province" is an action research to test the model, it is necessary to supervise, monitor and assess during the operation. The supervisors, monitors and outside evaluators are the key persons who determine the success of the prograrn. The plans are:
10
Chapter I: Project on the Establishing HIV/AIDS Progam in Workplace
a) Supervising and
monitoring. The activities were oonducted try the Health Education Support Team (IIEST) and the Project Staff. .FIEST and project staff supported the education activities in the 12 selected factories twice a month. They gave guidance, suggestiono assessed the problems for improvement of the intervention activities.
b) Report on the intervention activities was carried out by the monthly meeting among Factory Outreach Workers (FOW), IIEST and prroject staff to report on the intervention activities, summarize the education training and discussed their problems and planned for subsequent month activities, so the cornmon goal can be reached.
c) Project assessment by extemal organization. The assessment was carried out by office of Population Technical Assistance (OPTA).
1.6 Project Assessment.
Different forms of assessment were conducted:
1)
Pre-post intervention KABP surveys among factory workers. Pre-post assessment surveys on management's attitude on the support to HIV/AIDS prevention education campaign in their factories. Compare the effectiveness between large and medium-size factodes.
2) 3)
Indicators
l)
2)
Input indicators 1.1) Project personnels.
1.2) Intervention activities conducted during the research progam.

Output indicators.
2.1) Ratio and numbers of target workers receiving education from

the program.
2.2) The quahty of service rendered knowledge and counselling by the project personnels on HIV/AIDS education to the target
population.
2.3) Reasons for those workers not obtaining the education.
3)
Outcome indicators.
3.1) KABP on HIV/AIDS prevention of the target population. 3.2) KABP of the target population on living with AIDS 3.3) Model for HIV/AIDS prevention and alleviation in
workplace.
the
Establishing
HMAIDS hograms in the Workplace
1l
Chapter
Project on the Establishing HIV/AIDS Progam in Workplace
Figure
Frame of assessment.
. . .
Context of medium and large factories Management Structure
. KABP'S change
.
among workers Policy ofthe fastories to havc
Jnputfromthe
i i
MinimumPackage
i :
Policy and supPort on

sustainable
HIV/AIDS
assessment of the assessment and
prevention activities oftbo
t
assessment of the project
12
Establishing HIV/AIDS hograms in tho Workplace
Chagerft Projed Stegies
Chapter II: Project Strategies.
Strategy for sustainability
e Development . Development
of network.
ofpotential structure of management unit in the workplace.
. .
Outreach communication sfiategy.
Education for behavioral change strategy.
Establishing HIV/AIDS Prograns in the Workplace
13
Chapter tr: Project Sfraiegies
Chapter
II
Project strategies
order to meet the objectives and expectation as outlined in the "Establishing HIV/AIDS Program in the Workplace: Outreach to Factcnies in Pathum Thani Province", the national strategies on prevention and alleviation of AIDS 1997-2001was adopted and modified to 3 strategies suitable for the project activities. The 3 strategies were tested arrd,implemented in the project. They are:
1. Strategy for sustainability. 2. Outeach communication sfiategy 3. Education for behaviour change stategy.
In
2.1 Stratery for sustainability.

The important process in AIDS prevention strategr is the holistic approach of development of the workplace and strengthening of the community by motivating the active participation ofthe community. From past experience, it is obvious that community participation is the most important strategy in the success of any development. Projeot lacking community acceptance and participation will fade away after the end of the project. Therefore sustainable
development required community participation and partrership of concemed organizations. The development process must render active cooperation among personnels, good personal relation, constant communication and athact all parts of the organization to participate in the development process. The social problem is too complex for only the govemment sector to solve the problem and too great for the community to handle alone. To strengthen the capacity of the population to have confidence in self-reliance is the most important oomponent leading to the success in solving the social problem.
The sustainability of the program for safe sex and preparing the commrmity to live with HrV/AIDS infected person is the major goal. The important factor is to have a suitable organization with appropriate structure with potential members who are willing to carry on the task continuously with the technical cooperation and support from both the govemment and private sectors, both locally and externally.
In theory, the sustainability of the outreach program prevention and control depends on 3 sustainable components.
t4
on HIV/AIDS
Establishing HIV/AIDS hograrns in the Worlglace
Chaga II: Project Strategies
l)
Sustainable policy of the institution.
2) Financial sustainability. 3) Institution sustainability (the capacity of the stuctue and personnel of the institution to continue the project activities).
h principle, if the institution or factory has the policy, the ftrancial

support should be available to carry out such policy. It is then possible to plan and organize an appropriate structure of management and enforcem,ent of personnel's potential to carry out the activities. This require technology, education and training and outside support to assist in the organization and management at the beginning if the factory is not ready to carry out the project
alone.
Two main activities are required for a sustainable strategy.

1) Development
of partnership among 5 parbrers, the govemment sector,
the business sector, the NGO's sector, the community, arrd
the academic institution. This should lead to policy and financial support.
2) Development of potential and structure of the management unit in order to carry out activities in the workplace and shengthening of personnels' potential so they can continue the activities, resulting in a reduction ofHIV/AIDS infection and appropriate management if there are infected patients in the workplace or the community.
First activity: Development of partnership.

Partners working closely together in the "Establishing HIVTAIDS Programs in the Workplace: Outreach to Factories in Pathum-Thani provincet' project were the government sector, the business sector, the NGO's, the community and the academic institution. These five parfirers must organize a related social structure that has a common goal, find a new process for the development according to the set objectives.
The major task of the five parfrrers wene to analyze the situation in order to identiff the problem, planning the activities, divide the task acoording to their expertise, supervisen monitor and assess their activities as planned.
The task of each partner were clearly identified in the project.
1) The Government sector. They were the HIV/AIDS
oommittee of Pathum Thani province having the governor of Pathum-Thani as a chairperson. The committee was composed of the Provincial Health Officer, Head of the Labour Protection and Welfare Office, Head of the Industry Office, representatives from the NGO's and Chairnran of
Chapter II: Projoct Sfistcgies
Navanakorn Personnel Ivlanagement
Forum. This committee plan, the budget and the activities to solve HIV/AIDS coordinated the problems in the province. This committee started their work in the fiscal year 1997 which coincide with the beginning of the program.
Having a ohance to participate in the meetings of HIV/AIDS committee of Pathum-Thani Province and presenting the project as one of the province's activities was the most effective strategy in becoming partnership with the government sector.
2) The Business sector composed of administrators of the 12 faotories in Navanakom Industial Estate selected as intervention sites of the project. The cooperation of the adrninistrators was an integral part in bringng the project into the factories and made it possible to set up factory policy on health for the workers as welfare service of the factory. 3) The NGO's were those continuously working on HIV/AIDS problem in the workplace. They were informally organized, having experience in educating to stimulate the conscious of the community to have awareness that HIV/AIDS problem is everybodyns problem and it is one's dut5r to protect oneself by having safe sex. This sector was willing to cooperate in setting up the ourriculum for training of the project staffand the factories' personnel.
4) The community in this project was the Navanakorn Personnel Management Forum which was already set trp officially. Their major responsibility was to advice, coordinator glving consultation and work in the project together with other parfirers. It was possible to set up networks during the project operation, RP and PV network. These networks would coordinate the intemal factory's activities, inter factory activities and may be able to set up netrrork outside the project's target factories to expand their work on safe sex campaign in order to reduce HIV/AIDS infection and prepare the community to live with AIDS patients,
5)
The academic involved was the ASEAN Institute for Health Development, Mahidol University. The AIHD received firnds from the Etropean Community's Prograrn on HIV/AIDS in Developing Cotmtries to conduct the research for 18 months starting October 1996 to March 1998.
l6
Establishing HIV/AIDS Prograns in the Workplacc
Cha$er n: hoject Strategies
Partnership in the Project
HMAIDS Committee
Pathum
Thani Province .,
Provincial Health
-t'
-t'
fE-*,rtlr"-C;*-tt""l
lAnDP."ilTt tr I
ve 's l5ecto.rwco;i
/Private
---./-ilrJ\ g-/
*@<m #
I
---*/o*t'**l f-r_":'"T,ti., 1
ItrST:
vvvvv Factories
f
r
Note:
Health Education Support Team
RP : PV :
FOW = Factory outreach worker

Resource Persons Peer volunteers
Second activities: Potential development and management unit development.

Experience gained from Graduate AIDS Volunteer (GAV) program conducted rurder the program Bangkok Fight Against AIDS (1993-1994) indicated that having GAV working in the small and large factories grving education to workers on HIV/AIDS prevention could be carried out only while the project was going on. After the completion of the project, the activities faded away because there was no service unit in the factory to carry on the activities neither there was a consulting agency to help solve the problem. Since AIDS situation keeps changing, it is necessary to have new knowledge and information, and the volunteers must have more confidence and knowledge compared to ordinary workers.
From such experience, the present project had included a plan to set up a group of AIDS personnel coming from middle management level such as safety stafi training offiicer, or medical staff to act as the contact person linking between the management stafi the factory volunteer workers or peer volunteers @V), the project staff, and the govemment staff. This group of people should have sufficient knowledge about HIV/AIDS to be able to give consultation to factory
Chapter II: Pmject Srdegies
volunteers and have skill in giving HIV/AIDS education to factory workers. These Resource Persons (RP) will work on HIV/AIDS prevention program over time or may integrate the activities in to part of their regular job.
because the idea is
The Resornce Person would not receive any payment from the project for them to work as volunteer with the connect of high level factory administrator. The number of RP should be 2 persons per factory.
Peer Volunteers (PV) are volunteers from staff and workers who are
devoted and volunteer to work for social welfare of the workers. They must be those who are well-accepted by their colleagues and the management staff. These volunteers will organize and implement HIV/AIDS preventive education and activities for workers having RP as their consultant. It is estimated that there should be at least l0 well-trained Peer Volunteers per factory to work effectively. Due to the rapid change in knowledge and situation of HIV/AIDS such as the genetic of the virus, rate of infection, condition of the disease and the characteristic of the infected population including prevention and care of the patients, it is necessary that the workplace must be in keep with the present trends of change. The project staff realized such need and had set up Health Edurcation Support Team or IIEST, composed of four staffs from Provincial Health Office, Labour Protection and Welfare Office. The team provided technical support and strengthening the potential of the RP, and Peer Volunteers. They also supervised and monitored the activities including distribution of material and equipment need for the activities such as condoms, pamphlets and information and news on Hry/AIDS. It was expected that these govemment personnel will continue to work with the factories after the completion of the project.
factories to have a policy on prevention and care of HIV/AIDS for the workers and continue to provide education and support the management rmit, continue support to the resource persons, the peer volunteers and the factory outreach workers and their activities on HIV/AIDS education, (safe sex and iirring *ith AIDS patients). Mean while, the government sector, the provincial Health Officer and the Labow Protection and Welfare Officer, will continue to offer their technical support to the factories.
It is also hoped that the result of the sustainable progr,rm is for the
2.2 Outreach Communication Strategy.

While the Community organization is not yet strong, and the potential of the resource persons are not yet sufficient to carry out the activities alone, outreach communication is necessary at the beginning of the project to stimulate the awareness, develop the potential of the team in the workpiace and also to establish the activities on HIV/AIDS prevention and care. Example of outreach workers are graduate AIDS volunteers in factories (1993). In this project such
l8
Chapto II: Project Strategies
outreach workers were called Factory Outreach Workers (FOW). This group of personnel were at the same age with the workers, they were knowledgearble on
HIV/AIDS problems, they were outside communicators who would carry on the
activities during the 12 months period of the project.
The major task of FOW are:
Coordinate between management personnels and workers and the project staff in order to establish appropriate personnel structure in carrying out the activity by the intervention factories Resource Persons @P) and Peer Volunteers (PV).
knplementing HIV/AIDS prevention education activities and preparation to live with AIDS patients in the intervention factc'ries to staffs and workers.
The expectation from the outreach communication in the factorir:s was that FOW would strengthen the management unit, coordinate the sustainability of the volunteer network and strengthen the potential of RP and PV to be able to carry out the activities to a certain level. In order that this model can be applied in other projects, it is necessary to establish an appropriate number of FOW who have experience and potential in implementing HIV/AIDS prevention education. One field coordinator and 4 FOW were selected and tested.
Number of FOW
Eventhough it was proven that the outreach program in the form ollGAV was successful in implementing HIV/AIDS prevention education among workers in factories in Bangkok, and some factories has carried on the activities after the completion of the project. But it was fotmd that having 2-3 GAY/factory u'as too expensive, mounting up to 64,000-96,000 bahts per factory depending on tlrc size of the factories. This average out to 278 bahts/worker. An attempt was made to reduce the number of FOW to a minimum and yet were able to carry out their
task according to plan. This project selectedr coordinator who had GAV experience and 4 FOW. Three intervention factories were assigned to 1 FOW for 12 months. With a reduced expense, it was hoped that a minimum number of capable and efficient FOW will be an attractive point for other project to
implement.
' "Craduate AIDS volunteer for prevention and control ofAID infeotiones in Bangkok", Publication#l; GAV prcjcL AIHD, Mahidol
Univenitv 1995.
Establishing HIV/AIDS Prograru in the Workplace
Chapter II: Project Stsategies
The Quality of FOV/

Basic characteristic, selection and training are important factors that the project utilized to indicate the capability and efficiency of FOW aocording to the standard of activity required.
Characteristic of coordinator.
The basic characteristic of the coordinator is the important factor in the strength of the FOW team. The quality of field coordinator should cover knowledge and experience in various field.
Knowledge. The coordinator should have knowledge and rmderstanding conceming HIV/AIDS and safe sex practice, living with AIDS patients and the process of implementing HIV/AIDS prevention
and sexual relation eduoation.
Attitude.
The FOW must be broad minded and have broad attihrde in accepting the difference of individuals and behaviorn in the society and does not measure others by his own standard and
value, and believe in people's potential.
skill.
IIas skill in teaching, is persuasive, capable of solving problems, coordinating and planing the activities.
Outreach activities of the FOW and the field coordinator:

The FOW team and the coordinator can withdraw from the factories if they see that the factories have potential and strength in incorporating the Hry/AIDS prevention education aotivities with other social welfare activities.
2.3 Education for behaviour change strategy.

The occurrence and epidemic of HIV/AIDS are closely related to believe and lifestyle of individuals which determine the human behaviour. This project had innoduced a model for human behaviowal change (BASNEF Model) which considers components that can reach individuals in their belief, attitude, subjective norm and enabling factor. These components are the driving force for the individuals to change their behaviour and to explain about one's behaviour. This project had implemented such model into the Hry/AIDs prevention education activities in the intervention factories in Navanakorn.
Establishing HIV/AIDS Prograns in the Wortplace
Cha$er tr: Projecr Sfficgies
BASNEF Model
Belief tlpt one behaviourwill effect the
t I
p""rrr."*l
behaviour
l---l
lntention to practice such Belief that one will

behave as expected
t--.*i*.l;_l T r-@!
I
t
f
t--JglgE-J
Enabling
* BASNEF Model Belief, Attitude, Subjective Norms and Enabling Factors
-l
source: J.Hubbley, understanding behaviour: The key education, Tropical Doctor, 1980.
to
successfi.rl
Establishing HJV/AIDS programs in rhe Workpl
uo
2l
Chryter II: Project Strategies
Figtre IV. Activities according to BASNEF Model and the application in the project
BASNEF
BASNEF
model
Activities
Activities according to the
model
o Skill building, provide o Provide infonnation for large and small
Activities applied inthe Project
Belief
more knowledge o Create a supportive environment for the new
group workers.
o Provide HIV/AIDS prevention education for RP and Peer vohmteers o Organize seminar and discussion
belief
for
Navanakorn Personnel Management
Fonrm Attitude
o Create a supportive
environment
o Strengthen community
o Prepare all levels ofpersonnels from management to RP and Peer Volunteers
action Re-orient health services for health promotion and prevention diseases
Motivate participatory activity among RP and PV o Set up health promotion and other services by IIEST, i.e., of providing HIV/AIDS information, consultation, health care service for sexual transmitted diseases and
o
care
ofHIV infected
persons and fanrilies,
distribution of condoms and printed

materials Subjective nonns
o Create a supportive o RP cooperate and support Peer Volunteers
environment
Strengthen community
to conduct HIV/AIDS preventive edrrcation o Set up group or organization ofvohurteer
.
Enabling
factors
action Establish health promotion
forum
r Management
set up
policy to support
policy
HIV/AIDS prevention education and

a supportive
r Create
action
environment
r Stengthen community
r Re-orient health
services
o Set up health promotion
volunteer forum o Support talking poster to the intervention factories. o Set up service for information, printd materials, health care and prevention and consulting service by IIEST o Support the activities of RP and Peer Volunteers dwing the factory safety campaigrr week and Wodd AIDS da1', etc. r The factory management support
policy
Minimum Package of Activities for HIV/AIDS prevention education.
HIV/AIDS prevention activities of volunteers o Support service on information materials,

o Support the
printed matters and condoms.
To achieve the belief attitude by information giving abve is not sufficient for the workers to be aware of the need to change their behaviour. It is necessary to have two-way commtmication so the exchange of inforrnation,
22
Establishing HIV/AIDS Prograrns in the Workplace
Chryter II: hoject StratEgies
feelings, thoughts and experienoes between individuals or glotlps can occur. When- individuals have belief and attitude to change their behaviour, it is therefore necessary to develop subjective nonns which could influence such change, at the same time some enabling factors should be created to support and sustain such new behaviour. From this model, the project staff had developed the education process that would effect behaviour change with the characteristic of being small, deep, long and sustainable.
implementing HIV/AIDS prevention education to a small group of worker, no more than 30, so two way commrmication could occur and good discussion could take place and new concept and belief could be created.
Deep
implementing the education in dept by having small goup discussion (5-6 per groups) and one to one discussion, so the information, attitude and belief of the target goup could be reached and the education process could be planned to fit with their
lifestyle.
Substainable plan the education Process so the target goup could develop their there confidence to solve there own problem, provide
Long
long termed education which should effect in continuous leaming process to think, analyze, plan and intend to ohange their
behaviours
The goal ofeducation

1. Safe sex
2.
LivingwithAIDS
Goal ofthe education

Unsafe sex is the most important factor in contact and spreading of HIV/AIDS in Thailand, especially among working age group. The increasing nurnber of infected population let to the conflict of living condition in thr: cornmnnity and society. The education activity aims at 2 major goals:
l. For the workers to have safe sex relation that is free from AIDS.
Emphasize lifestyle that can prevent themselves from HIViAIDS by creati4g skill, attitude and sex value that is appropriate and also gender equity. Motivate the workers to realize that they could chose a safer sex which is their own choice and they could really practice.
Establishing HIV/AIDS Programs in the
Workplace
----2:l
Chapter II: Project Stafiegies
2. For the workers in the intervention factories to be able to live with AIDS patients. Statistics on infected persons is obvious. It is necessary to provide knowledge, understanding and belief about the fact on the mode of infection of HIV/AIDS and create attitude and sympathy for the infected person's problem and appreciate human value which will lead to a happy mutual living in the society.
Content of HIV education covers attitude towards AIDS, problem and impact, sexuality, emotional behaviour, gender, living with AIDS and basic information and knowledge on AIDS, safer sex practice, choice for safer sex, source of service and welfare. Skill involved analysis of lifestyle, how to assess
and reduce risk and how to make choice.
Learning and Education Process : participatory education2.
l.
Encourage dialogue.
2. Sell/suggest ideas. 3. Parfrrership with client. 4. Client directed.

Learning and Education Process.
The project utilized participatory taining to create two-way communication, encourage dialogue, sell or suggest ideas, partnership with client and client directed techniques leading to exchange of information, ideas, attitude among the participants and finally to change attitude and behaviour.
The project staffhoped that after all education activities were carried out, 80 percent of the workers in the intervention factories would be aware of the problems, believed in safer sex practice and could live with infected percon in the community. They should intend to change their behaviour suoh as using condom every time they had sex with prostitute, reduced the number of sex partners, decreased number of infection through sexual relation and had the right attitude towards infected person.
Susan Ivl"L. Laver, AIDS is our problem: workers, 1993.
guide to effective communication about AIDS trained
of
farm health
24
Establishing HIV/AIDS Progrms in the Workplace
Chaph m Strategic lrnplementation
Chapter
III Strategic Implementation
l. Management of the Project.

o Project Office. o Project Staff.
r r
o
Project Committee.
2. Preparation before the intervention.

Development ofpartnership. Selection of intervention factories.
Coordination with factory management

the
o Activities to strengthen the potential of

working personnel.
o o o
o
Curriculumdevelopment. Training of Project Staff and volunteers.

Assessment of the training result.
Baseline survey on KABP on HIV/AIDS of the workers.
r r
Survey on needs, problem and obstacles ofthe intervention factories before planing the intervention activities. Development of intervention supervision arrd monitoring plan.
Monitoring Plan.
3. Intervention process
Large group education. Small group and person to person discussion. Special campaign activities.
Search select and training of peer volunteers.
Training curiculum for volunteers. Result of volunteer training.
Establishing HrV/AIDS Programs in the Workplace
25
Chapdr
III Stralegic Implementation
Chapter
III
Strategic Implementation and Results
The important objective of HIV/AIDS prevention in factory workers is to

develop a model for HIV/AIDS prevention education program that is continuous and sustainable. This chapter will deal with activities used in the project in details
by discussing about project management, preparation before the operation,

working process and the results of the project.
3.1 Management of the Project

3.1.1 Project office
AIHD had organized a project on HIV/AIDS prevention edtrcation program as one of the Institute's, special programs. The central office was at AIHD, Matridol University, Salaya Campus. The office for field operation was located in Navanakom Industrial Estate. This office was the center for field operation of FOW, RP and others, so this allowed flexibility and convenience in reaching the target goup. This center was
later called "Friends of Navanakom" by the participants.
3.1.2 Project Staff

The Project personnel was composed of Director of the project, manager, field coordinator, 4 factory outreach workers, office management staff (financial and secretary) and field operation staff. Three project staffhave the following responsibilities.
. . r
Project Director supervised and monitored the project activities.
Project manager managed, planned and monitored the intervention activities.
Project coordinator supported and coordinated the activities of FOW, IIEST and factory personnel.
26
Establishing HIV/AIDS Prognms in the Wmkplace
Chapter m Sfrategic Implementation
The personnels that had been developed during the project operation were:
1)
Factory Outreach Worker (FOIV). They were field operators who implemented Hry/AIDS prevention education activities in the intervention factories. They provided knowledge, understanding and change the attitude of the faotory workers and motivated the workers to form groups and stimulate awareness of other colleagues. Health Education Support Team (I{EST) was composed of 4 staff from Provincial Health Office and Labour Protection and Welfare Ofiice. The team provided technical support to FOW by giving printed materials and protection material such as condoms and coordinating the collaboration with local agencies on health service such as referral services, consulting service and claiming rvelfare money from the HIV/AIDS welfare frnds.
Resource Persons (RP) were middle management personnels in the
2)
3)
intervention factories. They were those from personnel office dealing with training, welfare service, labour relation and health service. They coordinated activities of management staff and workers. There were 2 RP per factory.
4) Peer Volunteers (PV) were volunteers from workers in
the
production line. They organized and implemented HIV activities for other workers in the form of friends helping friends. There were 10 PV per factory.
3.1.3 Project Committee.

Executive Board gave advice, consultation and planning of the projeot. The chairperson of the committee was the govemor of PathumThani province. The committee members were the representatives from provincial offices serving in HIV/AIDS Provincial Committee, these were the Provincial Health Officer, Industrial OfFrcer, Director of Labour Protection and Welfare Offrce, Chairman of Navanakorn Personnel Management Forum, representative from private sectors working for public welfare, Director of Office of Population Technical Assistant and Director of the Project. The committees were appointed by the Permanent Secretary of the Ministry of Public Health. They met at least twice. Steering Committee advised, suggested and making decision on the activities of the project. Since the working processes vary a great deal and require expert in different fields,. 4 working committees were orgemized.
__
27
Chapter Itr Stategic lmplementation
They were (l) Working Committee on Cuniculum and Training. (2) working committee on Factory Activities, (3) working committee on Supervision and Monitoring (a) Working Committee on Evaluation. The committee members were composed of Project Staff, pennns who worked on HIV/AIDS problem with factory wotkers from govemment sectors,
private sectors and universities.
The Steering Committee selected intervention factories, set up guideline
for surveys on needs assessment and basic information of the factories, the management and the workers. Recruited and trained FOW, RP and PV.
Organized seminar to introduce the project to factory management, received and improved the activities and assessed the result of the Project.
3.2 Preparation before full operation:

During the first three months (Ootober - December 1996) preparation for field activity was done as follows:
r r r r r
o
Development of partnership.
Selection of intervention factories. Discussion with management ofthe factories conceming activities to be conducted.
Survey on baseline information of workers about their KABP associated wittr AIDS. Survey on needs and problems of the intervention factories for
development of program activities.
Planning for monitoring and supervision of the project.
Details ofthe preparation before intervention activities are as follow:

3.2. 1
Development of partnership
To develop partnership for collaboration on HIV/AIDS prevention and care was of utmost importance. The approach was for the project staff to attend the meeting with sub-committee on HIV/AIDS prevention and care of Pathum-Thani Province on the 8m ofNovember 1996. Project staff representative presented the project outline to the committee and it was accepted as one of their project in the development of network for HIV/AIDS prevention and care of Pathum-Thani Province for fiscal year 1997. Aiming to work in factories, having Provincial Health Office as the major responsible organization in coordinating to amlyz.e the problems and set up guidelines to solve the problems.
28
Chapter m Strategic lmplementation
The sub-committee on provincial HIV/AIDS prevention and care composed of the Govemor of Pathurn-Thani as chairperson, Heads of Provincial Offices, Provincial Management Organization, representatives from private business sectors, public welfare organization, NGOs working on HIV/AIDS, representative from infected persons seryed as subcommittee members.
3.2.2 Selection of intervention factories. There were 163 factories in Navanakorn Industrial Estate located in 3 industrial zones. The guideline for selection of intervention factories was to select factories which were looated in the same or nearby vicinity
so that the dissemination of information would be convenient between the
intervention factories and for the FOW to reach each factory in a shorter
distant.
The project had aimed to divide factories into two groups, the
large size and the medium size factories. The large size factories had more than 1,000 workers and the medium size factory had between 100 to 999 workers. Six large size factories and 6 medium size factories were selected. Twelve factories were used for test and compare the efficierncy of each group. The guideline for selection of intervention factories were:
l)
Factories that hardly had HIV/AIDS prevention education during

the past year (there might be one education to 100-200 workers).
2) There were organized welfare units for the workers (health siervice section, training section, welfare seotion) which could be used to
incorporate or carry out the education activities.
3) The management cooperated and agreed to carry out the activities. From the above selection guideline, the working goup and FIEST, with the advice of Provincial Industrial Office, met with faotories management who expressed their interest to participate in the program and presented the ideas, discussed with the management and agreed to collaborate. Therefore 12 factories were then
selected:
___
29
Chapter III Strategic Implementation
Table 3. Twelve Navanakom Intervention Factories.

No ofworkers Female Male
Factory
Production
Total
Medium size factories HR - Silvine Electronic CARTON Optial

Electronic cable
250
277
t2s
144 320
t25
130
Magrifyrng microscope
Telephone products
TAKA COM
NITSUKO TTIAI KDKFIJJIKTJRA
Rohm Apollo Electonics
376
418 539 900
56 306 400 400
PABX
Power supply cord Radio parts
tt2
140
s00
1,340
Total
Large size factories
2,760
r,420
TOSTEMTHAI
SEIKOSHA
JVC Manufacturing
Aluminium door and window

frames
1,300
700
600
Alarm. wall and table clocks Colour television and electronic

parts
1,500
300 430
1,200
2,103 3,070
3,500 8,930 20,403 23,163
1,673 2,781
MATSUSHITA
Electronics
Electric Utilities
289 876 974 3,569 4,909
FUJIKIJRA FUJITSU
Electonic supply cord

Computer parts
2,(r24
7,956
16,834 18,254
Total
Grand Total
Source: Outreactr Prograrn for HIV/AIDS Prevention Project. Survey on fhe readiness of the factories,
November 1996
The factories selected as target area for the intervention activities had a total of 23,163 workers,20,403 workers were in large factories and 2,760 workers were in medium size factories. Eighty-five percent of workers were female. The 12 intervention factories were distributed in 3 zones. The personnel managers were members of the Navanakorn Personne! Management Forum and the Chair man of the Forum was also in one among the intervention factories.
30
Establishing HIV/AIDS Progrms in the Worlglace
Chapter III Strategic Implementation
Figure 5. Map of the Industrial Park.
l= f,hllktrrt
2--
Frrjllsx
J- lostcn' l I'ri
,l= l\,lnl,rusrrllo
5=
(= Solhosh{ 7= Ilohnr ,lpollo 8- C{ totr 0pllcnl
Jl'C
F Trktcorl
12-
l0= Nitsuko tl= KDK Fujlkrrrf, ll.R. Sllvitre N.rtnr$m Lhllrd Iliid Ottl..
N.r&ibur G.n.rrl HdPlarl
3.2.3 Discussion
with the intenention factories management

personnel
At the beginning, the project staff and IIEST met with
management of the intervention factories to introduce the project activities and expected results and asked for permission to survoy the management structure of the factories, baseline assessment of the workers "KABP on safe sex and living with HIV infected person and AIDS patients."
The project staffbelieved that the success ofthe project depends on the cooperation of the management staff of the factories especially the management personnel, which served as center for the coordination. Therefore the project staff had organized meeting with management personnel at intervals during the preparation of the project as well as during the intervention operation in the factories in order to reach the goal set in the project.
Activities carried out with factory management were as follows
l)
on the preparation of the intervention factories for implementing HIV/AIDS prevention education and care of AIDS patients, To develop understanding and cooperation from all parts involved in the project. The provincial committee on HIV/AIDS
Seminar
Establishing
HVAIDS
3l
Chapter m
Shtegic Implementation
prevention and alleviation of AIDS and project staff had organized seminar for the management of the intervention factories under the little "Deal with AIDS : Govemment and Factory aspecf'. The participants were management stafffrom the 12 intervention factories, Navanakorn Personnel Management Fonm1 management staff of factories in the nearby vicinity, heads of the provincial offices, nongovemment organization and Navanakom Labour Union.
The topics covered in the seminar were ttre discussion on importance of understanding and awaneness of HIV/AIDS prevention education, safe sex and living with AIDS patients. Preparation of the factories for implementing HIV/AIDS prevention education and the right attitude among workers. The seminar brought about understanding and cooperation among partrers and support on the operation ofthe project to reach mutual goal and obtained some useful suggestions such as to have factory staff responsible for AIDS problem the same as health staff. Support the policy for the factories to obtain ISOI800 (Health and Safety Management System) to provide safety, service and health care for workers so HIV/AIDS prevention and care could be integrated. Incentive could be granted to factories having AIDS prevention progam by reduction of insurance premium in the welfare funds.
2)
Group Discussian with management staff of the intqvenfion

factories.In order to establish network and two-way communication among intervention factories management stafl *Group discussion among factory management' had been organized among the intervention factories by dividing into medium size factories and large size factories. The first group discussion was held after 4 months of the operation. lnformation on AIDS situation in the counfir, epidemiological trends and risk of the workers based on survey conducted on workers' KABP and needs to implement HIV/AIDS prevention education to give knowledge, change of attitude and behaviour on safe sex and living with AIDS patient in the fufire. The management staffhad given valuable suggestion for the planning and
the on-going activities of the project.
3) Seminar with the factories management stalf, During the second 4 months of the project there was economic crisis in the country, it was necessary to report on the result of past activities and plan for future activities in order to minimize the obstacles that might arise. The other problems was it was found that there were infected workers in the faotories. It was necessary to discuss with FOW and IIEST in order to develop appropriate strategy. At the same time new knowledge and
32
Establishing HIV/AIDS hograms in the Worlplace
Chapter
III Strategio Implementation
technology on AIDS had developed, it was important to give update and accurate information to the management stafi such as screening of HIV among applicants or new workers, appropriate management for infected workers, inforrration on AIDS vaccine, treatment of AIDS with herbal medicine. These information and publications dishibuted allowed the management of gain confidence in carrying on the activities.
4)
Intemiew the management staff in dept to evaluated the project T\e project staff had organized interview for management staff in December 1997 md January 1998. Outside evaluators from Office of Population Technical Assistance Experts had interviewed individual staff about the way the activities were con-ducted in their factories, policy on health and safety, opinion on the project operation, their opinion on policy and operation on AIDS activities after the project has completed and their needs of outside support from other agencies.
3.2.4. Activities on potential development of project personnels.
The activities were composed of curriculum

selection of personnels and training of project personnels.
development,
l)
Curriculum development was the responsibility of working group
on curriculum development and training. The working goup composed of representative from NGOs' having experience
working with AIDS among workers, from Bangkok Fights Against AIDS (ACCESS, CLIST, CARE, PATH, TBCA, PPAT, OPTA). Manager of the project and project staff worked together in developing the curriculum for the training of FOW, I{EST, RP and PV with the same goal and training process on safe sex and living with AIDS patient. By using participatory fraining process, the participants were able to assess the attitude, analyzn their roles and planning their approach on solving the problems together.
2)
Selection of project personnels: FOW, RP, IIEST and PV FOW, Factory outreach workers, four of them, were selected by
advertisement through various media. Their qualifications were:
o o o
Bachelor degree or equivalent.
Age 22-29 years old and were able to work in flexible time, could stay in the operation site.
Had good human relation, interested and love to work for the society.
Chaprcr m Smtegic Implementation
IIEST, Health Education Support Team, forn of them were selected from Pathum Thani Provincial Health Office, from AIDS Contol and Venereal Diseases Officers, Health Education Officers and from Laborn Protection and Welfare Office, (they were labour relation officers). Four ofthem worked as health education support
tenm.
RP, Resource persons, two per factory were selected by
the factory management forrr middle management
personnel working in training section or laborn relation/social welfare, safety
officers or nu$es in health office. All together were 25 RP for 12 intervention factories.
PV, peer volunteers, l0 per factory, were selected and trained by project staff drning the carrpaign activities on HIV/AIDS prevention and care in the factories. The PV will be
discussed later.
3)
Training of FOW, HEST, RP were conducted at the beginning of

the project and also follow ups at intervals.
FOW: Four FOW and one coordinator had to work closely with RP of each factory. They had to coordinate AIDS activity in the factories with RP. The 3 day training was on "Technique on AIDS education for factory workers" for both FOW and RP. During this training, both groups got to know and understand each other and were ready to implement HIV/AIDS prevention education to target workers in the factories. The factory management were cooperative in selecting 25 RP to be trained with 4 FOW. The training process was impressive and the RP had organized and set up "Friends of Navanakorn Forum" located at the projeot office in Navanakom under the name "Center for Navanakom Friends" Their objective was to use the center for brain storming and activity planing. There was religious ceremony at the opening of the center in January 1997. It was a good start of outreach stratery ofthe FOW.
For IIEST, the Pathrmr Thani Provincial Health Office was cooperative in selecting officers from AIDS and Ve,nereal Disease Control Division, and Health Education DMsion and also from the Provincial Labour Protection and Welfare Division wtro selected Labour Relation officers, all together 4 of them to serve in IIEST. Since these personnels was more senior both in their knowledge and working experience, the training were oarried out along with 34
E*ablishing HIV/AIDS hograms in the Workplace
Chapter
other govemment officers under the topic *AIDS activity among workers" conducted by SWOP and Epidemiology Division, MOPH, The training was conducted for health offrcers and Labour Welfare Officers from various parts of the country having industrial community. This was canied out the same time AIDS project started and was the same curriculum the project staff organized for RP and FOW, differs only details according to participants'
background.
The topics and training process for each goup of

personnels had the same principles.
Table 4. Training curriculum for personnels working on AIDS outreach project. Cuniculum
FOW
TIEST RP
PV
Supporting
SWOP, PATWACCESS, CLIST/CARE Office of Populdion Technical Assistance
l.
Primary Training AIDS education

I
1.1 "Technique on
for factorv workets" (3 davs) 1.2 In-service training on'KABP

Survey and needs of intervention (5 davs)
1.3
"Living with HIV infected

oersons" (3
factories" ACCE!iS
&vs)
CART/CLIST
1.4 ln-service training on
"Working on AIDS witb

workers" (2 weeks)
1,5 "Professional Presentation
for
PATH
two-way Communication using
talkineposter(1 dav)
1.6 '"Technique on being AIDS Peer volmteers for workers" 1.7
AIDShoject
A]HD
for PV *Skill in presentation and commrmication" On the Job Treining

Transmission Diseases" (1 dav) days)
2.
2.
I'Sorual
Pathum-Thani Provincial Health Office
2.2"Pnmary consultation skill" (3

2.3 Field studieg on care
EClAn'{D, AIDS Projct Buddhist Care. Wat Phrabat Nun Pu Loburi

Suan Smtithum Pathum
of
temdnal stage ofAIDS by Buddhist way 2.4 Field Studies on Care of Terminal stage of AIDS by
Thmi
CDC, Regional Health
Christim way.
2.5 Field studies on solving AIDS problern in the North
office l0 and Faculty of Phannary Cheing Mai

Universitv
Rstablishing HIV/AIDS Programs in the Workplace
35
Chaper m Smtegic Implernentation
A. Training of FOW.
Outreach cornmunication stratery is to have field coordinator and FOW working in the intervention factories to develop understanding, motivate awareness and participation of workers in solving their own problem. FOW must have potential and skill to cope with these tasks. Technique and content of the training must create potential and skill of FOW to be able to carry out such tasks.
The limitation on time and financial support for FOW forced the Project Staffto select new graduates for the job. The fraining expense was based on condition that it would be possible to carry on even without outside support. The primary training and on the job training were therefore arranged as necessary as indicated in the table.
A1. Primary training. The major primary training was on "Technique on AIDS education and working on AIDS with factory
workers". The training was carried out with R.P. The cuniculum content placed emphasis on the preparation of personnels for understanding and attitude in working on AIDS which has to deal with sex, behaviour, and the direction in AIDS education to workers to obtain safe sex and know how to live with AIDS infected persons.
Content
AIDS education for factory workers" for FOW and RP had the following objective: (1) Develop knowledge, understanding information on AIDS.
of the training curriculum. The "Technique on
and gnving
correct
(2) Develop attitude on the value of the person and others, attitude about of sexual relation and AIDS. and about the infected
persons.
(3) Skill building on community analysis, cornmrmication and campaign on AIDS among factory workers and skill in working with others.
Topics of the training were
:
(1) Group activity

(2) Conect information
factors.
on HIV/AIDS, epidemics and related
36
ChaptLu
Itr Strategic Implementation
(3) Attitude, love, living with partners, changing partner, chances on having sexual relation, similar and different attitude in making decision between male and female. (a) Risk assessment on sexual relation and safe choice.
(5) Communication on AIDS, content, knowledge, objective of

oommunication materials, questions.
(6) Skill on communication and team work. (7) Survey on basic information ofthe factories and workers, layout of the factories, working structure, working facilities, lifestyle of workers and developing relationship with workers.
(8) Team work, assessment of problems obstacles and supports. Working plan on large group education, small group education and person to person education.
(9) Selection of volunteers.
(10)
Roles ofFOW, RP and PV.
process
Training Process. Participatory training using content as to develop two-way communication leading to self
plm. training
assessment and analysis and adjustment of working
Assessment was done before and after the
A2. On the job training. Other than the above training, FOW must receive some short course training at intervals. The training before field operation were:
(1)
implementing HIV/AIDS prevention education for factory workers in Pak-Num Samut Prakarn Project, CARE., and workers relation on AIDS of CLIST for 2 weeks.
person at Suan Santitham for 3 days.
(2) Skill development on living with HIV/AIDS infected

(3)
Workshop on talking poster for two-way comnrunication with PATH, 1day.

on survey of KABP and factoryneeds, 5 days. on micro teaching
(4) Workshop (5) Workshop
day on the job.
Training. From the strategy on supervision and monthly report of the project, it was fowrd that FOW required more knowledge, so I day seminar on sexual transmitted diseases and 5 days training on
37
Chapter m Stategic knplementation
primary consultation were organized so the FOW could efficiently use the techniques in their jobs. B. Training of Resource Person (RP.) RP must work closely with FOW, the project staffhad organized their training with the 4 FOW in the training on'technique on AIDS education" with the same objective and content as alreadv mentioned.
The training on "Teohnique on AIDS education" was conducted at
Bl. Primary training. With the ideas that
Pung Wan Resort, Kanchanaburi. This training led to a understanding of AIDS, mode of fransmission, prevention, attitude on living with AIDS patients and developed confidence for RP i
implementing HIV/AIDS prevention lecture to others.
"We got
tool"
coded from RP Conversation.
Project staff had organized two the job trainings" similar to FOW. One was on "Professional presentation for two-way communication using talking poster" and field studies on "Care ofterminal stage of AIDS" Professional presentation, with the ideas of sustainable activities, RP would have role in planing and support AIDS activities in the factories. The project staff had made communication media and gave to the factories to be used as media for workers. This composed of talking poster made of 4-colow 3-dimension pictures, 20 sets and 2 VDO cassettes on "Risky Life" and "Secret plan, secret love". The project staff had organized or workshop on how to use talking poster for RP so they can utilize the media for workers in promoting safe sex and promoting understanding AIDS patients. Professional presentation using talking poster was commented by
RP from large and medium size factories that the talking poster has good suitable for small Soup discussion which can utilize the media and thoroughly . For large goup lecture, only a certain pages of media was used along with distribution of pamphlets. The haining was useful.
B2. On the job training.
ooon
"We used the tool"

Commented by RP. 38
Establishing HIV/AIDS hogams in the Workplacc
Chaper m Stntegic Implementation
Field studies on care of terminal stage of AIDS patients. To develop understanding about AIDS infected persons and the needs of RP to have direct experience, the project staffhad organized field studies on care of terminal stage of AIDS patients for RP. The studies led to understanding and awareness of RP in working on preverrtion and living
with AIDS.
C. Training ofHEST.
Cl. Primary training. Training curriculum on "Working on AIDS with workers" was organized for TIEST which were govemment officers and attended the workshop along with other government officers from other provinces. The emphasis was placed on development of attitude and goal in implementing HIV/AIDS prevention education to workers towards the same direction as FOW and RP. Ttre difference in details of the curriculum was that the objectives of the training of HEST wefe:
(1) Development of ideas and goal in working on AIDS with factory workers to give outreach education and rmutual living. (2) Develop the right attitude on AIDS and sexual relation and on HIV infected person. (3) Develop skill on communication about sex, on analysis and reaching the target Soup and networking.
o r o o o o o r o
Situation and working condition on AIDS, regionally and nationally.

Analysis of AIDS problem in workers. Analysis and utilization of research results.
Attitude on AIDS and sexual relation.

Risk irmong factory workers.
Choice in reducing risk and assessment of risk.
Communication on sex and AIDS. Impact of AIDS on infected person and their families.
Know and reach the workers.
From the result of the training "It is the first time that the trainees had a chance to participate in the learning process. This technique will be used to hain other offrcers in the province." HEST oartici
39
ChaFer m SmGgic Implementation
C2. On the job training. Project staff had otganized on the job training for IIEST, and FOW by field study on solving AIDS problem in the North. With the cooperation of the Communicable Disease Control Office Regron l0 and the Faculty of Pharmacy, Cheing Mai University, the study tour was to study the cooperation project on solving AIDS problem among factory workers and prevention and care of AIDS in the community. The objective of this training was to lead to the analysis, comparative studies and summarizing the model used in AIDS prevention and care. The experience gained from this field studies was useful for HEST in developing plans on AIDS for the province later on.
3.2.5
Baselinesurryey.
Office of the Population Technical Assistance surveyed the basic information on sexual behaviour and KABP of the workers during November to December 1996 and presented the results on sexual behaviour and life style that risk AIDS infection of the workers in the meeting with factory management and on other occasions to assist in the plaming of AIDS activities.
3,2.6 Survey on the readiness, problems and obstacles

factories for planning the activities.
in
the
FOW and the coordinator and IIEST cooperated in conducting

survey on need assessment and basic information, problems and obstacles
in the intervention factories. The results were used for planing AIDS activities with RP and factory management so the implementation of HT/AIDS prevention education could be carried out appropriately in
individual factory. The basic infomration used in planning the activities wefe :
r r o o o
Basic information ofthe workers - sex, age, education.
Basic information of the factories - turnover of workers, production process, working hours of man and urachine, recess and breaks, peak season and time table of the factories.
Facilities available such as meeting room, library, voice mail, VDO and advertising board.
Organization available such as family planing fonrm, safety committee, committee on sports or music.
On-going activities such as safety weekn sports day or health examination week and campaign on "5-!"
40
EstablishingHIV/AIDS Progams intheWorQlace
Chapts In Stdegic ftnplementation
Welfare structure for workers, Training Officer, Welfare and Labour Relation Officer, Safety Officer, other welfare such as dormitories, rent, fust aid room, nurses's station, work-shifts, transportation, food coupon, overtime, health insurance and
compensation.
Figure 6. Potential Development process.

Goals and philosophy on potential development of
AIDS personnels
Field study for comparative model
3.2.7 Operation plan in the interuention factories.

From need assessment in the intervention factories, FOW and working groups with RP and personnel management, had adjusted the activity as necessary during the 12 months operation and asked for permission from the Executive Director before the action was taken, such as conducting large group training (not more than 30 workers) at the time the factories agreed upon, i.e., during regular working hours or during over-time, during stock-checking time and at the time when the factories are not operating - while waiting for raw materials or when machine broke
4l
Chapter III Strategic Implemortation
down. RP asked for cooperation from head of the production line to

arrange for the workers to participate in the activities.
For small group discussion, FOW who stationed in the factory from 10:00 - 17:00 hrs. used library or health office or safety office, as arranged by the factories, to hold the discussion with the small goup.
Table 5. Activity Plan in the 12 intervention factories.
t997
Activities
JAN
FEB
MAfi
APR
MA1
ru
J1JL
AU(
SEP
OCT
NO\
DEC
l.
Education
(30 workers)
1.1 Large group
++-
J>
1.2
Discussion
+ + +
<F
1.3 CamFaign,
display
exhibition and
advertisment board
1.4
s +
e
I
Lrurch
Activity
campaipur
1.5
News letter
s
++
s s
s +
2.Training of PV, PV Planned
<F
activity with
RP 3.2.8 Superuision and monitoring plan
for field operation.
The supervision team was composed of TIEST and rthe supervision staffofthe project. The supervision and monitoring were as follows :
Supervision and monitoring twice a month (once in large factories and once in medium size factories) in order to observe the activities on HIV/AIDS prevention education and gather ideas and opinions of the management, Rp and participating workers.
o r
42
Monthly meeting to summarize the problems, obstacles and layout the strategic plan together between HES'[, Rp, pV and
project staff. Materials used were record books and summery forms ofpV.
Chetr III Sfategic tnplementation
Figure 7. Operation framework in the target workers.
FOW-coordinate and implement
HIV/
HMAIDS
Motivate the management to beaware of problem Implementing HMAIDS prevention education and living with AIDS patients in large and small groups and one to
and
\y
Recruiting and haining of volunteers
3.3 Working process in the target workers.

months operation, the education activities were
From the working plan in the 12 intervention factories dgring the

:
12
3.3.1 Education activities in the large group. The standard curriculum utilized 1.30-2.00 hours. The participatory education process
provided two-way communication among 30 workers attended. The time offered was considered by the management to be once a week.
3.3.2 small group education. Fow stationed in the intervention factories held discussion with individuals or in a small group of no more then 5 workers in order to discuss in depth about rist behaviow. using talking posters, the Fow could persuade the participants to converse and create understanding andbeliefabout HIV/AIDS and venereal diseases prevention, blood testing for
Establishing HIV/AIDS progranrs in the Workplace
-43
Chapter III Strategic Implemantation
HIV/AIDS, risk behaviorr, safe sex, impact of HIV/AIDS infection to individual, family and the society.
The content of the education activities in both groups placed emphasis on safe sex relation, understanding and living with infected persons.
The education activities were
Lunch activity campaign: was the activity of the provincial health office to support the project activity in giving knowledge, create awareness about risk among factory workers in Navanakom.
Table 6. Large goup education curriculum and activities.
Topic
L Group relation
2. Knowledge and
Obiectives
Create intimacv Assessment of knowledge understanding attitude and points to make understood. Assessment of risk behaviour
gzrmes.
Technique
brain-storming station
Time
l0 mins. l5 mins.
Facts about
HIV/AIDS.
3. Risk behaviour
information message/ divide into groups and

discuss.
l5 mins.
4. Spreading
of
Create awareness that
water exchange/game
25 mins.
HIV/AIDS
5. Reduction of
HIV/AIDS is a close problem.

risk Attitude and believe reflect behaviorn and search for risk reduction and safe sex relation
Create rmderstanding about infected persons and effects.
participation activirty,
Demonstration
Divide into male
ad
20 mins.
female groups, discussion and presentation of iders. Group discussion/group choice. Conclude the point understanding. 25 mins
6. HIV/AIDS Infection and
effects 7. Summary Summary of safe sex relation and understanding HIV/ AIDS infected person.
of
l0mins.
44
Establishing HIV/AIDS Progpams in the Workplace
Chaptu III Sffategic knplementation
Table 7. Content of small gtoup education using talking poster.

Talking poster on HIV/AIDS:
Produced
set of 20 posters with 20 topics presented
by 3-dimension pop-up.
of:
:
PATH
Used as communication material while having conversation with 10 participants on on HIV/AIDS and sexual relation.
:
Objectives
Target group
Young factory workers age 15-29 years

20 topics.
Content:
White blood cells - guards of the body can be weaken by HIV/AIDS 2. Hry/AIDS infected and HIV/AIDS patients.
3. Confirsing situation after confusion activity. 4. Belief that does not help preventing
l.
VD, and AIDS 5. Relationship between AIDS and VD. 6. VD can be prevented and cured. 7. Conversing before blood check for HIVIAIDS. 8. Pro and con if blood duck tum out positive. 9. Alcohol--- unexpected risk. 10. Your risk--- where is it? - what is it about AIDS
11. This way
without risk and contact.
12. Ways to the risk. 13. Condom
the safe choice we can make.
14. Women and condom-why?
15. Give me time to know you.
Think how you met your partner. 17. Know your feeling, think ahead, search the fact. 18. AIDS inhibition drugs and physical and mental care.
16.
19. Worries of infected person, family and colleagues.
20.
Youwill do!
Establishing Hry/AIDS Programs in the Workplace
45
Chaper m Sffiegic knplernentation
Activities were carried out during lunch break from 1l:00-13:00 hours at the cafeteria. The activities were composed of musical show of Thai teenagers working against AIDS, question - answer competition for prvn, dishibution of pamphlets and condoms. Radioprogran. The activity was the collaboration with PATI{. There were question - a$iwer to give knowledge on HIV/AIDS in the program "Our friend this week" using AM station frequency I4g4lvfrIz. The program was on air every Sunday from 8:30-10:00 AM.
Creation of awareness activity. There were bulletin boards organized weekly to display picture and information on AIDS with distribution of printed materials and condoms on different occasion of the factory, such as safety campaign weelg 5[ week, Sport Da5 Labour Day, World AIDS Day.
3.3.3 Searching, recruiting and training of Peer Volunteers 8V).
The project had aimed to search and select volunteer workers at least l0 voltmteers per factory. These people would plan the activities together with RP in educating other workers on AIDS within their own factory. IIEST would support and give consultation as needed by the volunteers.
The recruitrnent of volunteers was to look for a person with some characteristic suitable to be a volunteer. The search was done during the first 4 months of training by FOW (January - April 1997) which was the initial preparation of the target goup. The application was to have those interested person sign up. The factory management and RP also had selected some ofthem.
The quality of Peer Volunteers :
1) Ilave
good human relation, aocepted by majority of workers.
2) Have long enough working time in the factory. 3) Interested and volunteered to work. 4) Deterrnine to work for other friends in the society especially
AIDS.
Search and Selection :
on
1)
2)
From those signed - up to be volunteers. Personnel management and head of each production division selected those who had suitable quality. The managemelrt submitted rulmes for formal training to the project, and the pennn must have higb probability to work a long time with the factory.
46
Establishing HIV/AIDS hograms in the Workplace
Chrytr m ftategic Implementation
Curriculum and training process.

The cuniculum for training of volunteers was a comprehensive course aiming to give knowledge and skill about HIV/AIDS education and creating awareness and value of being volunteers. The training was carried out in two groups of 60 participants. Another training was also carried out for 19 volunteers recruited from RohmApolo Factory.
The content of the curriculum for training is shown in table 8. The training utilized participatory training process. Network of trainers were
developed by that the fust goup trained took part in haining the second goup. This resulted in the setting up of network of Peer Volunteers in the intervention factories later on.
Establishing HMAIDS Programs in the Workplace
Chapter
Table 8 Cuniculum content for Peer Volunteer Training

Topic
Obiectives
Get to know each other Get to knowyouself, Understand and accept Others
Technique./ progesg
TTimc
30 mins.
l.
2.
Group relation Exchange of experiences.
Dissolving behaviour activitv

Exchange water game/ small group. Basic activities.
{Q mins.
3. Reviewknowledge/
Understanding about
Points to make clear Understanding
60 mins.
AIDS
4. Motivation 5. Working withHIV/AIDS

in the factories.
Create ideologr of Being
Camp fire. Basic activities/exchange

ideas.
60 mins. 30 mins.
voltmteers. Develop understanding in
working with HIV/AIDS

in the Workplace. Develop skill in
of
30 mins
6. HIViAIDS hoblem
among Workers.
$rrmmary of webs Pictures on

eDidemics. Case study / small
Analyzing Hry/AIDS
Create awareness on The difference of Opinion and viewp oint About infected
Derson.
7. Vievpoint
Workers.
among
30 mins.
grorp discussion.
8. 9.
I 0.
Risk factor for Male female And choice in

Roles ofmale And female
Risk in sexual Relation

and HIV/AIDS
Divide into male / fernale, brainstorming

Exercise,
45 mins.
Develop view-point That sex leads To behaviorn

Get use to discuss And
Brainstorming in
30 mins. 30 mins.
$nall erouD.
Small group vocabulary Exercise.
Communication about sex.
communicate Abotrt sex.

I l.Blood test envelopes.
Understand the tnfected

Dersons.
Imitate the situation. Practice. Pole-play. Discuss nnd plan on
30 mins.
l2.Talking postr.
I3.Role of volunteers.
Develop skill onthe Sex
45 mins.
of talkins Doster.
Develop awareness. Develop networks on
l5 mins
!Q mins.
15 mins.
l4.Network
activities.
on
HIV/AIDS
HIV/AIDS activities
Assess suggestionAnd
HTV/AIDS.
Small group brainstorming.
l5.Assessmenl
opinion for Future

session.
48
Establishing HIV/AIDS hograms in the Wor*place
Chapter
ry Outpub ofthe Factory Intervention
Chapter
IV_
Outputs of the Factory Intervention
The working plan was divided into 3 months preparation, 12 months intervention and 3 months assessment and report writing.
The intervention activities were carried out with the cooperation of the factory management and RP using supervision and monitoring strategy during the operation. It was necessary to adjust the plan and strategy to suit individual factory's condition at interval as shown in table 9.
The outputs of the intervention in target factories to be discussed in this chapter is related to the major strategy used for sustainable activities which will
be discussed in chapter 5 and 6. There will be some repetition in these 3 chapters which are cause and effect to each other from the changing process that occurred (table of index assessed at different level of the project).
The result to be presented
l)
2)
Participation
in the management of the project from the 5
partnership (from the first activity of sustainable strategy) Results from potential development of 4 types of pe:rsonnels i.e., 4 147 PV. The by-products were training curriculum and techniques used in tuaining the 4 types of personnel (from the second activity of sustainable strategy).
FOW,4I{EST, 25 RP and
3)
Results of the HIV/AIDS prevention education in intervention factories, obstacles encountered, adjustment of active and passive strategy and knowledge gained from workers' activities (change of behaviour strategy via education).
Assessment
4)
of project efficacy using cost-effective
comparison
between medium size and large size factories.
The index used to assess primary success were :
l)
20,000 workers from 12 factories obtained direct knowledge from large group education (30/$.) or one to one or small goup education (l-5/gr.) Knowledge also obtained fiom printed materials
Establishing
HMAIDS
Prograrns in the Workplace
49
Chaptcr IV Outruts of the Fadory Intervention
advertising boards.
and other media such as campaign activity, exhibition
and
2)
Resource Personnel (Rp) from 12 intervention factories \ilere trained and carried out the implementation of HrV/AIDS prevention education and supported the activities of peer volunteers in the workplace.
3) Health Education support Team (I{Esr)
govemment officers from provincial Health office and provincial Labour Protection and welfare office supported and carried on the Hry/AIDS activities in the workplace.
composed
of
4)
Peer volunteers (PV) in the factories, both officially and unofficially, l0 PV per factory were trained and carried out HIV/AIDS prevention education in the workplace.
sustainable HIv/AIDS prevention education in the workplace was obtained. The intervention factories had policy and plan in implementing HIV/AIDS prevention education in the workplace having Minimum package of Activities composed of:
5) Model for
. . e
Policy on HIV/AIDS.
Personnels coordinating and supporting HTVIAIDS education. Support for Peer Volunteers activities on HIV/AIDS prevention education.
50
Establishing HIV/AIDS programs in the Wor*place
Chapter IV Oulputs ofthe Factory Interventiotr
Assessment of the project using different index levels.

Major sfratery
Sustainable
Product
Ouput
sstainability
shatery l.Development
of
parhership
Participationin the management of the project by 5 parnrers.
=r factorymanagement
understands policy and strategic plan in
sustainable policy
solving HIV/AIDS problem and zupport the project. supporting struch[e from govemment and private sectors were developed.
2. Personnel
Development
=)
4 types of persormel potential were developed and carry out the activities (4
=+ RP act as consulting team and P.V.
sustainable
organization having
implementing
HIV/AIDS
FOW,4IIEST,25 RP
and 128 PV.) 4 training curricula.
prevention education in the factories.
I.
Mininrum Package of Activities: HIV,'AIDS

prevention policy Coordinating and supporting unit on
educa tion supporting outreach education program on AIDS by vohrnteers.
HESTfrom
Government
2. 3.
FOW
HMAIDS
Education to
change
behaviour srratery
FOW andteam educating workers I o per cent ofworkers obtaining education in large and small groups
F I
F KABP for safer sex I relation p KABP to understand

infected person
of Behaviour for safer Sex relation.

Change
tl
tl
+
reduction of HIV i:nfection
averagenumberof activity participation

in the large, small and campaign on
o
o o
Project
AIDS nunberofcondoms
distributed.
nunber of printed
material distributed Cost-effectiveness
analysis for large and medium size
efficiency
assqssment.
+ ?
Investnent in the project

lnvestment by the factories
financial
sustainability
factories.
Establishing HIV/AIDS programs in the Workplace
5t
Chapter
Mutputs
of the Factory Intervention
Results ofthe intervention activities
4.1 Participation of partners in the project.
stategy on partnership operation having govemment sector from Provincial Health Office and Provincial Labour Protection and Welfare Office to act as major organizations for support, the business sector, Navanakom Personnel Management Forum, NGo working on AIDS, community in the 12 intervention factories, the cooperation of these 5 parfirers led to the constructive activity of the project.
I.
Government sector. The integration of the project into regular activity of Pathum-Thani Provincial committee on HIV/AIDS led to continuing cooperation from govemment sector. The provincial HrV/AIDS committee served as forum for coordination of plan, budget and personnel during the operation of the project, as appeared that :
1)
There were 4-member Health Education Support Team (TIEST) who gave training and participated in the project activities during the l8 months operation. The important role of IIEST was to participate in 2 hows training of major curriculum for workers, support printed material, media, inforrnation on HrV/AIDS and condoms, gave consultation, advice,
health service and referral (with Rp and FOW) to workers.
2)
3) 4)
Work in the supervision and monitoring with project staff.

Gave support and help workers and family members who oontacted
AIDS.
5) "Lunch Activities" was organized by IIEST to

activities in the intervention factories.
faoilit"rte the project
52
Chapter
fV Outputs ofthe Factory Intervention
Figure
9.
Partnership in AIDS education in the workplace
Pathum Thani AIDS committee
.Provincial Health Office .Labour Protection and Welfare Offrce .Industrial Offrce
Navanakoni Industrial
Estate Forum
Health Education Suppo;'l Team |
@
+
HIV/AIDS in
factories,AIHD
0\
(HEST)
+
Personnel Management
Navanakom Personnel Manaeement Forum
4
Resource Personnel Forum
/ / /
Peer
Resource \ I Person(RP) \
Volunteers(P.9 workers
\ \
A
Peer Volunteers on
Outreach Program on
AIDS prevention in
workplace Forum
Expansion of Project Activities
1)
Pathum-Thani Provincial Health office adapted the training technique for workers for training of other health officers.
2)
3)
The Depart of Labour Protection and welfare had policy to develop HIV/AIDS consultants in the factories. The training of Rp in other
factories was carried out.
Large factories had carried out their policy to obtain ISo 1g000 for large factories having HIV/AIDS prevention education as one of the component in "Healthy'' policy.
II.
Business sector were the 12 intervention factories. with the cooperation of the factory management, the project aotivities were
allowed to be conducted in the workplace. This led to health policy for workers such as:
l)
Supporting the implementation of HrV/AIDS prevention education to RP, PV and workers. The management allowed the project staff and
Establishing
HIV/AIDS Programs in the Workplace
53
Chapter IV Outputs ofthe Factory Intervention
Fow to conduct the education both during and after working hours.
Some factories even paid over-time for workers to attend Ae
triining.
2) Supporting
3)
the set up of
pv forum
both officially and non_officially.
on Hrv/AIDS in other activities, for example, orientation workers having Rp to conduct the orientation.
Support materials, equipment and facilities for education activities and campaign at different occasions leading to integration of knowledge
of
neiv
III'
Private sector or NGO. These were organizations working for public welfare on AIDS problems in the factories. They were :
l)
2) 3)
assessmerft and participated in all activities as an external evaluatoi.
PATH------ ACCESS------ CLIST------- CARE of samut prakam Province, Plan Parenthood Association of Thailand. These agencies helped in constructing the training curriculum and training oimajor personnel, i.e., FOW, Rp,IIEST and pV. office of population Technical Assistance conducted project
project personnels.
Thammarak Nives Projeot of Wat Prabart N*p,r, Lopburi province and Suan santi Tham, pathum-Thani province, having experience as hospices for AIDS patients, cooperated in developirrg h"irrirrg oo techniques in living with and care of terminal ADS patients foi tfre
4)
Major Community were Navanakorn Personnel Management Forum and Safety Forum which were officially organized hal responded to the workers after training by settinj up- .Navanakom Resource Persons Forum" having Rp from lz intervention factories as members. This forum allowed the collaboration among Rp to solve AIDS problems and carry out the activities accordinf to the plan. "The center for Navanakorn Friends" was set up at Fow head quarter' Meetings, seminar and expansion of activities to factories outside the target group were organaiaatthis center. lopic on AIDS was incorporated into the agenda of the regular meeting of tt Forum.
"
Peer Volunteer Forum was organized after the volunteers were trained in their factories. The activities were wJil supported by the factory management.
54
Chapter IV Outputs ofthe Factory Intervention
rvranrqor uruvenilty "Mahidol University had introduced the HrV/AIDS prevention introduced education to be carried out in Navanakorn Industrial Estate which the provincial office thought it was a very useful pilot project. pathum-Thani I""tP had Province a chance to work close to the target gro.rf oip"ople with high risk, th{ ir' factory workers. As a consequence, we were able to learn about their problems and needs. These inforrnations will be used in our plan and we will use this model in expanding our work to other factoies "ajusting ueiaes these 12 interuention factories. "
Kruetip Chandrataniwat AIDS and STD control officer Pathum-Thani Provincial
Health offrce
I{EST 1l March 1998
"The new law on Labour protection Act l99g which would be effective stated that ttrere would be Labour welfare committee looking after general welfare of the workers including health. It was lucky that Mahidol university had started the HIv/AIDS prevention project and recruited Resource Persons from 12 factories to work. Labour notection and welfare office thought there could be more training on Hrv/AIDS and more skill on ssrrnsgling activities so the factories could carry out the work after the completion of the Project. To have participatory education was useful in understanding their feelings and motivating their conscious. This model can be used in other training."
on 19 August 1998
Natit Prasertwong
Labour Relation Officer Labour Protection and Welfare Office
IIEST ll March 1998
4.2 The success in potential development of personnel in the workplace.

Twenty-five RP were recruited and trained while only 11 factories were Both Rp and pv were able to conduct the Hrv/AIDS prevention education in the factories as expected. The factory management thought the education and counseling aotivities should be carried Ln evenlhough the policy had not yet been spelled out (source from interview of ,o"oug"-"it, Annex).
able to recruit 146
pv.
55
Chapter tV OuFub ofthe Factory Intervention
4.2,lThework of Rp.
Two Resource Persons were recruited from each factory (except 3 from Fujikura Factory, one each from personnel office, safetyoffice and factory nurse) with a total of 25 R.p. Rp were able to carry out the HrviAIDs prevention and care education activities as expected. They coordinated the activities between the management and PV and rendered support on printed materials and condoms. They also worked with pv in planing the AIDS activities in their factories during some special occasions such as campaign for safety week, Environment week, 5c,s, exhibition and bulletin board on AIDS education, poem competition, question box on AIDS and V.D., distribution of sheets and condoms in the water closet and set up of Peer Volunteer Forum, serve as lecturers and integrate AIDS into ttre orientation ofthe new workers. 4.2.2 Actiities and result of pV work*.
There were 146 peer vol'nteers from ll factories. one factory could not recruit the volunteers from workers. Training of volunteers were conducted 3 times, Sixty volunteers were trained during the first and the second round in June and July 1997. For Rohm Apollo Factory, 19 peer voltmteers were recruited during the last 4 months of tf," pro3eli and the training was conducted in November 1997.
(l)
With the idea that Peer Volunteers voluntarily and willingly wanted to worlg they would put their frrll effort to work continuously. From the questionnaires returned it was found that 44 per cent voltmteered by themselves. Only 13 per cent indicated that the management wanted them to volunteer. It was thought that the management might want to have volunteers from middle management rather than operators, which might be more efficient in the dissemination of information and consultation with the management, including the working stability of those personnel in their division.
(2) From the interview on activities of peer volunteers during their 3-4 months work, it was found that after their haining g4-g7 per cent had disseminated of HIV/AIDS prevention informatioo *as given through informal conversation rather than formal training. Other activities were through advertisement board and VDO show.
x
note : During the economic crisis of the comtry in August December 1992, there were both positive and negative imPact to industry and labour. For Navanakom, the increased production and to conform with Iso 9000 and 5C's (Ctear, Clean, Convenience, Crearing "O"patio1 health and hyglme, and cre*ing ) cmpaign had a lot of impact on AIDS activities
56
Chapter IV Oueuts ofthe Factory Intrvention
(3) The voluntesrs indicated that the activities were carried out alone or with other volunteers in the same factory, starting from planniog *a carrying out the activities together in implementing ruvriros prevention education. Three-fourth of the volunteers reported that they were members of peer volunteer Forum which *.r" io*ara uy the volunteers in order to strengthen their working power. (4) with the coordination and support from Fow and Rp in each factory, the Peer volunteer Forum was organized in each tbctory, and the factory management had issued an order to officialry set ii up. The Forum was managed by their own committee, given G ,r"_" themselves. There were I I forum in l l factories. (5) To enforce their potential and participate in their activities, the project staffhad donated to set up firnds for Peer Volunteer Forum to run their activities in their factories. The fund was expanded by donation from members at a rate of 20 bahts/month and by conduciing some firnd_ raising activities during the factory campaign. part of the firnds was used to make T-shirt for volunteers and some part was used to help the
infected workers.
(6) Majority of volunteers wanted to carry on their work after the completion of the project. They expected the management would go on support their activities which was not much at preserrt.
4.3 Result of implementing HIV/AIDS prevention edtrcation

This part will discuss the large group education, with standard curriculum, small group education and other special activities in the medium and large size factories by FoW and their team in the factories. The discussion will also include problems, obstacles and adjustment of the operation plan using both active and passive strategies. The last point to be discussed is the coverlge of workers receiving education.
4.3.1 Result of the education.
prevention education in large and small goup, one to one conversation according to plan. The comparison betwein large and medium size factories are as follows :
The project had carried out implementation
of
HIV/AIDS
Medium size factories can be summari zed .-to 4 categories
(1) Two medium size factories (KDK and carton) had allowed the workers to. receive training during their regular working hours from the beginning until the completion of the project in g months. After
57
Chapter
IV Outputs ofthe Factory lntervention
which the education was included into the orierrtation program of new workers within the last 4 months of the project. Both factories established their policy to carry the activities onward.
(2) Two factories (Takacom and Nitsuko), after the frctory personnel management had received explanation from the project staff and the labour problem was solved in Nitsuko factory, th" or*ug"ment had planned to have large group education in their factories during the over-time period. They paid over-time for those workers -who attended the training and all workers had received the education
during the last 4 months of the project.
(3) The fifttr Rohm Apollo was selected as intervention factory lactory, after all other factories had started, that is, during December, 1996. The workers were able to attend the training in tilne, but only twice that the large group education were given. The adjustment naa to be made to suit the factory situation conceming the readiness about the awareness of Hrv/AIDS problems in the factory, rmtil one worker who contacted Hrv came down with symptom in August 1997. Then the awareness was obvious and the management decided to plan with the project staff to have large goup education. Large group edtrcation was then conducted continuously along witn smill ;""; discussion. The activities were carried out during the last four month of the project by which the management had planned to have training for managers and assistant rnanagers in september 1997. Thi4y-thre; rounds of large group education were conducted with g7g workers attended. The factory management had given budget for I resot'ce person and 19 peer volunteers to be trained in December 1997. The factory had carried on activities by setting up "Friends for fiiends" (Rohm Apollo Education Trainers, RAET) group in December 1997. This is an example of a study case wheri the cooperation of the factory management had led to policy and financial s'pport to carry out the activities during the last 4 months of the project" There *",
sign that the activities would be sustainable in the future.
"
(a) The sixth factory (H.R. silvine) was in the category that the project could not carry out the activities as planned. Thi producti on was 24
hrs continuous, the machineries produced loud noise at all time. The management allowed project staff and Rp to conduct small group education and one-to-one discussion at all time. Iange gt""i, education were conducted r-2 time a week during t hr lunch b;ak, and it was possibre to conduct the education, There were some special occasiongctivities where printed materials and condoms were
58
Btablishing HIV/AIDS progrmrs in the Wortqlace
Chapter IV Outputs of the Factory Intervention
distributed. volunteer.
This was the only factory that did not have peer
Large size factories can be summarized into 2 categories
(1). Five factories (JVC, Matsushita, Fujisu, Tostem, Thai and Fujikura) allowed the project to carry out long-temr activities continuousty owing ttr" project time. There was close collaboration among personnel -*ug"-"ni, Re and Fow. Plans were set to have heads of sition attending large group education followed byproduction workers. All 5 factories alloweJ2 f,ridi"i"g twice a week during the regular working hours. other activities were carried out as appropriate. Coordinating units unit were set up and FOW were able to station in the factories. Peer Volunteers were recruited and trained as planned. All activities were canied out according to HIV/AIDS prevention program including policy to carry on the activities continuously.
(2)' The sixth factory (Seikosha) was the factory that the activities could not be carried out during the economic crisis towards ttre tast stage of the project. Large number of workers were laid-off and new workers were admitted. There was a plan to have project staff and Rp implementing Hrv/ArDS prevention education for I hour during the orientation of new workers. This factory did not the project goal even if there were some special activities, ,-ull group 19ach
discussion and peer volunteers' activities. 4.3.2 Obstacles.
Besides management problems within the factories, other extemal problem was the economic crisis in the country which started to have impact on the operation of the factories in August, 1997. However, the impact on factories in Navanakom was on the positive side because products of factories in Navanakom were for export. Some factories had to expand their production in response to the national policy. Accordingly, the production had to conform with quality contol and intemational standard (ISO) resulting in a negligence on social activities. As a consequence, some delay on the implernentation ,rf HIV/AIDS prevention education occurred.
since Septembet
In large factories, large group education was almost

1997. The altemative
that majority of workers could leam about AIDS-. The workers could then learn about HIV/AIDS in depth from printed materials distributed and from personal consultation plus other media ttrat were produced by the factories- For medium size factories, the activities were carried out sometimes. While other factories set their priority on their production, Rohm Apollo factory realized the importance or iuvlelDS-prevention
cancelled was to organize special activities
59
Chaptr
tV Outputs ofthe Factory Intervention
education and had arranged the time so every worker had received the education. Peer Volunteers were also recruited and trained and peer vohmteer forum was formed at the same time as other factories. ti"rt activities occuned during October - December 1997.
4.3-3 Adjustment of plan using
active and passive strategies.
Since external factor had impact on the schedule of the HIV/AIDS prevention activities in the 12 intervention factories, the strpervision and monitoring of the project was an integral part in achieving the goal of workers' education. The mechanism was :
o r o
Supervision and monitoring by IIEST and project Staff.
Monthly report on the activities in the regular meeting of Fow, IIEST and project Staff.
Assessment and evaluation Population (OPTA).
by outside experts liom office of
The above mechanism led to the adjushent of active and passive strategic plan in order to be flexible and suitable to the role and nature of each factory.
l)
Active strategy.
during the last 4 months of the project due to the increase of froduction during economic crisis. FOW had a-djusted the education activities by setting up education board every week, motivated Rp and pv to plan for special campaign such as poem competitior5 question - answer box on HIV/AIDS and sexual relation, VDO show during lunch break, exhibition on HrV/AIDS, distoibution of condoms on different occasion such as safety week, 5C's week, and increased activity of small group discussion" in - depth education and consultation. For medium size factories that could not carry out the activities as planned and could not recruit the volunteers due to tonflict about labour in the factory, the overtime incentive to increase production dgring breaks and the noise from the machine operation interfered with both lige and small group education. The education was then given on the bus for the workers and in the dormitories provided, with th; distribution of printed materials and condoms.
In large factories, large group education was not smoothly implemented
60
Establishing
HMAIDS programs in the Workplace
Chapter IV Oulputs ofthe Factory Intervention
2)
Passive strategy.
By setting up consulting and education telephone service called "Hope line", and arranged to have 2 Fow gwing large group education as requested by the factories such as while waiting for raw material to arrive, during the inventory rotation of workers or during machine broke down.
Table 9. Results of large, small and one-to-one HrV/AIDS education. Julv December 1997
o peration in
Factory
I
Jan-Apl.
l2 I M"vI Aue
997
3 Sept.-Dec.
Education
Activities
Small group discussion, conversation.
Medium size
TANACOM
NTTSTJKO hrs.
Round once a week. 2 once aweek 2

hrs.
Time
Overtirne Overtirne
No.
I I
daylweek. daylweek
K.D.K. zuJIKURA
CARTON
once a week
working
hrs.
2 dayVweek
hI.
-->
once a week
working
hrs. an<l Saturdav
I hr.
l-2 time of
week I hr. each 3-4 times during Oct.Nov. 1.30 hrs
each.
I I I
daylweek
H.R.SILVINE ROHMAPOLLO
Lunch
break. workinl3 hrs. ancl
daylweek daylweek
<>-
<+>
overtime
Large size
J.V.C.
l-2 timeVweek,
2 hrs each. once a month, 2 hrs each,
Overtime
2 days/week.
MATSUSIIITA
TOSTEM SEIKOSFIA
**kl"t
hrs,
tdayv*"rk
2 days/week. 2dayslweek
2 dayVweek.
once a week.
2 timesAreek,
working
hrs.
orientation. working
for new workers,
ruJITSU FUJIKI]RA
once a week,
2tus
once a week, 2 hrs
hts. _
working
hrs.
td"yvweetc
Largegroupeducation
Orientationofnewworkers
Small group discussion and conversation Large group education intemrptod.
6l
Chapter IV Ouputs of the Factory lntervention
4.3.4 Workers receiving
HMAIDS education.
trained and conducted the education activities as expected (except one medium size factory that did not have volunteer.)
Among 6 medium size intervention factories alnost all of the workers in 5 factories received large group standard education and small Soup discussion. The average ntrmber of education activities received was 3-6 times per worker. They also received enough printed materials and condoms. The only factory that the training did not-reach target was H.R. silvine because there was no peer volunteer. The education activities in this factory covered only 23 per cent of the workers.
Table 10 indicates the number
of Rp and pV
For the large 6 intervention factories the education activities covered one-third of their workers. The average number of education activities received was I per worker. All 6 factories had Rp and pv. sufficient number of printed materials were received. seiko p.c. Ivas the factory that the number of education did not reach the target due to the expansion of production at the beginning of the project and faced with economic uisis and financial loss towards the end of the project when there was a lot of workers fumover.
In conclusion, the education activities in the medium size factories was more successful than in the large factories which had many times more labour force. Even if longer time than this would be canied out 80 per cent workers might not be covered. The stratery should be adjusted by using large group (30/group) education to motivaie awareness, fotto* by small goup discussion and consultation then special activities such as exhibition, advertisement boards, voice mail, prinied materials etc., then regular newsletters. These activities should have some impact on the workers' attitude and behaviorn because from baseline r*"y in 1996 it was found that by average these workers had higher education level (degree, associate degree, professional training) than those in the medirrm
size factories.
62
ESablishing HIV/AIDS hograms in the Workplace
Chapter IV Outputs ofthe Factory lntrvention
Table r0 Summary of education activities during January

according to factory size.
Factory No. workers.
Per cent
Decembe
1997
Average no.
Education
Receivedr
ofeducation
received
pl
Condoms Printed distributer naterials (oieces)
No.
of
RP.
No. of PV.
Medium size
HR.
Silvine*
250
277
23
4.6 3.0 2.6

5.1
820 335
4,40Q
2
2
Carton Tanacom
r00
76 100
100
4,700
3,700
1,300
l3 t2
376
418 539 900
387 1,323 961 680 4,500
4
2
Nitsuko
ll
t2
KDK Fujikura
Rohm Apollo
4.3 2.5
3,300
1,200 18,600
)
2
100
83. r
l9
67
Total Large size

TOS 0em
2,700
3.6
t2
1,30o 1,500
55
2.0 0.9
1.0 1.3 1.2
710
293
371
6,400
t2 t2
ScikoP&C*
JVC Matzushita
23 69
7,200 4,400
1,600
2,103
2l
7 3
3,070
3,500 8,930 20,407
3l
)1
T2
1,466 323
1,910
t2
I4
Fujikura Fujitsu Total
7,400
6,900 33,900 52,500
1.0
l7
79
35.
r.2
2.4
5,073
91379
l3
25
Grand total
23,163
59.1
146
Education received means large group education (30/gr) small group discussion (l-5lgr) or one to one @nversation. 2. Averqge number ofeducation.received includes large group education plus srnalr gro'p discussion plus special activities. + The education received did not reach target.
l'
4.4 Cost - investment of the project

The analysis of cost investment was carried out using Micro-economic model developed b1 AIDS/FHI (1996). They were divideJ into expense for preparation before the intervention activity, operation cost, research assessment and evaluation and cost of condoms donated *d dirttibut"d in the project.
The money spent during the l8 months operation to total 4,237,980 bahts. _ Preparation cost was 15 per cent, operation cost was 65 per cent, which was higest research assessment and evaluation was 15 per cent and the condoms donated was2.4 per cent (table l1).
Establishing HIV/AIDS prograrns in the Workplace
63
Chapter
fV Outputs ofthe Factory Intervention
Table 11. Expense items of the Project

Major expenses
Preparation before factory intervention Research assessment and evaluation Expenses Per cent
630,900
750,000
t4.9
17.7
Operation cost
Condoms (donated)t
2,755,680
101,500 4,237,9E02
65.0 2.4
Total
Note
I
2
condom was 1.75 b x 52,500 pieces. The factory expense was not included.
Table 12. Per oent of expense in operation cost.

Type ofexpense
Salary for FOW and coordinator Salary for other project staff Per cent
22.8
20.3 6.0 8.4 6.8 23.5
12.3
Committee meetings on management

Seminar of factory management and partrers
Supendsion, surveillance and monitoring Materials and equipment for training
Office rent and equipment
Total
(2,755,680.00 bahts)
100.0
of the budget. The salary of factory outreach workers was 2J per cent compensation and honorarium was 20 per cent (table l2).
When the proportion of the expenses was calculated, it was formd that the expense for education materials such as equipment, printed matters, handbooks for training and materials used for display and exhibiiion qlme up to 24 per cent and
The expense for preparation before the intervention began was similar for -:Sryi size. and large size factories. The preparation activities included survey of the factories, development of curriculum and training of project staff GIEST, FOW, RP, PV) mounted up to 52,567 bahts per factory.
64
Establishing HIV/AIDS progrurs in the Workplace
Chapter
Mutputs
Table 13. Cost analysis of the operation.

Result of the education
Large factories
5,305
Medium size
factories. 2,760
Number of workers receivine
Hry/AIDS prevention education.

Number of intervention factories. Number of condoms distributed (pieces). Number of printed materials distributed (pieces) Number of resource persons trained. Number of Peer Volunteers trained.
Expense for preparation per factory. 6 33,900 6 18.600
5,073
4,506
t2
79 52,567
t2
67 52,567
Operation expense per factory.
29r,142
15l,47l
Expense per head of worker. In calculating the operation cost per worker it is necessary to include the expense paid by the factories such as over time paymlent for workers to came for
the training and the time that factory staff and workers spent in the intervention activities- one medium size factory was selected as an example for the calculation. Since Rohm Apollo was the factory that all intervention activities were implemented within the 3 months duration as planned and
;
l) 2) 3) 4)
had clear cut training of 33 rounds for 1.5 lrs of education, using standard curriculum, covered g7g workers or 100 per cent.
Had2 trained Rp. Had

13
PV.
The factory management had policy to carry on the education afterwards. All there activities took place during september November 1997. Assessment of behaviour changi foisafer sex will have to wait longer. This change would not yet take any effect by the KABP surveyed in November - December 1997 as
conducted at the same time as other l
factories.
Operation expenses of Rohm Apollo Factory.

The estimation of expense by the factory depends on the number of workers receiving the standard Hry/AIDS preventioniducation (l t/, - 2 hrs), training of peer vohurteers (at least 10 workers), the consultation by nplut least i worker), and one personnel management staffor head of production to coordinate the intervention activities continuouslv.
Establishing
HMAIDS
Programs in the Workptace
65
Chaptr
Mutputs
For Fow and field coordinator, the expense was calculated from 3 months working hours. It was found that the total expense was z}g,szg bahts, the factory paid 186,318 bahts, from contribution 23,[10 bahts for 900 workers receiving the HrV/AIDS prevention education which was 232.g0 batrts per worker. The expense paid by the factory was 207.02 bahts per worker receiving
standard large group training (table 14).
Table 14. Operation cost of Rohm Apollo Factory

Items
I
In kind contribution
Cash
Total
1. Time spent
l.l Pessonnel mqnagernent (Salary x time x no of months) : 100,000 x 0.1 x 3 : 2,10.00 bahts.
1.2 RP (salary x time spent x months) = 30,000 x 0.05 x 3
711 t0
7,110
4,500
:4,500.@
balrts.
4,500
24,000
15,000
1.3 FOW (salary x time spent x months) = 24,000.00 bahrs. 1.4 Field coordinator 10,fi)0 x 0.5 x
8,000 x I .0 x 3
24,0N
15000
1,500 3,800 137,000
15,000.00
bah;
2. Training cxpeIu e in the factory.

2.1
RP. (haining time x perdium x workers): b/d. x l: l,!00.00bahts.

(training time x perdium x workers)
bahts.
3 x 500
1,500
2.2PV.
19:3,800.00
I x 200 x
3,800 137,000
2.3 Workers. (training time x (OT+production lossyhl no. ofworkers: 1.50 hrs x 100 batrts x g7g = 137,000 bahts
3. Facilities and management. 3. I Consulting ana cooroina@

(2 x 3 m2) x 150 bahts/m2 x 3 mo. = Z.fOO.OO Uants3.2 Training facilities = 33 = 33 x 1.50 x 5,000.09 bahts. 3.3 Communication = tOO tants x f S time = 1,500.00
2,700
5,000 1,500
2,7N
5,000
1,500
ro@
bahts.
4.
Training materials = 1F00 bahts
4.1 Condoms (pieces x price)

bahts.
1,200 x 2
:
x
2.400.00
2,4(n
6,800
2,400
6,900
4.2 Printed material (pieces x price = 680

bahts.
l0
= 6.g00J0
Total Note: l.f"uining*.r-;t

? 3
Cost per worker

timi
to the project.
r86Jfi)
207.02
25.010
2W.514
27.W
232.n
4 FOWwort<cdfirlttime.
RP devoted 5 per cent oftheir
|:y1:lTi*"r*
g:y"l.d. I per cent oihis time ro HrV/ArDs prevention education

ofhis time to Rohm Apollo.
5 Field coordindor devoted 50 per cent
6. Number ofRP and PV were real number. 7 Operation time was 3 months (Sept. - Dec. 199?).
66
Establishing HIV/AIDS programs in the Worlcplace
Chapter V: Outcomes of the Project
Chapter
Outcomes of the Project

The activity of the project for both management and workers in the factories in Navanakom Industrial Park, aiming at factory policy development and change of workers' behaviour in order to facilitate prevention of HIV/AIDS and to live with AIDS patients has been reported in chapter 2. In this chapter, the result of the activities which has been collected by various ways from the beginning to the end of the project will be analyzed (details of the study procedrue will be presented in the appendix) and reported as follow :
Result of the project on workers includes:

Knowledge about HIV/AIDS infection and contact, epidemics and prevention.
o o
Behaviour change leading to safe sex behaviour.
Attitude about HIV/AIDS infection, getting the disease md living with AIDS patients.
Behaviour change, readiness to live with AIDS patients.
Result of the project on the HIViAIDS policy of the factories includes:
r r
Needs and necessity of the policy in the factories.
Attitude of factory management about HIV/AIDS prevention policy of the factory.

changing person.
o Continuity and
sustainability of HIV/AIDS education activities on to safe sex behaviour and living with HIV/,{.IDS infected
5.1 Result of the project on workers.

The data on the results and outcome of the HIV/AIDS education activities on workers were obtained by interviewing 500 and 1,500 male and female workers randomly sampled from medium size and large size factories respectively. The data were collected before the beginning of the intervention activities and after the completion of the project. At the same time the group
67
discussion of male and female workers from medium size and large size factories were conducted to get in depth information on quantitative analysis of the results.
Sampled population.
The factories in Navanakorn Industrial Park that joined the project were 6 medium size and 6 large size factories, with a total number of 8,164 workers in the 12 factories. This number may vary according to the production season. The number of male workers was 4,909 and female workers was 1g,254. The data were collected by interviewing both before the beginning and after the completion of the project. Five hundred workers represented medium size factori", *d t.S00 workers represented large size factories as shown in the table.
.vrare Female
200 300
300 1,200
500 1,500
:,,r:,,:#.iffi....
The sampled population had similar socio-economic status both in the medium and the large size factories. For the male workers, g0 per cent of them were between 25-29 years old and had good education, that is, ti'om secondary school and above. The male workers in large factories had better education than that in the medium size factories. About half of the workers were single, but the workers in large factories the ratio of single workers were slightly highir than that in the medium size faclories. Majority of workers were from the province. The ratio of workers from Northeast was highest and then the North and the Central regions of the country respectively. The male workers had switched their jobs as was found that 50-60 per cent of the workers had worked some place else tefore. For female workers, the socio-economic stafus were similar to male workers, that is the similarity exists between those working in the medium size and in the iarge size factories. More than 90 per cent of fernale workers were below 30 years if age' The ratio of female respondents from large factories were yolnger than those from the medium size factories. About 3 quarters of female workers lnished secondary schools, and half of them were single. Most of them were from the Northeast, the central and the North. Mujorrtv of them had been working at least 2 yearc in the factories. About half of female workers from large factories started their work at these factories while less than half of female workers from medium size factories had worked in other factories in Navanakom before. When the socio-economic status of the sampled workers lvere examined both at the beginning and after the completion of the project, it wa, f;tflr"; they were similar. Therefore only the data after p-j"", completion were presented, assuming sampled workers could ,"pr"r.nt workers from lz intervention factories.
68
Establishing HIV/IDS Programs in the Workplace
Chapter V: C\rtcomes ofthe Project
5.1.1 Knowledge on epidemic and prevention of HfV infection

contact of AIDS.
and
The base - line survey conducted before the beginning of the project on Hfv infection and contact of AIDS indicated that both male and female workers in the medium size and large factories had the correct knowledge on the subject. That is, 80 per cent of workers could describe how the infection occur and be able to mention more than 2 ways to prevent the infection. This was because majority of workers received information on HrV/AIDS regularly. However, more tha:r 3 quarters of all workers, especially those from large faotories indicated their desire to have more knowledge. This might be because the information they received was one - way communication and mostly from mass media such as from television, radio and newspaper as seen in the data presented.
At the end of the project, it was found that the ratio of those
interviewed from medium size factories had increased knowledge on HIV infection and contact of AIDS while no change was obsenred among workers from large size factories.
Beside the change in the ratio of those having correct information
on more than 2 ways in AIDS prevention, it was also found that the workers had correct knowledge and had confidence in the prevention techniques. As was obvious that most of the workers emphasized 3 prevention techniques, that is, use of condoms which was most mentioned, next was to avoid visiting prostitute and avoid using used
iqjection needles.
Use ofcondoms in every sexual act Per cent of workers indicating this technique Per cent of workers indicating this technique is reliable and had used this technique 86.3
80.0
15.4
30.s
81.6 33.0 31.7 42.8 t2.7 16.7
78.1
7.9
Avoid going to prostitute.

Per cent of workers indicating this technique.
31.6
63.3
l1.0
8.8
14.4 14.3
Per cent of workers indicating this technique is reliable and had used the technique.
Avoid using used injection ncedles.

Per cent of workers indicating this technique.
24.2
34.8
27.8
21.0
30.1
Per cent of workers indicating this technique is reliable and had used the techni
22.r
69
Chapter V: Ortcomes of the Project
Participation in the campaign activities.
In the 12 medium size and large size intervention factories there were
23,000 staffand workers. The target of the project was to cover 20,000 staffand workers using all education activities which was close to the total number of all workers. That is, the project hope to educate all workers in the factories.
By interviewing management staff and from interview and conversation with workers, it was found that the intervention factories participated in the project were involved in the export production of electrical pds, steel parts, and the machine kept running 24hrs. The workers in the production line were rotated every 8 hrs, with t hrs break. The factories encouraged workers to work overtime every day including holidays. During working hours the workers must concentrate, work continuously and coordinate their work with others since the working system was line production. Therefore most of the workers, mainly young female, worked 10-12 hrs. a day. Their I hr. recess was valuable time to
eat in cafeteria and rest.
The implementation of HIV/AIDS prevention education can be classified into 3 categories:
l)
chapter. The project staff had to get permission from factory management ahead of time so they could manage to pull certain number of workers from production line without effecting the factory productivity. Most of the time it was done by using overtime and overtime budget provided by factory manager.
Training. This activity was nm by project staff having curriculum, process and steps defined in details as presented in the previous
2)
Small group discussion. The project staffthought this was the most suitable education process for the working nature of the factories where workers had to work in shift. This allowed workers to inquire aboutthe information in details and exchange of ideas and experiences occurred during the discussion. This activity was carried out by FOW and it was expected and assigned to Rp and pV which had been trained to carry on the conversation during their daily living condition.
Special campaign activities. This was done to educate public at large in the form of exhibition on HIV/AIDS in special occasions such L safety weeks, world AIDS day, advertisement board, mail voice etc.
3)
These special activities were organized jointly between partners Provincial Health office, Project Staffand related factory staff.
of
From the interview of 2,000 workers on the education received in the factory, it was found that 85 per cent received their education. This ratio is
70
similar between the medium and large size factories. The ratio of female workers receiving knowledge was slightly higher than that of male. The participation in the education activities for the workers, one worker might participate in one tlpe or more of activities and could be more than once. are shown as fcrllows :
Workers participated in the naining. Workers discussed with PV. Workers participate in the exhibition. Workers receiving AIDS publication
60.5
13.2
70.8
13.9 27.1
24.7 7.6
31.1 53.1
25.4 6.2 35.0

55.
25.8 70.0
73.8
It can be seen that
in the medium size factories could participate in the education activities more that those from large factories except the special exhibition where more workers in the large factories participated.
Workers
Female workers especially those from medium slze factories, had higher ratio of participation then male workers.
Ratio of workers receiving education from factory personnels, RP and PV, were lower than those receiving education from project staff.
r o o
The eduoation process that reached majority

distribution of printed materials on HIV/AIDS"
of
workers was
When the working nature and the Hry/AIDS education coverage and participation of project activities of the workers are considered, it was found that during the time the project staff was conduction the training activities, about one third of the workers were educated, and the coverage was greater in the medium size factories. From conversation with management staffof the large factories it was found that large factories had planned their production 3 months, 6 months or 12 months ahead. This covered production goal and workers involved. It was therefore impossible to let the workers out for HIViAIDS education. To have large group eduoation requires at least 3 months advanced notification. This is also true with other training such as fire prevention which require long term planning. For the medium size factory, the production order was not large and there were laps between each production so the management could plan for the education easier.
Establishing HIV/AJDS Programs in the Workplace
71
Chaper V: Outcomes of the Project
5.1.2
Change of sexual behaviour to safe sex relation.
Safe sex relation of male and female workers is the important objective of the project. The scope of "safe sex relation" covirs the expectation of reduction of number of visits to prostitute by male workers, reduction of sexual partners by male and female workers, use of condoms in sexual relation with high risk partner and bargaining for safe sex such as postpone of the relation or use of condoms. From the interview of the sampled workers, it was found that workers in Navanakorn, both from the medium and large size factories, have high risk in contacting AIDS. These workers were young, most of them were singles, came from family surrounding to live in a free surroundings with friends of the same age, either in factory dormitories or in rooming houses. This environment is inductive to having sexual relation and contact of AIDS.
project was carried out and after the completion following behaviours.
The risk of contacting AIDS of workers.
The assessment of sexual behaviour change to safer sex relation was done by comparing the behaviour of sampled population before the
of ttre project on
. o o o o r o o o o
Risk assessment of sexual behaviorn. Risk assessment of workers. History of AIDS. History of V.D.
Reports on behaviour change.
Sexual behaviour.
Sexual behaviour of singles. Sexual behaviour of male and female workers.
Risk and non-risk behaviour.

Sexual behaviour with prostifutes. Sexual relation with several parbrers.
Use of condoms.
Partnerts communication about sex.
72
Chapter V: Outcomes of the project
1) The risk of contacting AIDS of workers.

The dissemination of knowledge on epidemic ancl prevention of AIDS as carried out according to the project strategies placed emphasis on dissemination of information leading to motivation of thinking, consideration, assessment of situation in order to make decision about sexual behaviour. Therefore studies were conducted to find out how the target workers assess the situation and their risk in contacting AIDS.
Risk assessment of sexual behaviour.
Survey conducted before the beginning of the projeot indicated that the factory workers in Navanakorn had good basic knowledge about AIDS and could use their knowledge in assessing risk of sexual behaviour correctly. As most of the workers interviewed indicated that having sexual relation without using condoms were of high risk as compared to other sexual behaviour as indicated in the table.
Sa oli6s
'B$qft.,b iaviour
I
0 n t]
Kissing with nose. Kissing with mouth and tongue. Hugging. Mutual was tabulation
59.3 87.5 25.0 79.4
55.3 79.8
18.8
58.5 81.:t
58.4 78.0 21.9 80.4
2r.0
70.0
78.6
Not using condoms u,hen

sexual relation with.
have
100.0 100.0 100.0
- Singer / waitress. - Prostitute.
99.4 99.4 99.1
99.4 99.4 97.5
99.8 99.8 99.2
- Friends.
Risk assessment of workers.
Eventhough workers assessed risk in sexual behaviour in the right direction, but when male and female workers, both manied and single, from medium and large size factories assessed whether they had high risk in contacting HrV/AIDS, 70 per cent of workers fiom large factories indicated they had no risk while 60 per cent or more from medium size factories assessed that they had no risk. The comparison before the beginning and after the completion of the projects are:
73
bfq!ryW$o lS/
wo$ers.
infection
of
1...i,,,r,1
61.4 73.7
no risk in
-
Ratio of workers assessed that they had AIDS.

- Before the beginning
"611agting 66.7 72.2
75.1
72.4 76.2
After the completion of the proiect.
83.
r o r
The per cent of workers assessed that they had no rir;k were higher from the beginning of the project in all groups.
The workers from medium size factories assessed that their risk was higher that those from large size factories.
Risk assessment of male workers was lower than female workers both from large and medium size factories.
The important points in implementing HIV/AIDS educatir)n were to get the workers to know and being aware that AIDS problem is closr: and everyone are at risk of being infected, the prevention is to have safe sex relation. Majority of workers assessed that they had low risk could be because they thought they already had safe sex relation because they only have sex with threir spouses or have not had sexual relation before. The male workers reported that they ceased to visit prostitutes and used condoms so they were confident that they had safe sex relation and part of them were ignorant be cause they had not yet been educated to know about risk chances. This is seen from conversation with one female worker.
"I now know rnore about AIDS. Before I never thought I had any risk because I only sleep with my husband, and I trusted him, After the training I realized that I had chance of contacting AIDS. I can't be sure my husband does not sleep rruith other women."
Blood test for HlV.
Eventhough tlic sampled workers assessed that they had no risk in contacting AIDS, but one-quarter of the workers had their blood checked for HIV at least once. Male workers had their blood r:hecked when applied for jobs or whcn having their annual check up. trss than 20 per cent had their blood checked because they thought they had high risk
74
Establishing
HMIDS
Chapter V: Outcomes ofthe project
behaviour. Female workers had their blood checked at antenatal clinic

when they were pregnant.
Ilistory of AIDS.
From the thought that male workers especially single male workers might visit prostitute more often and might contact srD which is closed to Hrv infection, the history of STD was then studied. It was found that
about 13-14 per cent of male workers from medium and large size factories had contacted STD before. More than half of this group
indicated the contact was from 6-10 years ago and
if they had STD they
bought the medicine by themselves.
Report on behaviour change.
Only 25-28 per cent of male and female workers from medium size factories and 16-21 per cent of male and female workers from large factories assessed that they had risk in contacting Hrv. About 3 quarters of these workers changed their sexual behaviour. only half of female workers from large factories reported their behaviour change. This may be due to the fact that they were already married and could not change their husbands behaviour.
2) Sexual behaviour.
Since the proportion of single workers was slightly higher than the married workers, therefore this group was specially studied as compared to all other sampled workers.
Sexual behaviour of single workers.
About 40 percent of single male workers did not have girl friends and 58-60 percent of them agreed with pre-marital sexual relation. Seventy-nine and 71 per cent of single male workers from medium size and large factories had sexual relation respectively. For single male workers who reported they had girl friend, 38 per cent frorn medium size factories and 50 per cent from large size factories indicated there had sexual relationship with their girl friends.
Before the beginning of the project the ration of male and female single workers who agreed with premarital relation was similar to that after the completion of the project, that is, about one half of single males and one-fourth of single females agreed but there was an increase in the proportion of single males who had sexual relation with their girl friends, especially those from large factories.
Esablishing
HVAIDS
75
When the sexual behaviour of single workers from large and medium size factories are considered, it could be concluded that the workers did not resist premarital sexual relation and alter HIViAIDS prevention education was given, the premarital sexual relrfion inoreased due to sexual behaviour change of single males in avoiding prostitute visit and having safer sexual relation with their girl friends.
Proportion of single workers agreed with premarital relation.

- Before the project began. - After the project completed.
59.1
25.3 20.8
5:1.0
23.3 30.3
58.0
60.2
Proportion of single males with girl friends reported having pre-marital sexual relation.
- Before the project began. - After the proiect completed. 27.7 38.3
2:t.9
4tt.5
Change ofsexual behaviour.
The implementation of HIViAIDS prevention education was to

change sexual behaviour to a safer sexual behaviour, that is, to reduce sex partners, reduce visit to prostitute, use of condoms every l,ime they have
risky sexual relation and discussion about safe sex relation
between spouses. The results of the education were assessed by cornparing sexual behaviour change before and after the completion of the pro.ject.
Reduction of visits to prostitutes.
The sexual services were offered both directly and indirectly. To in the number of visits to prostifutes by male workers during the project activities was to compare the proportion of those reporled to have sexual relation with prostitutes, bartenders, Karaoke girls and strangers that they met during rhe 12 months before the interview. The results indicated there was no reduction in the number of visits to prostitutes by male workers fiom mediun size factories but there was an increase in having sexual relation with stranger they accidentally met. For male workers from large factories, there was a reduction in the nunrber of visit to prostitute but not the indirect sexual service girls. when the type of girls the male workers had sexual relation with the last time, it was found that there was a reduction in the number of prostitutes they visited as shown in the table.
assess whether other was a reduction
76
Establishing HIVIDS Proglarns in the Workplace
Per cent of male workers havins relation with - prostitutes - service girls in barslkaraoke - strangers accidentally met Per cent of male workers having sexual relation with prostitutes the last time.
15.4 8.5 8.5

6.1
16.3
14.6
9.4 6.0 7.9 4.7
8.4
13.7 5.1
7.0
8.2
6.4
Use of condoms.
Even if the number of visits to prostitutes or risky sexual relation might not decrease, but when the use of condoms was considered, it was found that male workers from medium and large size factories reported they used condoms every time they had sexual relation with prostitutes or with strangers which was considered risky. when this was compared with the survey done before the beginning of the project, it was found that there had been a number of male workers, eventhough not so numerous, reported they used condoms only sometimes and not every time they had sexual relation with prostitutes.
Partner's Conversation about safe sex.
During the interview both male and female workers were asked whether they discussed with their spouses about using condoms during the last time that they had sexual relation, either with spouses or lovers (annex). It was found that about 30 per cent of male workers from medium or large size factories had discussed about using condoms with their partners, Less than i5 per cent of female workers reported they discussed about using condoms with their partners. The results were similar for both surveys.
However, even if there was only low proportion of female workers who reported their discussion with partners about using condoms, from the conversation it was found that by teaching how to use condoms properly through the HIV/AIDS preverrtion education, brought about the courage of female workers to talk about and touching condoms and made up their mind that if they knew their partners had sexual relationship with other girls they would ask them to use condoms in their sexual relation.
Establishing HIV/AIDS Programs in the Workplacc
77
Chaphr V: Outcomes of the Project
This was evident from the conversation with 19 yea$ old female worker from medium size factorv:
"previously I thought it was embarrassed to touch condom, even dare to look at. But after I saw the project staff made flowers condoms, then it was not so dirty and asked them to teach me. Now I I will use it, if it is necessary"
conversation about sexual relation between husband and wife.
of HrV/AIDS prevention education, encouragement on conversation between husband and wife about sexual relation and persuasion for husband to use condoms with other parbrers was promoted. The assessment of using knowledge to apply in practice was to compare the proportion of male and females interviewed before the beginning and after the completion of the project. No difference was observed.
course
sexual
In Thai society, it was not popular to use condoms among husband and wife, either to prevent pregnancy or prevent infection. During the
Per cent of workers reported having sexual conversation and improvement.

- Before the project.
- After the 56.6
44.9 50.6
45.5 46.6
40.1 47.5
58.9
Per cent of workers thought their partners had sexual relation with others.
- Before the project. 9.6 4.4 47.5
33.
After the project. Per cent of workers having conversation

-
8.3 4.t 28.2 27.4
43.r
42.6
about being infected through partner. - Before the project. - After the
project.
with other partners.
31.3
70.9 76.6
70.5 65.7
3l.g
Per cent of workers asking their partners to

use condoms
- Before the - After the
project.
project.
l7.l
70.3
6.6
13.8 68.2 5.5
7t.l
60.7
78
Establishing HIVIIDS Programs in the Workplace
Chapter V: Outcomes of the
hoject
5.1.3 Attitude about AIDS patients.
HIV infection, AIDS contact and living with
In the 12 intervention factories, there was more than factories reported there were workers in their factories being infected with Hrv and having symptoms but did not expose themselves and were observed by the management staff and fellow workers, as evident in one of the interview ofthe management staff.
"Several persons thought that some one
in the
contacted AIDS, but we told them we can live with him. Personallv not think it was bad and did not have to reveal he had AIDS."
factory I did
From the interview it is obvious that the assistance to AIDS patients was rendered indirectly by ignoring the problem and let the worker continued his work.
for the factory workers to have real knowledge about the mode of
infection of HIV/AIDS, hoping they would not have prejudice and afraid to work with Hrv infected person, which would lead to isolation of them from the society. The survey conducted after the completion of the project indicated that the education given in the form of training, small goup discussion and special advertisement activities had created interest about AIDS in the workers daily living. About 80-90 per cent of male and female workers in the medium size factories reported there was conversation about HIV infection and contact of AIDS.
The implementation of HIv/AIDS prevention education intended
The experience of workers who had known HIV infected and AIDS contacted persons were only 22-31per cent among workers who reported they had seen or had heard about infected persons. Most of the infected persons they heard about were outside Navanakom Industrial Park. only l-2 per cent of workers from medium size factories and 5-6 per cent from large factories reported they knew there were infected persons in their factories. The attitude of workers about infected person was positive in terms of sympathy but not enough to render any support. one fourth of male workers, which was slightly higher than female workers, said they were neutral and a few said they were afraid. From these interviews it could be concluded that the auitude of workers about AIDS infected persons was on the positive side. More than g0 per cent of workers thought they could share working room, eating with and travel
79
along with infected persons. These behaviours are normal behaviour that
they do with other workers. It is obvious there was no disorimination against AIDS infected persons. But with more intimate treatment such as taking care when they were sick, comfort and hugging, only more than 50 per cent of workers said they were happy to do.
Change of attitude to live with AIDS infected persons.
When the attitude and behaviour of workers about HIV/AIDS infected persons were compared before the beginning and after the completion of the project, it could be concluded that the project had created the conversation about AIDS in the factories and workers could tell whether there were infected persons in their factories more than before the beginning of the project when there were no conversation on AIDS or about infected person in the factories. The interview after completion of project indicated there was an obvious increase in the number or proportion of workers who indicated they could carry out activities with infected persons the same as normal persons as compared to the proportion before the beginning of the project.
:iufected persors.
of workers reported they could carry out the activities with infected persons.
Proportion
Shnre'rrvor{dug place. - Before the beginning of the project.
,,:,Si $
etedpersons. l-, t,',.,1 - Before the beginning of the project. - After the completion of the project.
- After the completion of
the project. -
74.4 94.2
74..4
65.7 95.2
' 'ij' ' .i:::i
79.3 91.3
,':.,, ,:. I
70.7 91.7
:
84.8 90.3 95.2 66.s 68.5

j ril,l
72.6 86.4
;,';,;...,';::,
;Ttaye}ftl:ffi1*5.t$umecar.
",-,i,'Ji
76.8 80.3
,i
76.9 80.6
i
H Takiry*ar&"Qiihepatients.
- Before the begiruring of the project. - After the completion of the project. - Before the begiruring of the project. - After the completion of the project.
9r.2
96.8
94.4 96.1
a a.
.:
.i,,,1, .
91.8 95.5
.....
'.'58.2
g goffirt=ssit,hugging.
g llave sg4ual
Per$on$.
,,;,
: .,
67.9
59,4 67.0
i,*t:i.
.:::. i,.
70.0 69.8
.:
63.2
66.1
,
....i.i..tr- -'. ,,:.r,,-.:i :
.. ri . ,
- Before the beginning of the project. - After the completion of the project.
61.9 68.9
relation with .infected

1.7
6i3.0 70.4
t.7 1.2
L,
oa,.l
65.8
':, - Before the beginning of the project. - After the completion of the project.
2.1
1.3 1.6
2.0 0.5
80
Establishing HIV/IDS Progranrs in the Workplace
Chapter V: Outcomes of the project
5.2 Results of the project on AIDS in the factories.

The major objective of the project conceming workplace indicated the project would strengthen the potential of unit in factories in prevention and solving Hry/AIDS problem.
The project involved in coordination with three major organization, i.e., Navanakorn Personnel Management Forum, networks of Management Staff of
intervention factories and network

intervention factories.
of
workers and volunteers
of the 12
5.2.1 Organization of Navanakorn for Social Management Forum. (NPMF)

The Navanakorn management personnels involved in the project was Navanakom Personnel Management Forum, composed of personnel managers from factories in Navanakom and representatives from private organization and govemment organization served as members of the Forum. The objective ofthe Forum was to work together in solving labour and welfare problems among factory members. There were 160 factories and 72,000 workers under their responsibility. From their reports on their activities, conversation and interview in depth of sampled population, the project then carried out the activities to promote the potential of the Forum as follows:
1)
Strengthening the Foruni potential on policy developmenL
Before the beginning of the project, the project staffhad contacted the Navanakorn Personnel Management Forum and invited the Chairman
of the Forum to serye in the executive committee of the project. This committee offered advice and consult about the project activities. This was one of the strategies in strengthening the Management Forum by allowing them to take part in the project's policy development and management of the activities on HIV/AIDS prevention education in their factories. Both policy and management guideline developed could be
used in the operation and evaluation in the project leading to improvement and selection of suitable policy later on.
2)
Strengthening the Forum potential on management and operation planning.
During the project operation, the project had sent project staff to be member of the Forurn. The project staff participated in the Forum meetings, presented ideas and created awareness among the forum
Establishing HIV/AIDS Programs in the V./crkptace
81
Chapter
v: Ortcomes of
the Project
members about the need to have policy and guideline in the factories about HIV/AIDS prevention and care. The Forum membefs took part in setting up the qualification and selected 12 intervention factories to represent medium and large size factories to participate in the project and also coordinated with 12 factories to select RP to work in their factories. This stategy forced the Forum members to be involved in the decision making and activities of the project. This strategy also induced other member factories besides the 12 intervention factories to be involved, informed and participated in the decision making about AIDS problems in the factories. This resulted in a spilled over to other factories to initiate HIV/AIDS activities in Navanakorn Industrial Park. The Chairman of Navanakom Personnel lVlanagement Forum was interviewed in depth after the completion of the projeot before his term ended. FIe stated that the Forum would carry on the HIV/AIDS prevention and living with AIDS activities in the member factories. The new chairman of the Forum also confirmed this statement.
5.2.2 Management organization of the 12 intervention factories that

participated in the project. In the management structure of the 12 intervention factories, the personnel management section was responsible for the welfare of the workers. There were Labour Relation and Welfare Unit, Education and Training Unit, Health Care Unit and Safety Unit in every factories. Therefore the project staff had contacted the personnel managers about management and operation of project activities. The personnel management section was the focal point for potential management of the factories to develop policy and operation plan on HIV/AIDS prevention and care. At least there must be policy, organization and personnels to coordinate and support AIDS education and mechanism to carry on the outreach program in the form of vohmteers. When the results of the project activities were assessed and comparison made between factories, assuming the project were ready to strengthen the management organization of each factory equally, and from in depth interview of the factory management, it was found that there was some limitation in the faotories resulting in different degree of readiness to participate in the project activities on HIV/AIDS prevention and care in the 12 intervention
factories.
1)
Size of the factories.
In medium size factories, the management staff could manage to carry out the HIViAIDS prevention education better than large factories.
82
Establishing HIV/IDS Ptogrms in the Workplace
For example, large group education and small group discussion were carried out according to plan. The reason that size of factory was important in the management of education ptocess was because of the
production size and production process were different between the large and medium size factories.
Medium size factories

Large size factories.
76.6
19.8
24.4 6.8
2)
Types of factory owner.
The factories in Navanakorn Industrial Park were export production factories receiving Board of lnvestment support. Majority of owners or major share holders were foreigners from Japan, Korea, Taiwan. These foreigners had different policy in personnel management. This had certain impact on the management of HIV/AIDS prevention education activities. Among the rnedium size factories, the results of the activities in medium size factories owned by Japanese were close to the target set by the Project while Taiwanese owned factories the results were very low. In these factories the workers could participate in the activities using their own spiue time such as to look at the exhibition.
3)
Lack of awareness by management staff.
When the information about project activities was presented to factory management staff, both in the Navanakorn Personnel Management Forum meetings, through discussion with management staff of medium and large size factories, and distribution of printed materials was not enough to convince the management to be aware of HIV/AIDS problem. In factories where there was no HIV infected workers, the management was not concerned about the problem and did not cooperate fully with the project activities. As seen from the result of the medium size factories, the results of the activities at the beginning of the project did not reach the target set because the management did not provide time for workers to participate in the activities. Btrt when there was HIV infected person in the factory, the management changed their attitude and encouraged the workers to participate in the activities as seen in the table.
Establishing HIV/AIDS Programs irr the Workplace
83
Chapter V: Outcomes of the Projcct
Duration of Project
1-3 months
Aetivities.
Educatipn,
1,165 1,832 1,197
Distribution:,
561
,,
'
discussion
539
4-6 months 7-9 months 10-12 months
449
2,100
3,000 5,161
4,110 16,335 20,200

15,965
542
519
1,826
At the end the project, conversation in depth with personnel management of 12 intervention factories was organized. One factory had
changed the personnel rnanager, but every one expressed that their factories had policy on HIV/AIDS prevention and care, even if the written policy did not exist.
of
l)
2)
There would be no blood test for
HlV.
Infected workers will not be discharged from work. The regulation of Ministry of Labour and Social Welfare will be strictly followcd. HIVIAIDS prevention education will be included in the orientation
of new workers.
3) 4) s)
Will support and promote activities of
Peer Volunteers on AIDS
and Forum or other organization and network of AIDS, volunteers.
WiU have refi'esher's course for large group

appropriate to the production activity of the factory.
of
workers,
5.2.3 Network organization of workers and volunteers in the

intervention factories.
12
ln
each interucntion factory participated
in the program, there
were volunteers to give information on HIV/AIDS. These volunteers obtained their knowledge on HIV/AIDS prevention education from project staff, 12 volunteers per factory. From the interview with management staff it was found that these volunteers had formed forum to work together. They had term of reference for each person, submit working plan for support from management staff having RP in the factories to support thcir activities.
84
Size and rurmes of factories.
Names of forum.
Number
of
members.
Medium size factories. Carton Optical

K.D.K. Fuiikura Nitsuko Thai TakacomThailand Rohm Apollo HR. Silvrne
Larq:e factories.
Friends of CartonAIDS volunteer Forum
13
KDK relation Forun AIDS volunteer Forum

Clear Skv Forum
12
ll
t2
19
VolunteerRAET
JVC AIDS Volunteer Forum
JVC Manufactwine Matsushita Electric Work. Tostsm Thai

Seiko P&C.
t2
L2
AIDS Volunteer Forum

Friends Forum Relation Forum For Friends Forum
Threads Forum.
Fuiikura Thailand Fuiitsu Thailand
t2 t2 I4 t7
Some of the volunteer forum had continuous activities in the fonn of a colurnn pubtished in the factory newsletter to disseminate information on HIV/AIDS such as in Tostem factory. There were bulletin boards in every factories carried out by the volunteers. Even if it could not be said that such activities would go on indefinitely, from the management interview, there was a tendency that not less than half of the 12 intervention factories were consulting with volunteer organization to obtain some support from factory management. Support from factory management will motivate members of the forum to carry
on the education activities for their friends and colleagues.
&tablishingHMAIDS Programs in tlte Workplace
85
Chapter V: Outcomes ofthe Project
86
Establishing
HMIDS
Chapter
M: Conclusion and Discussion
Chapter VI:
Conclusion and Discussion
1. Studies on the results and impact.
2. Operation Model. . Role of intervention factories in Navanakorn Industrial Estate. o Three strategies offered by the project. . Management tactics. . Analysis of investment.
3. Lessons learned. 4. Recommendation in response to economic

crisis
Establiddng HMAIDS Progams in the Workplace
87
Chaoter Vl: Conclusion and Discussion
Chapter
VI

Projeot on Outreach program is an operation research to test the operation model in the 12 intervention factories in Navanakom Industrial Park, PathumThani hovince. The operation time was 12 months in the community and
operation site, 3 months preparation and 3 months assessment and evaluation, a total of 18 months. The operation time was important factor that decide the result and impact ofthe project.
To obtain the results according to objective
amd expectation,
the project
had utilized the strategies in the National Plan on Prevention and Alleviation of HIV/AIDS 1997-2001 and adjusted into 3 strategies, tested and applied in the operation of the project. Those were strategy on sustainable, stratery on behaviour change through education and strategy on outreach service as discussed in the previous chapter. From the results, it is seen that the project was carried out in the right direction and could be adjusted and applied to other factories in other
With basic knowledge, adaptation of thought and attitude and awareness life style via sexual relation obtained through education and appropriate communication and supportive environment from the
areas.
about healthy and safer
commurity, behaviour change could occur. This chapter will discuss and conclude the suggestion obtained from the results of the operation research on the outreach program on HIV/AIDS prevention in 4 major topics:
1.
Results of the activities in the intervention factories and impact. Operation model.
Lessons leamed.
2. 3. 4.
6.1
Policy recommendation.
Studies on the results and impact.
6.1.1
Results in the intervention factories.
The goal of the project was reached in l0 out of 12 intervention factories, 5 medium size and 5 large size factories that carried out the HIV/AIDS prevention education, eventhough there was no written policy,
88
Establishing HIV/AIDS Programs in the Wor*place
Chapter VI: Conclusron and Discussion
there was a trend that this would be incorporated when the law on labour protection on health and safety took effect in 1998"
The evidence in these factories was the setting up of management unit for coordination and support of HIV/AIDS prevention education in these factories with Resource Persons and support of Peer Volunteers to carry out the activities. The quahty and number of volunteers and network met with project goal and expectation.
The education in the medium and large factories were in large Soup education (not more than 30 workers per group) using standard curriculum, ffid small goup discussion (l-5lgr.) or one to one conversation plus special campaign activities through exhibition, advertisment board, lunch program, voice mail and newsletter etc. These activities were conducted according to the size of the factories and the number met with the project target, that is, there were more than 20,000 workers participated in the activities with an average number of 2-5 participations/worker in medium size factories and l-z participations/worker in large factories.
6.1.2 Product of the Project.

Cturiculum and education techniques used in sfrengthening the potential of govemment ofiicers, resource pelsons in the factories, Peer Volunteers and staffto serve as trainers were composed of 4 ourricula:
1) "Technique
to be HIV/AIDS
trainer
for
Factory Outreach
Workers (FOW) and Resource Persons (RP) in the Factories."
2) "Working with workers" for Health Education Support Team

(I{ESr).
3) "Safe Sex Relation and Understanding Infected

Staff.
Persons" for
4) 6.1.3
Training Technique for HIV/AIDS Volunteers.
Results and Impact.
Two aspects of the impact of the project were studied. The first one was to study change in knowledge, attitude and behaviour of workers to safer sex relation. The second aspect was to measure awareness of the factory management about the need to have policy or guideline on HIV/AIDS prevention and care in their factories.
First aspect. It was expected that after the workers had participated in the HIV/AIDS education activities carried out by Project
EstEblishing
HMAIDS Proglams in the Workplace
89
Chaptg VI: Conclusion and Discussion
Staffand factory perconnels, they would change their behaviour to a safer sex relation. The study was carried out by comparing the interview of workers conducted before the beginning and after the completion of the project which was 12 months apart.
l)
More than 80 per cent of workers in the medium and large size factories had correct knowledge conceming HIV/AIDS infection prevention of more than 2 ways before the beginning of the project,
They received this knowledge through one-way communication media such as television, radio, newspaper. After the completion of the project the ratio of workers educated was 90 per cent. They also had confidence in the efficacy of 3 prevention techniques, these were,
using condom every time they have sexual relation, avoid visiting prostitutes and not using the same syringe with others.
2) More than 85 per cent of workers said they were well informed about the implementation of HIV/AIDS prevention education in their factories and the results were similar between medium size and large size factories by the project. The percentage was slightly higher for female workers as compared to male workers. The number of participation in the activities was greater than I for each worker.
r r o o
Workers from medium size factories had more chance to participate in the education activities than workers in the large
factories except the exhibition. Seventy per cent of workers from medium size factories and 25 per cent of workers in large factories had been trained in the standard curriculum. The printed materials on HIV/AIDS reached and brought about HIV/AIDS informations and knowledge to target workers the most when compared with other means.
Female workers participated in the education activities more than rnale workers.
3) Risk assessment by workers. This should bring about change in sexual
behaviour of workers. But it was found that all groups reported they did not have increased risk in their sexual relation as oompared to the time before the project began. This could be explained by the fact that they were confident since they either never have sexual relation or only had sexnal relation with their spouses. The group that reported having risk, 3 out of 4 workers reported reduction in the number of visit to prostitutes brlt had increased number of sexual relation with strangers they accidentally met, while single males had increased pre-
90
Chapter VI: Conclusion and Discussion
marital sexual relation with their girl friends. There was an increase in using condoms with prostitutes or strangers than the first interview. However, this is not significant.
4) Discussion about condom use between husband and wife. In Thai society, it is not popular to use condoms in the sexual relation between husband and wife, either for pregnancy or infection prevention. During the course of education, it was encourage to have discussion between husband and wife about sexual relation and use ofcondom by husband when he had sexual relation with other girls. No difference was observed before the beginning and after the completion of the project. s) The dialy interest of workers about HIV/AIDS was aroused by the project activities. More than 80 per cent of workers reported about infected workers and AIDS patients, even it orly l-2 per cent had come across such persons. The attitude about HIV infected and AIDS workers was positive. There was no prejudice and indifference between these infected workers and the normal workers.
The impact of the education activities on workers may not be obvious in changing their behaviour to safer sex relation. This could be
due to 2 reasons:
1) The campaign about HIV/AIDS infection and prevention through public media and specific media by the Government had been
continuously conducted resulted in behaviour change in sexual relation among Navanakom Industrial Estate workers before the beginning of the project. These behaviour changes were the knowledge, belief and reduction in the mumber of visits to prostitute and use of condoms when having risky sexual relation.
2) The econornic crisis in the country since August 1997 was rmexpected. The export factories had to change their production
strategies and social welfare activities had to be postponed. Therefore the 2-way education of the standard curriculum had to stop in several factories. The duration of education was cut short for 34 months. The expectation that as soon as the workers were educated they would change their behaviour became difficult because change in sexual behaviour is a sensitive issue and require more than just education. (as mentioned in earlier chapter 5)
Second aspect. The projeot piovided activities to strengthen the potential of management staffof each factory with the same standard. But it was found that there were variation in the limitation and readiness of individual factory in conducting the HIV/AIDS education activities. This depended on the size of the
Establishing HIV/AIDS Progams irr the Workplace
9l
Chaptet VI: Conclusion and Discussion
factory, type of products, awareness of the factories and lack of fore-seeing knowledge of the management staff especially experience about HIV infected
workers.
However, all 12 intervention factories had guideline about HIV/AIDS prevention and care in their factories even if this was not yet written down, that
is.
1. No blood test for HIV/AIDS
for workers.
2. 3.
The infected workers will not be laid out. Rules and regulation of the Ministry of Labour and Social Welfare would be strictly observed.
The knowledge on Hry/AIDS prevention

orientation of new workers.
will be included in
the
4. Promotion and support on the activities of AIDS volunteers and forum

or network would be carried on.
5.
Refresher's course for large Soup of workers would be conducted as appropriate to the production process ofthe factories.
6.2 Operation Model.

The model used in the opration research in Navanakom Industrial Estate depends on the context of Navanakorn Industrial Estates, Management of research project and analysis of capital investment that brought about the operation process resulting in the impact as already discussed.
6.2.1 The Context
of Navanakorn factories.
The 3 specific characters of Navanakorn factories that favoured the project to reach the hypothesis set were:
1) Being an Industrial Estate.

From the survey conducted before the beginning of the project it was found that the workers in large and mediwn size factories were HIV/AIDS high risk population, asing between 1830 years old and most of them were single, coming from family surrounding to live in a free environment with friends of the same age in dormitories provided or in rooming houses. This environment favours sexual relation to occur easily and this brought about risk in HIV/AIDS infection and contact. This group of workers was suitable to be target population in the project and should be worth the investment.
Chapter VI: Conclusion and
Discussio
2)
Navanakorn Personnel Management Forum.
The network of personnel management in the Navanakom Industrial Estate having personnel managers from factories in Navanakorn as members was an offrcial organization set up to solve labour problems and promote labour welfare in the member factories. The strategy of the project was to send Project Staff to contact the Forum and invited the chairman of Navanakom Personnel Management Forum to serve in the Projects Executive committee and then sent Project Staffto be member of the Forum. By participating in the Project's Executive Committee and by presenting the project to members of the Forum to create awareness among the members of the need to have policy or guideline on HIV/AIDS prevention and care in their factories, and by asking the Forum to set qualification and select 12 intervention factories for the project to study were the key points in getting the Forum to be involved in the decision making from the beginning of the project. The impact was expanded to other factories in
Navanakorn
to
carry out similar activities on HIV/AIDS
prevention education.
The Navanakorn Personnel Management Forum was the key instrumental organization to extend the project activities to factory commurity at large.
3)
Management structure in the intervention factories.
factories participated in the project, there were personnel management sections that were responsible for welfare of the workers. There were Labour Relation and Welfare Unit, Education and Training Unit, Health Care Unit and Safty and Protection Unit in every factory. The project staffhad made contact with Personnel Manger of each factory in order to plan and coordinate the project activities before hand. Therefore it could be said that personnel rnanagement section was the focal point in strengthening the potential of the factory management to develop policy and guideline on HIV/AIDS prevention and care in the factories. At least there must be policy, supporting unit and personnel to coordinate and support the HIV/AIDS prevention education and to have program using volunteertr to disseminate the information on HIV/AIDS in the factories.
In the management structure of the 12 intervention
Establishing HIV/AIDS Programs in tlre Workplace
93
Ch4ter M: Conclusion and Discussion
With the above qualification, it could be concluded that the 12 intervention factories were ready to be involved in the projeot activities for implementation of HIV/AIDS prevention education and the project had brought in to the factories the same factors to strengthen the management potential of each factory with the same
standard.
6.2.2 Three major
strategies of the project.
The education activities conducted in the 12 intervention factories. medium or large size, using the same strategies by the project.
1)
Outreach communication strategy by Project Staff.

There were 4 FOW responsible for 12 factories. FOW was responsible for the education activities in 3 factories. The field coordinator was responsible for the support of the 4 FOW.
The FOW were trained by Project Staff and had suitable

qualrty, that is:
Quality: they were trained with suitable curriculum to have enough knowledge and skill to serve as AIDS lecturer or educator or can serve in the education team in the operation site.
Quantity: 4 FOW and field coordinator were suitable number to conduct activities in the field and work as a team efficiently. In large group education, there must be at least 2 in a team to conduct various education activities with participation from the trainees. The efficient work of FOW was obvious to fatory and govemment management, they were convinced that there was a need to have training team with special techniques to conduct HIViAIDS education activities to factory workers.
The special techniques mean professional knowledge and skill in the process of implementing HIV/AIDS prevention education to workers.
r
2)
Sustainable strategies: to develop sustainable activity by strengthening potential and develop structure of coordinating unit in the factories.
94
Chapter VI: Conclusion and Disqrssron
2.1) Potential strengthening of personnels. The activities were development of curriculum for haining of HIV/AIDS educator technique in the factories. The trainees were R.P. of
the factories.
Content of the curriculum. It was obvious and accepted that the curriculum for training of techniques to be Hry/AIDS educator in the factories was suitable for those who work as HIV/AIDS prevention education implementer in the factories. The curriculum placed emphasis on creating awareness, change of attitude, human value appreciation and create goal leading to safe sex relation and living with HIV/AIDS infected persons.
Process of the training. Emphasis was placed on participatory training process, to have two-way communication, develop thinking skill, analytical skill and search for choices. This had impact on emotion" feeling and awareness of risk behaviour leading to participation in solving their own problems and the
factories' problems. This was obvious from the activities of RP and PV.
2.2) Development of coordinating unit in the factories. From expericnce, it was obvious that there was a need to have a coordinating unit to carry on the activities in the factory after the completion ofthe project. The project had developed 2 RP and 10 PV in each factory. The factories had set up coordinating units to support HIV/AIDS prevention education activities in the workplace having RP to support the ouheach program of the PV. The RP and PV were recruited according to the project's target number. RP served as coordinator creator, educator of HIV/AIDS education activities. This lead to official education of the factory by including HIV/AIDS prevention education in the orientation program of new workers and other special campaign activities of the factories. The problem arose when RP acted as inspector of the workers, then the conflict with production section occurred and this could have certain impact in the HIV/AIDS education activities.
The l0 Peer Volunteers (PV) recruited by the factories, received training by outreach education process. The selection guideline was important to the activity of the volunteers. The
95
working time, unoffrcial leader, influencial person, good human relation, devotion and like to work for social welfare were the qualities that would help the volunteers to work efficiently. And if the volunteers came from production section, this will help in the disseminative of the information.
2.2) Professional support from the project. There was Health Education Support Team GIESD composed of officials from the province who received continuous training to strengthen their potential. This team support the factory Rp and pV in technical aspect providing knowledge and consultation material and media" and carry on the HIV/AIDS prevention education activities in the factories after the completion of the project. 2.3) rnstitution sustainability strategy. By strengthening the capability of personnels in the factories, and establishing coordinating unit to serve as service structure in giving knowledge and consultation and to strengthen the potential of government provincial ofiicials to serve as professional supporting unit for the factories, this was the strategy to strengthen the commumty and have community participation and solving their own problems having government to support was one way to have sustainable activities.
3)
Behaviour change strategy. By providing education through various activities during the
project operation such as large group education, small group

discussion and special exhibitions leading to behaviour changes. Behaviour change strategy by providing deep, small, long and sustained education used in the project resulted in the knowledge, understanding and change of attitude about sexual relation of the workers. The index was a reduction of HIV infection through the use of condoms in every visit to prostitute or stranger which was increased and the readiness to live with HIV infected persons. The factories had appropriately handled the infected workers.
6.2.3 Studies on management.
l)
supervision, monitoring and assessment. These are important activities in operation research since there is a need to adjust the operation plan to suit the situation and to assess and study the impact of the project. Monthly meeting was set up to report the
96
Chapter VI: Conclusion and Discussior
activities, supervise and monitor field operation in order to obtain the summary and solve the problems by adjusting the operation plan in the direction that the goal of the project could be reached. The project was evaluated by outside organization in order
to study the results and the efficiency of the operation
research
model comparing between medium and large size factories. 2) Strategy in partnership development for cooperation. This approach was effective and brought about the success of the project. This strategy is recommended for the expansion of HIV/AIDS prevention education in other area. 3) Appointment of Project executive Committee by the Permanent Secretary of Health was the positive impact on the support of the project since it indicated the intention of high ranking govemment officer on the policy of HIV/AIDS prevention. 4) Study on the management structure of the factories including needs, knowledge the workers learnt, readiness of the management staff, problems and obstacles in conducting the education activities. These are basic information required for project planning and arrangement to be agreed upon between the factories and the project. All informations gathered were shared at the monthly meeting and all partners participated in the adjustrnent as occurred during the project activities in order to have suitable operation plan. Even if some factories could not carry out education activities according to plan, it was obvious of the problems that occurred. 5) To set up field station for FOW offrce in the Navanakom Industrial Park apart from headquarter at AIHD, Salaya. The positive impact was that the Project Staff and RP could have coordinating center followed by Volunteers meeting place which was used towards the end of the project. This was convenient and close to the intervention factories. The center was within reach of the workers to came for consultation, it offered some more privacy and served as a center for management staff at different levels from factories and outside to meet and discuss about the project's activities. 6) Tumover of workers was minimum compared to ottrer studies such as graduated AIDS volunteers (GAV). The workers had high education and skillful and the factory management offered appropriate welfare to keep the workers wittt them. The implementation of HIV/AIDS prevention education would be
Establistring HIV/AIDS Programs in the Workplace
97
Chapter Vl: Conclusion and Discussion
carried on with these workers more than those who had lower education. The problem of the project lied on the rotation of govemment offrcials especially at the high-ranking level where it could have sorne effect on the continuity of the project. As was obvious that during project activities there were 3 Pathum-Thani Govemors, 2 Provincial Health Officers and,2 Labour Protection and Welfare Officers. On the factory side, one Personnel manager was changed, one Resotrce Person resigned while other offEcer and IIEST were still working in the area. Besides transfer of policy and willingness of project to the new executive personnels, strengthening of the operation workers should be carried out in order to have sustainability both at the provincial level and at the factory level.
7)
Change of behaviour through education process. The tactic used in this project was the workers had direct education and understanding leading to sexual behaviour change and to reduction of HIV infection as measured by increase in the use of condoms every time male workers visited prostitutes or have sexual relation
with strangers. They were also more ready to live with HIV infected workers. The manager also had treated the infected
worker appropriately.
Large group education with standard curriculum was suitable for medium size factories, allowing enotrgh time for factory management to plan for the education activities ahead and allow the factory to decide how much coverage they wanted based on the efficiency of the production. For large factories, it was found that special campaign activities such as exhibition and printed materials were more effective and covered more workers than large group standard education. The education baokground of workers in the large factories was at the level that they could study by themselves. Large group education was one way to motivate leaming capacity but the curriculum might have to be adjusted to suit the training session during working hours and to motivate only the target workers who could disseminate the education to others.
However, the important factor is to have RP or HIV/AIDS counseling in the factory and have network of volunteers carry on the outreach education among workers. The support of the factory management is the key to success in expanding the education and knowledge.
98
Establisbing HIV/AIDS Programs in the Worlcplace
8) Behaviorn change through education. By creating leaming process for the society using participatory education and two way cornmunication to promote good role model leading to change of life style and behaviour as explained in BASNEF model, should be the major mechanism in giving education to change behaviour. The behaviour change could be sustained if the social environment was favourable. e) Outreach communication strategy. The work of FOW resulted in effective education and this was obvious to both the factory management and govemment administration. They realized that there was a need to have a team of trainer with good technique. The specific technique used in giving HIV/AIDS prevention education to workers and other target group could be developed among Health Officers and Labour Protection and Welfare Officers so they can serve the province, or an efficient NGO could be commissioned to give direct education to workers and resource persons in the factories and organize exhibition and advertisement board, distribute printed materials and giving update information including consultation to factories in the network. This seems to be the right direction to be supported.
t0) The Labour Protection Law 1998 was effective as of 19 August 1998. This law covers safety, and industrial health and
environment in the workplace. As it is stated in phrase no.96 of the law, the workplace having 50 workers or more must set up welfare committee composed of at least 5 representatives from workers. In a workplace that already have labour committee according to Labotu Relation Law the labour committee could serye as welfare committee in the workplace. The welfare committee have function in consulting with employer on welfare for workers, suggest, inspect and control the welfare service rendered by exployers to workers. Therefore welfare committee could suggest any welfare service that benefit workers. The incorporation of I{IV/AIDS protection education to be one of labour welfare is possible. With the cooperation of both government and factories in strengthening the potential of personnels and Labour Welfare Committee in the factories to serve as resource persons and peer volunteers on AIDS. This would automatically bring policy and activities on HIV/AIDS protection education into the regular welfare program of the workplace.
Bstablishing HIV/AIDS Programs in the Workplace
Chaptr VI: Conclusion and Discussion
6.2,4 Analysis of capital investment.

The cost analysis of the project was discussed in chapter Itr using Rohm Apollo factory as an example. The expense of 3 month education activities covered training of 10 volunteers to carry out the outreach education activities among workers, working with one resource person (RP) or IIIViAIDS consultant coming from middle level factory management, having at least one personnel manager or production manager to collaborate in the education activities continuously by grving HIV/AIDS prevention education (1.5 or 2 hrs, standard curriculum) would cost 207 bahts per worker.
From the study it was found that in large factories, training of workers with 2 hrs. standard curriculum covered 25 per cent of the workers. At the end of the project, 85 per cent of workers knew about the project and had the right knowledge about HIV/AIDS. Using various education techniques such as one to one conversation, small group discussion and other campaign activities with the outreach service of the volunteers, it could be concluded that if the implementation of HIV/AIDS, prevention education using standard curriculum (1.5-2 hrs.) is canied out to 25 per cent of tl-re workers, starting from management level, with other special activities and dissemination of correct information, the total coverage could be done if the activities could be carried out continuously.
6.3 Lesson learnt.

Factors leading to success in the factories.
l)
Success is defined as achieving education goal
indices used were

educated.
(l)
in the factories. The Participation level. (2) Coverage of workers
(l)
Participation level is measured by:
r o o r o
100
Long term operation activities. Development of RP and coordinating unit.

Support of vohmteers and network.
Allowing workers to attend standard large group education during working ,hours or overtime by paylng the O.T.
compensation.
Developed policy and guideline on HIV/AIDS prevention and carc in the workplace.
Establishing HIV/AIDS Prograors in the Workplace
Chapter VI: Conclusion atd Discussion
(2) Coverage of workers educated was measured by implementation of large goup education to a minimum of at least 80 per cent of
workers.
Factors effecting success according to the indices used.

These were the character of personnel manager, management poGntial, size of factories, type of products, owners of the business, HIV/AIDS situation and the readiness of the community. These analysis's were the context of 12 intervention factories in Navanakom Industrial Estate, having personnel management responsible for welfare of the workers with labour protection and welfare unit, training unit, health care unit and safety unit working for welfare of workers in all 12 factories. The coordination through personnel managers should be the right approach to have continuity in the factories. Therefore the character of personnel manager is the key to success depending also on the readiness of the community and the above mentioned factors. It could be concluded that:
1) Size
of factories had impact on the coverage of workers eduoated. In the medium size factories, the coverage was higher than in the large
factories during the same time that the activities were conducted. The size of factories was related to the development of management potential because the production process and production size were different between medium and large size factories.
2) Types of owners. Most of the factories had foreigners as major share holders or owrers. They were Japanese, Korean or Taiwanese etc. All had different ways of personnel management and different social welfare system for workers. This had impact on the project activities. It was observed that factories having Japanese as owners were more successful than Taiwanese owned factories.
3)
HIV/AIDS situation and readiness of community. The presentation

of the project to factory management might not be enough to convince them to organize education activities in their factories since they had no experience having HIV/AIDS infected workers in their factories. The good example was one medium size factory, in the early part of the program the results did not come out according to plan. But when there was infected worker in the factory and the wave of HIV/AIDS education activity appeared among factories in the industrial park, the factory management had changed their attitude and promoted all workers to participate in the HIV/AIDS prevention education activities. The development of resource persons, peer volunteers and their net works were fully supported and the factory paid overtime to
Establishing HIV/AIDS Prograrms in the Workplace
l0t
Chaptrr
Vt
workers to participate in all activities within the last 3 months of the project, inspire of the economic crisis of the country.
4)
Character and management potential of the personnel managers. The qualrty of the personnel management was having good hunan relation and well accepted by production manager and other section. Understand the needs of workers for social welfare especially health and safety aspects, have authority to decide about budget. The training stafffound that years of work in the factory had some influence in the
above quality.
In medium and large size factories that the education goal was
not
achieved, it was found that the personnel managers were new comers and could not develop social network to be accepted in the community. Some other factories that had carried out very good activities at the beginning had to reduce ttre activities when there was a change in personnel managers.
In the factories that achieved the project goal, the personnel management had long working years in the factories, had seniority, were well respected by foreign executive director. These personnel managers were able to organize the education activities continuously including budget spent by the factories.
It was important that the production section understand the importance of HIV/AIDS education activities since most of the workers were under the supervision of production management and was responsible for the factory's production goal. Line manager must realize that health of workers had direct impact on production, HIV/AIDS infection could directly effect the production
goal of the factory. Years in factory also indicates the job security of personnel managers.
In extending the HIV/AIDS prevention education to other labour force to it must be realized that choice may not be available to select only factories or workplaces that have all the favourable factors. The suggestion from this project could only be that the factories or workplaces that have more favourable factors may be dealt with first so the success model could be established resulting in attempt for other factories to follow.
cover the whole country,
102
Table 15. Cooperation and coverage of large group education in interuention factories.
Larse size factories Level ofcooperation
El Fr rt)
Medium size factories
p p
t!
M
O
d8
V
a
z x
U
I
v
F
Fi
..1
;) o
F
A A
z
v)
2
x
E &
&
1. Longtermworking
2.
Plan Developed RP. and
3.
4.
5.
6.
7
coordinatins unit. SupportedofPV and net-work Allowed workers to participate in the education during workins hours Overtime payment for education oarticioation Developed policy and zuideline. 80 per cent coverage of large goup standard education
x
x x
Establishing HMAIDS hograms in the Workplace
Figure 9. Situation and readiness of the community.
-->
Continuity
Coverage
I I
of
Safe sex
the activities
relation
t
I
v
Reduction of infection
Appropriate
management
HIV/AIDS Situation and Rediness of the Community.
6.4 Policy recommendation in response of economic crisis.

The rate of new HIV/AIDS infection was decreased after the govemment had announce "National Policy on AIDS". Prevention education and oampaign were widely oarried out all over the country. However, the 2 per cent infection (1997) among drafted yolrng men and pregnant women would result in active AIDS contact in the new feature in every part of the country resulting from accumulated infection during the past 10 years. There was an increasing number of active AIDS infection in Navanakorn Industrial Estate as well.
The economic crisis of the country resulting in increased emotional tension leading to unfavourable behaviour. The prediction that the rate of HIV/AIDS and sexual transmitted diseases will increase including other violent behaviour led the Ministry of Health to set up "Health Intelligent Unit" to conduct surveillance on health related economic crisis. HIV/AIDS infection is one of the
foreseen problems.
104
Establishing HIV/AIDS
hograls in the Workplace
Chapter VI: Conclusion md Discussion
At present AIDS is still among the first few health hamardproblems that the govemment has to pay attention and put effort in solving even during the economic crisis. This disease keeps in creasing in severity. The condition with World Bank Loan stated that the Government will not reduce budget for Hry/AIDS prevention and care and will have more active strategy in solving the problem by prevention of infection, spreading of the virus by infected persons,
freatment and care, welfare for AIDS infected persons and their children.
The factories in Industrial Estate are the place where attention must be paid since it is the place where a large number of population in the reproductive and working age gether and having sexual behaviour at risk to HIV infection. The problem exists in the reduction of budget available, and the management did not the understanding the problem. It is necessary to choose the activity which has the
highest cost-effectiveness.
However, the implementation of HIV/AIDS prevention education in the workplace should have some level of importance such as only in the skilled labour. The outreach program is one of the models which is very useful in AIDS prevention. The recommendation are: 1) The developrnent of parhrership strategy between the government sector, the private sector, the business sector, the community and the academic institution to cooperate and utilize their potential and experience in solving the problems as evidenced from this project. The sustainability of the activity could be obtained both at policy level and operation level. When the common goal are understood, the direction are clear, and then the participation could occur at every step of the activities.
2) Development of government and private personnels potential in becoming HIV/AIDS trainers using specific technique, then implement HIV/AIDS education in different situation and environment efficiently. Promote the development of training team in each operation area, could be the govel'nment, NGO organization or network having experienced academic institution as fbcal point.
3) Support the preparation of the workplace to be aware of the HIV/AIDS

problems by rnotivation through partners, then use real example such as Rohm Apollo case to describe the situation of the need and got ready to have HIViAIDS prevention education implemented to the workers to obtain safe sex relation and prepare to live with HIV infected person.
4) Dissemination of knowledge should be in the form suitable to the gpe of factories. The factories in Navanakorn Industrial Park were factories with standard production system in the form of line production working
105
Chapto VI: Conclusion and Discussion
in rotation during 24 fus and promoted overtime work. This tlpe of factory effect the result the standard large group (30/gI.) education which required long term planning and good coordination between training unit and production unit. There was cost in training and production process. Therefore a more appropriate model and
currioulum should be developed for specific condition in the factory.
5) Government organization having direct fimction in HIV/AIDS prevention and care should conduct a behavioural surveillance on sexual behaviour along with sero-strveillance of the disease among workers in order to keep abreast with AIDS trends and situation. 6) After the Labour Protection law is in effect in 1998 on labour health and safety, AIDS should be one of the topics for health welfare of the workers. The HIV/AIDS prevention education activities could then be sustained and incorporated into the regular system of labour welfare.
106
Establishing HIV/AIDS hograms in the Wortplace
Anrs
I:
Evaludim prroees.
Annex 1. Evaluation process.

.
o
Assessment and analysis of result.
Data collection steps. Data collection method.
Establishing HIV/AIDS Programs in the Workplaoe
Annex
l: Evaluation
process.
Annex 1.
Evaluation process.
The outreach program on HIV/AIDS prevention education to the factory is a study to find a suitable model for dissemination of knowledge on HIV/AfuS prevention among workers in Navanakorn Industrial Estate working in large and medium size factories. The project staff had canied out study, researJh and evaluation in different steps of the activities using 2 indices in measuring the success ofthe project:
l.
2.
sexual behaviour change of target population, that is, workers in the medium and large size factories.
Development of policy and plan on Hrv/AIDS in the workplace.
Data collection steps. The data collection for study and evaluation of the project had been carried out according to the various steps of the activities as follows:
The input into the project. The record of kinds, numbers and quality of all input resources were kep. This includes personnel, material, budget, and activities. The daily report system of personnels, of financial u""o*i and of monthly report of project input was developed and carried out.
The process of the project The record on the process of education to target groups were also kep. This includes training techniques, small group discussion, assessment of the training programs by ivaluation of pr-*Jport tuaining group discussion to assess knowledge, understanding and practice -and uses of various media for training and education.
The output from the project. The record of kinds, numbers and quality of service and products arose from project activities were kept by ,"po.tinl services and surveyed by interviewing workers to study the ratio of workers obtaining the services rendered by the project. This includes participation in the tuaining, knowledge obtained from printed materials distributed and goup conversation with workers about the quatity of services they received. The outcome of the project. Change of knowledge, skill and belief of the workers which were the target population were studied by interview 2,000 workers from medium and large size factories, both before the beginning and after the completion of the project. The important indices used were:
108
Annex I :. Evaluation process.
o o o
Ratio of workers who knew more than 2 ways of preventing HIV infection.
Ratio of workers who had willingness to change their behaviour to reduce risk in getting HIV infection. Ratio of workers accepting infected person in their society.
The effect of the project. The record of behavioural change in prevention of HIV infection of target population were kept by the interview conducted before the beginning and after the completion of the project on.:
r o o
Ratio of workers using condoms when having sexual relation with non-regular partners. Ratio of workers having more than one partners. The policy or plan of the factories to have HIV/AIDS prevention activities in the workplace. This was carried out by having interview of both workers and manasement staff.
Data collection method.
l)
Suruey conducted by interview male and female workers. The 2,000 sampled workers from 6 medium and 6 large size intervention factories were interviewed before the beginning and after the completion of the project using the same set of questionnaires on different aspects as follow:
Part 1. Information on workplace and personal data ofthe workers.
Part 2. Information on HIV/AIDS risk. Part 3. Awareness of the risk and behaviour change. Part 4. Attitude ancl sexual behaviour. Part 5. Attitude on living with AIDS person.
2) Group discussion with sampled workers from medium and large size factories. The in depth information of male and female workers were conducted with 10 groups of workers before the beginning of the project and another 10 groups of workers at the end of the project. 3) Group discussion with management staff. To obtain information on how the management staff treated the workers on HIV/AIDS prevention, policy and planning on HIV infection and contact of AIDS of workers in the factories. The group discussion were conducted both before the beginning and after the completion of the project. The management staff were classified into groups according to factory size. That is, the management staff from medium size factories and large size factories.
109
fuinex
l:
Evaluation process
4)
Group discussion with trainers. These were 5 FOW, 2 provincial health officers and I provincial labotn officer. The conversation was conducted twice, 3 month after the commence of the project and after the completion of the project. This was to assess the process of education to various target groups in the medium and large size factories.
5) Evaluation of the training. The evaluation of the trainers in the project

was conducted by:
Evaluation of FOW and RP in the factories who received intensive training on the technique of education by life skill for 3 days. The evaluation was conducted by having them checking the questionnaire individually at the end ofthe training. Evaluation of provincial health officers and labour relation officers who were partnels in the project by group discussion after the training.
Evaluation of PV in the factories by caried out "Four statiod' group relation activities so the volunteers were allowed to analyze together the result after their training.
o o
Assessment and analysis of the results. The major evaluation of the project at the end of the activities was the data obtained from interviewin g 2,000 workers and group conversation with workers and management staff.
110
Establishing HIV/AIDS Prograns in the Workplace
Annex 2: Data on interview surve\E
Annex2:
Data on interview Surveys of mal e and female workers at the end of the Project
Table 1: Personnal Data o socio-economic stafus of sample population classified by sex and size of factory Table 2: Knowledge on epidemic and prevention from getting HIV / AIDS of respondents. Table 3: Participation in FOW project activities Table 4: Perception of Respondents on their own risk in getting infected Table 5: Ever infected of STD Table 6: Patterns of sex behavior single respondents Table 7: Sex practices and condom use during past
years
Table 8: Partner's communication among married

respondents
Table 9: Attitude and behaviors on living with AIDS

patients
Table 10: Perceived own risk in their sex behavior
Annex 2: Data on interview surveys
Table
: Personnal Data o socio-economic status of sample population classified by sex

and size offactorv
Medium
Female 309 100.0
Male
No. or respondents
Percent total
Lwge
Male
331 100.0 Female
Total Male
Female
190
1,169
100.0
100.0
4.7
43.7 37.4 10.0 4.2
521 100.0 5.0 46.t 37.6 9.4 1.9 3.1 9.2 43.9 36.3 7.5 54.3 43.7 1.0 1.0 28.6 3.3 25.1 43.0
7.5 10.7
1,478
100.0
Agc in yeers
15
19
yean
7.8 34.3
46.5 9.1
5.1
15.3
t3.7
47.5
-20 -Z4yars -25 -29yats

- 30 - 34 years - 35 and over Education attendant
- grade 6 and over - grade 9
41.4
37.8
50.9
28.1 4.8 0.9
3r.9
5.7
9.r
0.6
2.3
t.2
2.1
6.8
6.8 25.2 50.8 12.0 5.2
0.9 2.4 4s.6
0.9 27.5 57.7
2t.l
41.0
11
A
27.0
56.3
10.5 4.1
- grade 12
- vocational school - college and over
4t.4
9.7
r0.1
3.8
3.7
Marital Status
- single
- living with spouse - living separately 51.6
46.3
47.9
48.2
55.9 42.3
1.2
59.7 38.2
1.2 1.0
57.2 40.3 1.0

1.5
0.5
1.6
0.3 3.6
- WidowlDivorce/Separated
Home town
0.6
- Central region
24.7 3.2 30.0 42.1
36.2 2.9 24.3 36.6
30.8 3.3 22.4 43.5
30.4
1.6
31.6
- Southem region
- Northem region
- North-eastem region
r.9
22.1 44.4
21.6 46.4
Duration of work in this
frctory
- Under 3 months 16.8
11.0 8.4
2.1 E.8
3.3 8.0 10.6
4.9
8.1
-3-6months
-7-12months
- more than 1 year but less than 2 years - more than 2 yean
t4.2
7.9
15.3
4.9
16.8 58.9
13.6 20.5 55.0
I1.5
18.6
9.4
r8.3
59.8
r8.0
59.6
45.8
5t.7 42.4 24.2

33.4
Where did you work before this factory

- work here since beginning - In different factories in Navanakom - work else where 36.9 28.9 34.2 32.7 43.4 23.9 45.6
49.1
45.7 28.s 25.8
2r.5
32.9
24.6 26.3
tt2
Establishing
HMAIDS
Annex 2: Data
or1
intrview suvevs
Table 2: Knowledge on epidemic and prevcntion from getting HIV i AIDS
' respondents.
of
Medium
Large
Male
No Ever received AIDS within thc past Percent ofhow to prevent getting HIV/AIDS correctly rt two methods Preventive methods and their
efiectiveness
Female
ofrespondents knowledge yeer selffrom least
190
92.1
(190)
90.0
(190)
309 331 94.8 92.7 (30e) (331) 90.0 80.0 (30e) (331)
1,169 521 92.8 92.5 (1,169) (szr) 86.8 88.1 (r,r6e) (52r)
l,4il8
93.2
(r,478)
87.5
(1478)
Abstinence was mentioned as preventive Method - percent respondents mentioned

abstinence - prcent who believed in method Effec{iveness and ever used it 2. Reiluction ofser partners - percent mentioned this method
- percent believed in method in Effectiveness and ever used it
2.6
(le0)
20.0
(5)
2.6
4.5 (30e) 42s (r4) l.3 (3oe) 2s.0 (4) 80.0 (30e) 15.4 (247) -
5.1
(331)
29.4
(1,169) (521)
8.2
4.2
7.4
(17)
5.1
42.6 27.3 42.7 (e6) (22) (ll0) 1.2 1.9

1.2
(1,478)
(le0)
100.0
(5)
86.3
(331) 40.0 (5)

81.6
(r,16e) (521)
57.1 70.0 (r4) (10) 78.r
(1,478)
50.0
(18)
99.2
3. Condom use everytime of sex acts - percent mentioned this method - percent beliwed in method Effectiveness and ever used
4.
(1e0)
30.5
(331)
33.0
(1,169) (s21)
83.3
it
(164)
(270)
0.3
7.9 32.O 9.5 (el3) (434) (1,160) 0.2 (2) 0.7 0.2 (l) 1.0
0.1
(1,478)
Normal scrual intercourse (not hard sex)

- percent ruentioned
(l)
0.9
Q)
0.9
5. Abstain from having sex - percent mentioned - percent believed in the method effectiveness and ever used it
6.
1.1
(le0)
(30e)
-
1.6
(33r)
(1,169) (521)
(1,478)
Masturbation
- percent mentioned - prcent believed in the method Effectiveness and wer used it
0.9 (331)
100.0
(1,169) (521)
0.6
0.6
0.5
(3)
31.6
42.9 100.0 (3) (7)

14.4
14.3
(1,478)
42.9
(7)
7. Abstain from having sex - percent mentioned
with CSW
lt.0
(30e)
8.8
(1e0)
- percent believed in the method Effectiveness and ever used it 63.3
(60)
1.1
(34) 2.6 (30e)
31.7 (331) 42.8 (lo5) 1.2 (331) r2.7 (331) t6.7 (42)
(r,169)
(168)
2.6
3t.7 13.7 (521) (1,478) 50.3 13.4 (165) Q02) t.2 (521)
t6.9
2.6
8. Do not use private thing - percent mentioned
with PWHIV (re0)
(1,16e)
(1478)
- percent believed in the method effectiveness and ever used it
9. Do not use syringe with others - percent mentioned - percent believed in the method Effectiveness and ever used it
24.2
27.8
21.0
22.5
(re0)
34.8
(30e)
22.1
(1,169)
30.1
(s2r)
26.1
(1,478)
28.0
(46)
(86)
(246)
(88)
(332)
113
Anno< 2: Data on interview surve)6
Table 3: Participation in FOW project activities

Medium
Male
Number of Rcspondents Percent ofRespondents who know there
Wes FOW proJect in their frctories 190 85.8
Female
Male
331 84.9
Large Female
Total
Male
Female
3(D
91.9
I,169
88.0
521 \tnt 85.2 88.8 37.8 6.1 2.8 9.6 t.7 1.9 29.t 11.5 13.4 5.3 5.3 t.7 5.3 59.3 50.6
34.9 6.4
4.1
Percent of sourcc of knowledge

- frain provided by project personnel - converse with FOW personnel 60.5 8.9 70.8
t7.l
10.0
13.9
24.7 4.5
1.8
-IE&Cbyvolunteers
- converse with volunteers -
4.7
t3.2
2.1
7.6
1.5 1.2
25.4 3.6 2.5 6.2 2.8 0.7 35.0 7.0 8.7 6.8 3.5 2.1 5.7 55.1 22.9
7.8 3.2
1.8
IE & C by Resource persons converse with Resource persons watch exhibition watch P.R. Board attend luncheon Special program received voice mail
3.2 25.8 11.6
4.9 9.0 27.1

15.5
3l.r
t4.4
8.2 4.5
J.J
33.3 8.8
22.6
6.8 8.9
- participate in the contest on - sent question Q and A
AIDS motto
23.3 7.8 9.0

6.1
tt.1
7.0 4.7
2.6
7.3 70.0 60,5
1.2
participate in Q & A during factory
21.3 73.8 50.5
4.2
53.1
3.0 9.0
59.0 28.7
exhibition
45.0
- received pamphlAs - received condoms
Table 4: Perception of Respondents on their own risk in getting infected

Size
offactory
Laree Female
Medium
Number ofrespondents Percent ofR. receivcd ofno risk Percent ofR received ofno risk by
Total Male
Female
lvlale Female Male

r90
73.7
309
72.2
331 83.1
1,169
78.2
szl
79.6
\n8
77.0
(r42)
thcFollo$ing reaso[r - having sex with spouse only

- stop going to CSW - do not have drug injecteo
- use condom everytime - never had sex - others Percent of respondents who reported ever IIad blood testing
Q22'
27.9 0.0 5.9 2.7 51.3
Q76'
26.1 20.3 8.0 8.3 10.9 26.4 24.4
(er4)
25.9
(418)
(1,136)
26.3 0.0 8.9
3l.l
23.2 4.2 13.4 7.0
0.0 9.6
0.8 54.2 9.5 21.7
2r.l
21.0
t2.2
24.2
27.8 21.3 6.7 10.0 9.6 24.6 23.2 52.t 28.9 19.0 15.7 r9.0 23.1 r3.2 29.0
l.l
53.7 10.0
22.2
Percent ofrespondcnts who reported ever IIed blood besting by number oftest
- onoe
- twice
- more than 2 times Reasons for having had blood testing - having risk behaviour - physical exam before e,lrtrance to the
50.0 32.5 17.5

20.0
22.s 20.0 15.0 22.5
64.0 24.0 12.0

1.3 5.1
53.1 27.1 19.8 13.6

17.3
68.5
67.7
2t.7
9.8
1.2
22.0
10.3
1.2
9.9
12.7 55.2
8.8 12.4 58.5
factory
- annual physical check up
- pregnant/ANl - others
I1.5
69.3
24.7
12.3 32.1
t2.8
2r.0
l9.r
lt4
Establishing HIV/AIDS Progrdns in the Workplace
Annex 2: Data on interview survevs
Table 5: Ever infected ofSTD

Size
offactory
Medium
Male
Number ofrespondents Percent evcr infected of STI) Percent evcr infectcd ofSTD classified by Period - During the past l-5 years
- During the past 6-10 years Percent of& ever infected STD by type 190
14.2
Female
Large Male Female 331
Male
Total Female
309
5.0
7
u6e
1.3 5
r3.6
33 48.5 51.5
26
46.r
53.9
100.0 0.0
100.0 0.0
521 r4.4 59 47.5
1,478
2.2
12
100.0
t4
42.9
I
101.0
2l
9.5 9.5
s2.5
353
22.9
(r2)
0.0
of Senice
- Drug stores - Health center
33.3
t4.3
14.3 14.3 14.3
tt.4
14.3 14.3
- Govemment hospital - Private clinic - Private hospital - Others
t4.3
14.3
:
28.2 76.7
52.4 16.0 77.4
50.0 50.0 21.2 56.0
ri.r
33.3
37.1 19.4
(l)
22.6 61.4
Percent ofR, perceived they had risk of Getting HMAIDS Those who perceived of him risk Have had changed sex behaviors
25.3 77.1
(48)
(87)
(53)
(248)
77.2 (l0l)
(435)
Table 6: Pattems of sex behavior single respondents

Size
offactory
Large
Female 697
Medium
Total Male 281

Female 846
Male Female Male

Number ofrespondents Single respondents by type oflover r do not have lover r have lover - have lover - having lover
- having fiance
r00
149
t8l
41.4 49.7 0.6
8.3 60.2
39.0 46.0 3.0 12.0 58.0

8.3
58.4 30.2 3.4

8.1
62.0 29.0 2.6

6.5 30.3
40.6 48.4 1.4 9.6 59.4 9.1 24.8 l2.l 8.5 45.5 74.7
6r.3
29.2 2.7 6.7 28.6 0.0 0.0 0.0 0.0
Percent ofsingle respondents had prenatal sex Percent ofsingle male classified by degrees of scxual relation - fust talk" no touch - touch hands, hngging
- mutual masturbation, nothaving sexual intercourse - having sexual intercourse Perccnt ofsingle make having had sexual
20.8
9.5 23.8 11.4 5.7
26.7
13.3 13.3
38.3 79.6
49.5
7r.9
0.0 0.0
Intercourse
(e8)
(r68)
fumex 2: Data on interview surveYs
Table 7: Sex practices and condom use duing past years
Male
No. ofrespondcnts 190
Medium
Female
TolL Large Female Male Female Male

331
Size
offactory
3(D
1,169 521
l,{18
Perccnt ofR reported ofhaving sexuel intercourse during the past

yeer
with:
16.3
csw
girl
- Bar/karaoke
8.4
13.7
- Someone I met by chance

- Friend - Fiancey'Love
- Spouse
Percent ofR, reported ofcondom use Everytime with dilferent parfners iluring the past year
- csw - Bar/Karaoke girl - Someone I met by chance - Friends - FianceeA,ove
21.6 23.6 53.2
0.0 0.0 0.0 0.0 0.6 48.5
9.4 6.0 1.9 14.8 26.3 47.4
0.0
0.0
0.0 0.0 0.3 39.7
ll.9 6.9 10.0 r7.3 25.3 49.5
0.0
0.0
0.0 0.0
0.4 41.5
100.0 100.0 100.0 65.5

11.3
100.0 100.0 100.0

57.1
- Spouse Last scx ect within last yeer - csw - Friend

- Inve / Fiancee
2.0
0.0 4.0
19.5 1.3 273

5.1
100.0 100.0 100.0 61.1
0.0
3.2
17.4 1.5 444

5.0
12.9
0.0 3.4
t7l
4.t
16.3
':o
2.3
49.5
470
629
22.6
46.3
- Spouse Percent ofR, et the lest sex act have Been convinced to condom use Percent ofR. intended to use condom Everytime when hatl sex with - csw
- Bar/karaoke girl - Someone I met by chance - Friends - Iove / Fiancde
23.2 43.2 29.0
10.9
0.3 39.9
23.0 u.3 29.4
0.7
41.9
10.5
30.0
15.2
9.2
94.7 96.8 88.9 71.0 31.1

2.1
- Spouse
96.8 96.8 94.8 90.3 65.4 15.2
97.9 98.2 91.2

72.E
35.6 2.4
98.3 98.5 96.7 90.5 65.2 15.8
97.3 97.7 90.0 72.2 37.7 2.3
98.7 98.2 96.3 90.5 65.2
r5.7
116
Annex 2: Data on interview survls
Table 8: Partner's communication among maried respondents
Male Female Male

No of married respondents
91
Medium
r54
Size
offactory
Larse
Female 465
Total Male
148
238
Female
6t9
48.3
Pcrcent of R reported of wer talked or conrult with spouse ebout sex.
58.9 50.6 46.6

4.4 33.1
4.1
47.s
51.3
4.2
Pcrcent
spouses
of R who
sex
thought their
else
hrd
42-6
wilh enyone
40.2
Perccnt ofR rcported ofcvcr talkcd with rpouser ebout the chence of getting AIDS from her/him Perccnt ofR who ever requested spouse to use condomwhen having sex with rnyone else.
31.9
76.6
27.4 5.5
65.7
29.1
68.4
6.6
68.2
60.7
5.9
62.6
Esablishing HIV/AIDS Programs in the Worlcplace
tt7
Anner< 2:
Dda on inlerview suvgts
Table 9: Attitude md behaviors on living with AIDS patieirts

Size
lvlale Fenale Male

No. ofrccpondcntr 190 85.8
Medium
30!t
89.3
offactory
Large Total Ivlale
Female Female
Percent ofR. reportcd ofpeople in factory evcr talkcd about AIDS during the past year Percent ofR. cver known somsone who got AIDS Percent ofR ever known someone patients - people in the same family - people in the same company - worker inNavmakom - acquaintance
33r 92.7
LJ69
91.8
s2l
l,4ilE
91.3
m.2
22.6
23,2
3r.7
22.4
25.r
26.5
0.0
2.2
2.1 1.0
0.0
97.8
8.2 88.7
2.7 5.4 2.7 89.2
2.7 6.8 3.4 87.1
1.7 4.2 1.7 92.4
2.6
5.4
4.6
87.4
ofR rcported offeeling Towrrds AIDS patients of PWItrV

Percent
- need some help 2.2
- rympathy - just riebt

- afraid - dislike - others
4.2
22.2 r7.8 0.0
15.6 on activities 94.2 84.8 95.2 68.5 68.9 2.1
0.0 74.3 8.2
l1.3
1.0
5.2
2.7 54.0 23.0 12.2 2.7 5.4
0.7 60.5 19.2 12.8 2.4
4.4
49.6 22.7 r4.3 r.7 9.2

92.3 81.9 9s.7 69.3 69.8 1.5
2.s
0.5
&.0
16.5 12.4
2.0 4.6
PcrcentofR rttitnde
witb P'|YA
sit in same office
eat same table sit in the same car
cae provided when ill - caring the patient - having ser( tvi& PWA
95.2 86.4 96.8 67.9
67.0
91.3 80.3 96.1 69.8 70,4
91.7 80.6
v2.4
81.8 95.8 66.5
66.1
95.s
66.1
65.8
0.5
t.6
t.2
0.7
Table 10: Perceived own risk in their sex behavior
Male
No. ofrespondenb Percent of perceivcd of low riskwith the following Actr
- dry kiss - freh kiss - hueeing - muhral rrasturbdion - having sex with single, karaoke withont condom - having seJ( with CSW without 55.9
Medium
30t)
Size offactory
Larse
Female
Total 521
1,47E
Female Male
331
r90
1,169
2l.l
87.3
69.0 31.5 93.2
58.4 26.9 91.6
60.1 34.7 90.5
57.4 24.E 90.0
61.9 33.8
91.0
girl
condom
- having
ser(withfriendwith condom
1.6
0.0
0.9
0.9
t.2
0.7
ll8
Establishing HIV/AIDS Progrf,ns in the Worlglace
Annex 3: Group discussion - in depth interview.
Annex 3:
Group discussion - in depth interview.
1. In-depth interview: factory management staff
2. Group 3. Group
discussion: Resource Persons on HIV/AIDS of the factories (R.P.) . discussion: Factory Outreach Workers
(FOw).
4. Group discussion: Male workers. 5. Group discussion: Female workers. 6. Questionnaires: Filled by Peer Volunteers (PV) in
the factories.
Annex 3: Group discussion - in depth inlerview
Annex 3
In-depth interview: Factory management staff
Objective of the study. To study the direction and operation plan in prevention and control of HIV/AIDS in the workplace after the end of support from "Outreach program on HIV/AIDS prevention." Method of study.
lnterview of factory management staff in depth was conducted. The management staff from the 12 intervention factories who were responsible during the participation in the outreach program on HIV/AIDS prevention education were individually interviewed on the following aspects:
l.
2.
a J.
Characteristic and management of the factories.
Policy on health and safety.
Attitude of management staff on the impact of factory production by infected workers.

The reason the management staffcooperated and supported the project activities.
4.
5.
Policy ideas and operation activities on HIV/AIDS of management

staff during the project operation.
6.
Policy development and planning on HIV/AIDS prevention after the completion of the project.
Using the operation model of the project for other the workplace. Implementation of HIV/AIDS prevention education to workers, needs for support from outside organization and financial support for the education activities.
7. 8.
Results of the study.
l)
Characteristic and management of the factories.
Six large size factories were involved in the production of electronic parts, computer parts, electrical supplies, color television and doors and 120
Annex 3: Group discussion - in depth intewiew.
window frames. These were Japanese investment. There were more than 1,500 workers working in each factories. They had education level from secondary school to university level but mostly were secondary school graduates. The labour welfare offered by the factories were social security, life insurance (accident and health insurance) health care, bonus, diligent rewards, food service, transportation and some factories also provided dormitories. Health problems that occurred were general sickness and general accident (not from work). These were similar in all six factories.
six medium size factories produced electronic parts for computer, electrical supplies, only 2 factories produced telephone parts such as telephone circuits, PABX and telephones. Eighty to 100 per cent of the production was for export. small portion was for local use. These factories were more than l0 years old. Most of them were Japanese
investment, only one factory was Taiwanese investment with Italian and American partnership. The number of workers in each factory were 150999 workers. The workers education level was from first secondary (grade 9) to university level. Labour welfare includes social security, life insurance (accident and health), health care bonus, diligent rewards, food service, transportation. Some factories also provided dormitories. Health
ptoblems include general sickness such as influenza,

amenorrhea, backache (not from work).
headache,
2)
Health and safety policy.
Large and medium size factories provided free annual physical checkup to all workers. Factory environment was checked. There were health stations with full time nurses, doctors attending at least 2 hrs/week. Health promotion was done through annual sports day. No blood check for HIV/AIDS was performed on workers. The management staff indicated it would be
(1) Violation of human right. (2) Even if it was checked, it would not be revealed. (3) There was clear policy on blood check and the infected person can still work as normal.
3) Attitude
of management staff on the impact of factory production by infected workers.
Management staff in medium and large size factories indicated no impact on production process would occur it there were infected workers in the factories, but in line production, efficiency would be effected because the infected workers would be sick and out of work more often
12r
than normal workers. One management staffsaid. workers, production process might be effected."
o'In
factory with fewer
4)
The reason the management staff cooperated and supported the proiect activities.
Management staff from medium and large size factories indicated the
project would be useful to the public and would be health promotion to workers. Two of the management staff said'the workers knew every little about HIV/AIDS, after the project activities they know more about it."; "Plenty of informations on HIV/AIDS are coming in to the industrial factories. Most of the workers are from provinces and know nothing about HIV/AIDS prevention. With close to 10,000 workers in our factory, it is important to educate them otherwise it could be problem in the future."
From factory management staff, the following pro- and con- can be
concluded:
Pro:
- All project staffwere devoted to the project.

- Workers had more knowledge about HIV/AIDS and the management staffs were motivated to be aware of the importance of the problem. - There were more organizations to support the project, especially
govemment agency.
- The education process was good in implementation, presentation technique was good, clear and easy to understand. One of the management staffsaid "this project is useful to the public, developed human potential network."
Con:
Not enough motivation for workers, not attractive to workers.
- Coordination with health ofiicer and govemment agency was not good enough.
Factory management staffshould be informed at least one month ahead about the activities so they could plan ahead.
- There should be monthly meeting between Project Sta{f and factory staff so summary could be presented to the factory management for clear urderstanding.
5)
Policy ideas and operation activities on HIV/AII)S of management staff during the project activities.
The management staff of the medium and large size factories said there was no definite policy on HIV/AIDS prevention and control in their
122
factories, but would incorporate this topic in the orientation of new workers. Support to RP and PV activities would be continued both on education and exhibition. The form of activities would be discussed.
Two management staff from medium size factories said "AIDS activities were incorporated into the regular program. AIDS forum was set up and the activities was carried out by RP and PV continuously." Another management staff said "'We are drafting AIDS policy but has not yet been submitted for approval."
One of management staff from large factory said "We will definitely have AIDS policy. We only wait for factory policy for this year. This topic will be included in our health policy. There is a plan on monthly AIDS education for 1998 to be carried out by our volunteers."
6)
Policy development and planning on HfV/AIDS prevention and control after the completion of the project.
Since all 12 intervention factories had not yet developed definite policy on HIV/AIDS prevention and control, it is not possible to discuss their activities.
7)
Using project model as operation model in the workplace.
management staff from medium and large factories indicated there should be consultation with RP and PV on the form of the activities. They might use the same process or only some parts of it such as incorporate HIV//AIDS education in the orientation of new workers, no blood test for HfV, set up problem boxes, distribution of printed materials, set up
All
consulting service, and have workers and staff trained by the project to carry out the activities.
8)
Needs set up
for outside support on IIIV/AIDS prevention education and offunds for support.
Management staff from large and medium size factories thought outside support from related agencies such as HEST, AIIID, Provincial Health Officer and related organization are required including update infbrmation on HIV/AIDS. The financial support to be set up would depend on appropriate time
used and the number of trainees trained.
r23
Annex 3.I : Group discussion: Factory Resource Persons (RP)'
Annex 3.1
Group discussion: Factory Resource Persons (RP)-
Objective of the study.

of factory resource pefsons (RP) was organized in order to summarize the activities on implementation of HIViAIDS prevention education to target workers via various media and activities, that is,
Crroup discussion and conversation
the male and female workers and also other related activities.
Method of study.
The conversation was organized into 4 groups with 5-6 RP per group. All 24 RP were from 12 medium and large size factories'
Results.
The conversation was taped, typed and summarized as follow:
Reason for the success of RP activities.
1.1 Training, study tour
and results.
RP from medium and large size factories were trained and went on study tours twice. Results from group discussion that the training and study tour were very useful to RP.
Training on technique to be trainer on HIV/AIDS prevention at Pueng Wan Resort in Kanchanaburi Province let them to have clear understanding about HIV/AIDS on mode of transmission, prevention, and attitude about living with AIDS infected person including confidence of RP in transferring the knowledge to others. One of the RP said "This training is like we are armed with knowledge."
Technique of professional presentation using talking poster was thought to be good model by RP from medium and large size factories. They thought this model was good for small group discussion where every page of the media could be used correctly. In large group discussion, only some pages of talking poster were used as examples, with distribution of
Establishing HIViAIDS hogams in the Workplace
r24
Annex
3. I :
Croup discussion: Factory Resource Persons (RP).
printed materials. Therefore talking poster might not be fully utilized as it should be. However, RP still thought the training was useful and as one RP said "This training is like we are
using our weapons."
1.2 Impact of RP activities.
Reasons and feelings in becoming RP.
RP from medium and large size factories thought they were selected to be RP by the management staff because their duty and position were appropriate to the project activities. Some RP expressed their feelings that they volunteered to be RP because they wanted to know more about I{IV/AIDS. There were some difference in RP opinion:
(1) Some RP from large factories thought RP should be those working close to workers such as head of production section while personnel management should be only coordinator. (2) Project staff should contact management staff and develop their understanding and acceptance before the beginning of the project. One RP from large factory said "It is diffrcult to reach the management staff, but after the management accept the project, they can then develop policy together with govemment and private organizations. Bringing in finished formula is not as successful as it should be."
(3) RP from medium size factory "It is a duty, I am happy to be consultant and make myself useful, at least I can protect myself."
Responsibility to the Project.
During the year of the project activity, the factory staff and workers participated in the project, gathered and organized a forum, developed brochures on AIDS and distributed to the workers, having RP from large factories as consultant. The activities slowed down later on because of lack of motivation. One RP said "it is like a ball being bounced, once falls down it needs more driving force, we can't do it all by ourselves." RP. from medium size factories served as coordinator between project and management staff, as consultants for PV and workers who participated in the project and organized advertising board, brochures for HIV/AIDS education, distribtrted condoms and organized orientation of new workers having HIV/AIDS prevention education as part of the orientation.
t2s
Annex
3.1 :
Group dtscussion: Factory Resource Persons @P).
Project continuation and supports from related organizations.
RP from large factories expressed the willingness to carry on their activities with the support from related govemment and private organizations working on AIDS and also from management staff.
expressed that the HIV/AIDS prevention education would be carried on by incorporating the subject as part of the orientation for new workers. The support on printed materials, condoms and list of names of supporting organizations were requested including lecturers and experts on the subject and infected persons who volwrteered to serve as lecturers.
RP from medium size factories
4 Lessons learned from the project. 5 Suggestion if

estate.
the project would be carried out in the industrial
RP from medium and large size factories thought if the activities would be carried out in the industrial estate, the following points should
be considered:
r r o
6
The management staff should be well informed, agree with the project activities and prepare everything before the beginning of the project.
The number of intervention factories should be increased, since there were more factories expressed their desire to participate in the activities.
Training of RP should be carried out without honorarium, since all of them were willing to cooperate with the project.
Selection and potential development of RP with efficiency.
RP from large factories expressed that being good RP depends on individual. Everyone could become good RP. The supporting factors were factory's policy, working characteristic of the factory that could allow convenience and support to RP in carrying out the HIViAIDS activities.
RP from medium size factories said RP should be those working close to workers such as head of the section because this could make the job easier. There should be meetings among RP to discuss and solve their problems together.
t26
Annex
3.
I : Group discussion: Factory Rsource Persons (RP).
Other suggestion.
Summary of suggestions by RP from medium and large size factories:
r r
o
The project should work with 3-5 factories for 3-6 months at a time then tum to other factories. This will allow more frequency in reaching the workers continuously.
Project staffshould be more capable and attentive. There should be 3 months or annual follow up after the completion of the project.
Annor 3.2: Group discussion: Factory Oufeartr Workers (FOW).
Annex 3.2
Group discussion: Factory Oufieach Workers (FOID.
To summarize the activities of FOW in implementing HIV/AIDS prevention education to workers in Navanakorn Industrial Estate.
Method of study.
Data were collected by group conversation with FOW on subjects related
to their work.
Results.
t. Eflicacy
of the project.
o Achieving the objectives.
r
o
Role and participation of FOW in the success of the project.
The success of FOW. Personal character and quality of FOW. Selection system, training monitoring of FOW. Cooperation from factories.
r
o
Lessons learned from working in the factories.
r r r
Working experiences. Appropriate techniques.

Other suggestion.
Results of the project.
1.
Elficacy of the project.
l.l
Achieving the objectives.
128
EstablishingHIV/AIDS Progms in the Worlqlace
Annex 3.2: Group discusston: Factory Outreach Wotkers (FOW).
FOW thought the main objective of the project was to educate 20,000 workers using different education techniques such as large group education, small group discussion about safe sex behaviour and preparing to live with HIV/AIDS infected persons. The 12 months project activities was to short to work with workers in the 12 intervention factories. It was not possible to really change the workers' risk behaviour on HIV/AIDS infection.
1.2 Role and participation of FOW in the success of the project. The role of FOW was to organize small group discussion on HIV/AIDS and living with HIV/AIDS infected persons. Set up
exhibitions and advertising boards on HfV/AIDS and collaborate with RP on different activities.
When FOW were asked to assess their success in carrying out their it was found that the success was only satisfactory. The important factors were the understanding of factory management about the project was not clear and also the roles of FOW and RP in the project were not clear.
activities
2.
The suecess of FOW.
2.1 Personal character and quality of FOW.

FOW expressed that suitable FOW should have at least bachelor degree in any area, having some experience and should be single for the flexibility in working hours is required. The character, they should have good human relation, lively, reasonable, must be devoted and love to work for the public.
2.2
Support, control and monitoring the project.
FOW were temporary staff of the project hired at 8,000 bahts per month. Living and working quarters were provided in the field station in Navanakom lndustrial Estate.
The project prepared FOW by set up trainings and study tour for FOW according to the techniques in becoming HIV/AIDS trainers and educators, techniques in consultation, using of "talking poster" and study tours at Care, CLIST, Wat Praputhabart Num Pu and Suan Santitham.
FOW said they could perform better if more provided and the working system should be team work.
Annex 3.2: Group discussion: Factory Outreach Workers (FOW)'
2.3 Coopefation from factories: Large
and medium size factories.
FOW expressed that there was no difference in cooperation from large or medium size factories. The cooperation depends on the acceptance of the project, workers and working system. "Sometime the management cooperated but the production section was too busy'"
Lessons learned from working in the factories. 3.1 Experience with factory management staff'
No idea was given since FOW did not have any contact with
management staff.
3.2 Experience with RP.
To work with RP, it was important to have continuous relationship with RP, be intimate yet polite and humble with them. Objective of the project must be clearly explained.
3.3 In working with PV, FOW expressed that in the selection of PV should place the emphasis on their devotion and love to work for the public. From experience it was found that majority of volunteers were selected by management staff and they felt they were forced to do the job and had no devotion in working with HIV/AIDS prevention education. The collaboration with
volunteers had to be through RP which was not flexible.
3.4 Experience working with workers in the line production system' FOW thought giving large group education was more effective,
both in quality and quantity, than other techniques.
3.5 Other suggestions.
FOW thought precaution should be made in
1) The project staff should not live in the same place. Personal conflict may arise resulting in bad impact to working
cooperation.
2)
Instruction from Project Staffmust be clear and systematic.
130
Annex 3.3: Grouo discussion: Male workers
Annex 3.3
Group discussion: Male workers.

The outreach project on HIV/AIDS prevention and care is an operation research. During the project activities there were quantitative and qualitative data collection. Quantitative data collection was interview of 2,000 workers before the beginning and after the completion of the project. Qualitative data was group conversation with workers before and after the project. The objective of group conversation was to observe whether there was any change in knowledge, attitude and behaviour of workers on HIV/AIDS prevention and control and their participation.
Method of the study.

Group conversation with male workers was to select male workers age 1549 years old, both single and married. They must be those who had participated in the project activities. Five-6 workers were selected by the factories for group conversation.
Factories Single Large Medium
Male workers.
Mar:ried
Results of the studv.
l.
Knowledge, attitude and belief about HIV/AIDS.
l.l
Medium size factories.

workers either single or married had correct knowledge, understanding and belief about HIV/AIDS on the following subjects:
Majority
of
Cause or mode of infection. they knew that the important mode sexual relation either between female and female, male and male, or male and female. The infection occured when there
of infection was
131
Annq< 3.3: Group discussion: Male workers.
were contamination of vaginal mucous or semen through ripped sex organ and bleeding. The infection occurred through contamination of virus via body openings such as sexual organs, anus or wounds. The other mode of infection was by using the same syringe with infected person such as in drug addicts. The third one was to receive blood transferred from infected person. The fourth one was from matemal to fetus through umbilical cord. The last one was through wounds contamination with HIV infected blood.
Observation of HIV/AIDS infected person. Majority thought it was diffrcult to tell who was infected especially when there were no symptoms. No conclusion would be drawn wrtil the persons were checked whether there was virus in their blood. No observation could be made for newly infected person, therefore the spreading of the infection could be rapid.
Symptoms of infected person. Majority thought the expression of symptoms depends on the immunity of the person. If the person was in good health, exercise regularly, have good mental health the immunity would be good and the symptoms would slowly express and not so virulent. 'fhe experience with AIDS patients was wheels on skin, itching, rough tongue, loss of appetite, could not sleep, loss of weight and died.
Prevention. Majority thought prevention could be done by using condoms every time they have sexual relation. Sexual relation between female and female is to avoid contacting vaginal mucous. The best prevention is to stop having multiple sexual partners. For drug addicts, avoid using the same syringe or sterilize the syringe before use.
Care of AIDS infected persons. Majority thought no drug was available for complete cure of AIDS. The treatment could be only palliative, that is to take care of complication symptoms or decrease the virulent or prolong life by
1)
drug treatment with modern medicine or herbal medicine
2)
exercise and keep good mental health so the immunity could be strengthen and prolong life. The most important thing was not to have prejudice against HfV infected person but on the contrary sympathy and moral support should be given about the fight against the disease.
Question about AIDS. Majority of workers understood about AIDS. The question they had was not significant enough to distract
r32
Annex 3.3: Group discussion: Male workers.
their daily living or life style. Married male workers wondered how much chance the fetus has in being infected through infected mother, or how much chance of infection for the one who had to use the same hospital accident cript smeared with blood of infected person. No question was asked by single workers for they received anough information from other media such as newspaper, magazine and
television.
1.2 Largefactories.
wrderstanding about
Majority of single and married workers had knowledge, belief and IilV/AIDS.
cause or mode of transmission. Majority knew HIV/AIDS could be transmitted through any form of sexual relation, female with female, male with male and male with female because HrV exists in blood, semen, vaginal mucous. The use of same syringe among drug addicts for rV injection could also transmit the virus. The transfer of maternal blood to fetus through umbilical cord and during labour and blood transfusion or through wounds of infected and non-infected persons during accident were all the transmission modes described by the workers. Observation of infected person. Majority said it was difficult to tell who was infected especially at the beginning of the infection. However, it could not be sure of the infection even it the symptoms appeared, the only way one can be sure was to have blood test for HIV. Symptoms. Majority said the infection period could be 3-5 years depends on the health and mental conditions of the person. Those who had seen the full blown case said the symptoms were loss of hair, wheels on
skins, itching, wounds, herpes and burning sensation was severe until they could not sleep. The disease could not be cured due to lack of
immune system.
Prevention. Majority knew prevention can be obtained by using condoms every time of sexual relation and not having multiple parhrers.
Kissing and hugging did not bring about infection.
Care of AIDS patients. Majority thought there was no way to cure AIDS at present. The treatment was only palliative and prolong life. This
could be done bv:
1) Using medicine, modem or herbal to get rid of complications,

vaccine was still being tested.
t33
2)
Exercise and good mental health including meditation. If the physical and mental conditions were good, no stress, being loved and understood by family and friends. Family must be stable in supporting the infected person.
Question about AIDS. The questions were not many and most of them were given via media. For example, male workers wonder how much saliva was required to transmit infection? How much blood in drinking water could cause infection? Manied men asked why transmission could not occur through mosquito bites? How does one know blood transfusion is safe if the donor just being infected and
detection was negative.
2. Risk factors on HIV infection.

2.1 Medium size factories.
Majority of workers felt every body was at risk if visits to service girls (openly and secretly) or having multiple sexual partners. Even if condoms were used there was still chance of accident. Some men having sex with someone intimate such as girl friends or friends would not use condoms because they thought the feeling was not good. Single female workers were also at risk because the partners thought they were clean. The most risk group were not the same in the opinion of single and married male workers. Married men felt prostitutes had the highest risk because they had sexual relation with many men while single male workers thought single person had highest risk because they were free to have sexual relation with anyone they wished.
Who thought they were at risk? Majority thought they themselves were at risk through sexual relation, next was accident through wounds. Sexual relation was important because it could happen anytime depending on social - environment factors such as massage, pub, bar and even some type of restaurant having sexual service. Drinking accompanied such
service, so accident could happen easily. Who were more risky, male or fernale? Majority thought males had higher risk than females because they changed sexual partnerc more often. Females were at risk by sleeping with husband or boyfriend and not using condoms. If the partners were infected, of course, their risk would increase.
Reduction of risk. Majority knew how to reduce their risk. They could give up having multiple sexual partners or use condoms everytime they were at risk. If they did not drink, risk could be reduced because they knew what they were doing.
r34
2.2Large factories.
Group at risk were those visiting service girls and have sexual relation. Teenagers were those who wanted to try new things. Drug addicts who used the same syringes, workers with low income who liked to drink or addicts and use low cost sexual service which was not safe and do not use condoms. Sexual service persons, male or female, and doctors and nurses who had to contact AIDS patients. Sexual service personnels were at highest risk because they had to have sexual relation with high
risk group regularly.
Who throught they were at risk? Manied male workers thought they were not at risk since they used condoms every time they had sexual relation with girl other than their wives. Single male workers had divided opinions. The first group thought they were at risk because they used to visit prostitutes or had sexual relation with girls they were not sure of the infection or the condoms might be leaking. The other group thought they were not at risk because they had only sexual relation with their girl friends and were sure they were safe even if they did not use condoms, or never visit any prostitutes or visited but had properly used the condoms.
Who were more at risk, male or female? Majority thought male

were at risk higher than female. Male had more chance to have multiple sexual partners and had more sexual drive. Female risk was through their husbands or boyfriends. For married female workers it was diffrcult to ask their husband to use condoms. 'lherefore their risk relied on the risk of
their male partners. There must be cooperation between male and female workers in preventing infection. 3. The understanding of having safe sex and skill in having safe sex.
3.1
Reduction
of risk.
Medium size factories.
Majority of workers fblt if they had sexual relation with persons other than their regular partners, they would use condoms by all means. Married male said the safest way was to have blood check of sexual
partners.
Attitude towards condoms. Majority thought male partners should be the one to provide condoms. If female partner provides condoms, it will be seen in a negative way as very experienced woman and always prepared to have sexual relation. Only prostitute should do this. At the
Establishing FtrV/AtDS Programs in the Workplace
135
with condoms would give impression of being play boy, prepared to have sex at all time. If manied male canied condoms it will be seen that he had multiple partners by his wife.
same time, male
Persuasion to use condoms. Majority thought women usually were too embarrassed to ask their partners to use condoms. Men were not embarrassed but do not like to use condoms, especially when they thought their partners were clean. However, women had important role in insisting their partners to use condoms to prevent pregnancy and infection especially AIDS because it could not be cured. Trouble was women usually gave in.
Campaign to use condoms. Majority thought campaign should be

conducted among both male and female to use condoms everytime there were sexual relation with risk. Married men suggested emphasis should be placed on effect following carelessness such as impact on family, society and country as a whole from being infected with AIDS.
ill
3.2 Large factories:
For safe sex relation, majority thought this could be achieved by having single partner, not changing partners and use of condoms every time having risky relation. Having sexual relation by any means with high risk parters put them at risk.
Attitude towards condoms. Majority thought male partner should be the one to provide condoms. If female partner carried condom, it could be seen as being experienced and prepared to have sexual relation. It was normal for sexual service ladies or singers who provide sexual service to
carry condoms because they had to protect themselves.
Persuasion to use condoms. Male partners could suggest using of condom while female partners were embarrassed to do so. lnfect both partners had equally important roles. If the female partners insisted and said they were afraid of being infected male partners would agree. Campaign for the use of condoms. Male workers felt emphasis was placed on male rather than female in the past because female were embarassed to talk about using condoms especially among single female. Married men felt campaign among single females should place the emphasis on safety and cleanliness and prevent them from being infected or getting pregnant. If the target population were males, emphasis should be placed on protection of oneself from infection and the impact of contacting AIDS on family and themselves. The content, they suggested, 136
Annex 3.3: Croup discussron: Male workers.
should be appropriate to the life style of different groups of people such as university students, working people or family people.
4. Attitude towards infected persons, AIDS patients and inspection.

4.1 Medium size factories.
General feeling towards infected person
or AIDS patients.
Majority had mixed feeling, afraid or prejudice but would not express their feelings but would be more cautious when come close to AIDS patients. The other feeling was sympathy, feel sorry for them and would like to give moral support so they could live longer.
If the patients were their relatives or ones in the family, they would sympathize and take good care of them and give moral support. This feeling was different from those towards outsiders. This is became there were love, sympathy and understanding. With knowledge, how to prevent the infection, it was possible for them to live with and take care of the infected persons, including prevention of spreading of the virus.
Attitude towards infected person or AIDS patient, male or female.
Majority had sympathy for female because they were the weaker sex and had difficult time to protect themselves. The male partners were the ones who transmitted the disease to them and they did not seek for it. However, a married women would be infected for their behaviour such as had multiple partners or had pre-marital sexual relation or may be transmitted by blood transfusion. The cause should be clearly identified. For men they would be blamed for being careless but would not be blame for having multiple partners like women.
What were the feelings towards AIDS patients, with or without symptoms? Majority thought normal relation could be carried on with those without symptoms. With the symptoms, they would have to be more careful to get into close contact and try to protect themselves.
What were the thoughts about blood test for HIV? Majority never had blood check for [IIV. There were some cases who had blood checked when donating blood. This way there was time to prepare themselves for the results because the notifuing letters did not come so quick. If there was no letters then there was a relief of negative results.
There were mixed feeling about HIV blood checking, some did not want the check up because they were afraid to know if the test were positive. For those who wanted to be checked said they wanted to confirm
Estabtishing
IIIViAIDS Programs in the Workplace
137
that they were negative. But if the results tum out positive, then they would take good care of themselves so they could live longer. The test, however, should be done confidentially.
When the positive and negative effect of blood checking were If the test was not caried out, then there would be no worry but the disease could spread because of carelessness. If the blood was checked and were negative, then they would be happy. If the test turned positive, then precaution could be taken not to spread the disease. The negative side would be those who could not accept and may commit suicide. Manied men thought if they had their blood checked, they would go to the place where there were consulting service before and after the check-up such as clinic with no name, Red-Cross or
considered, majority thought similarly. hospitals. sexual people with high risk service ladies, men having multiple sexual relation, and especially those who were having family and a child in the future. Pre-marital sexual relation were common and it was worth to have blood test to prevent having innocent child with disease.
Who should have their blood checked? Majority thought
4.2Large factories.
General feeling towards infected person or AIDS patient. Majority
had mixed feelings of sympathy and afraid. Sympathy because the disease could not be cured at present and this disease is not accepted by society therefore they did not want anyone to be infected. Single male workers said they were afraid because from the picture shown in the training it was dreadful. Manied men said the society will reject them if they contacted AIDS and they will definitely die so it was difficult to accept the situation.
If the patients were their relatives or ones in the family, majority thought they could live with them in the same house. Single men said the patients should be cared for specifically to prevent spreading of the virus. The second group said they should be treated normally to prevent illfeelings but moral support should be given. Manied men said they could accept and be prepared to take good care ofthem but afraid the neighbours will be prejudice against the family. They would like to have more knowledge on caring for AIDS patients.
Attitude against infected persons or AIDS patients, male or female. Manied men felt the infected female should be sympathized because they were victim of the circumstances, the men were to be
blamed. For infected men, they should be blamed for their behaviour. For single men, the thought was there would be questions towards single
r38
women being infected of their sexual behaviour, but for infected men they would be blamed for their carelessness but not for their sexual behaviour.
not relatives. Married men said the dreadful appearance would not occur if the patients were well taken care of. For those without symptoms, normal behaviour would be carried on.
What were the feelings towards AIDS patients, with or without symptoms? Majority thought it was dreadful to be close to those with symptoms. Single men said they would not associate with those who were
What were the thought about blood test for HIV? Majority never had their blood checked for HIV. Manied men said they never thought of having their blood checked because they were not sure and not ready to hear the result, afraid if it turned out positive they would depreciate fast and may commit suicide. For single men, first group wanted their blood checked, second group said they were too afraid to hear of the result and
would not know what to do next.
When the positive and negative effects of blood test were considered, majority thought there were both positive side and negative side of the test. It there was no test, they could relax. If they were positive, then they had to take good care of themselves. The negative side was they would be unintentionally spreading the disease. If the test were negative, they could relax, if positive, they would be careful in not transmitting the virus to others, but might be miserable not knowing how they could survive. Therefore consultation before and after blood test was very important.
Who should have their blood checked? Majority thought those with high risk such as sexual service ladies and men with multiple sexual
partners. The other group was those to be married and have children. This was to prevent transmission to the child and between the couple. In fact
this was not normallv done.
5. Ideas about the education in the workplace.

5.1
Medium size factories. Change
in
knowledge and understanding on AIDS. Majority
thought they benefited from participating in the project. They gained more knowledge especially on prevention of HIV/AIDS infection by using condoms starting from inspection of the envelopes, expiration date, opening the envelopes, putting on and taking off properly until disposed. These were all new to them. they also learned about risk of being infected
139
fuinex 3.3: Group discussion: Male workers.
and were more careful in taking precaution. Manied men thought having sexual relation with girls other than wives or girl friends were all at risk and the impact would be on family, not only themselves. Single men said
condoms must be used every time when having sexual relation with strangers. The attitude about using condoms was to use with parbrers at risk but not with girlfriends because they felt it was safe. Attitude on sexual relation was to decrease their visit to prostitutes and take more precautions. For married men, some of them gave up having multiple sexual partners. For single men, the would use condoms regularly.
Method of education. Majority thought printed materials were not effective because most workers do not like to read, but like to look at pictures and throw away after looking. Lectures were good because they could ask questions and emphasis could be made on important points.
Water exchange game was interesting and could explain the risk of getting infection clearly, that is, ones could not tell they were infected until they had their blood checked. Everyone was both donor and receiver of the virus and it could spread very fast.
Suggestion on single female workers protection. Such as being conservative. Majority thought this was not possible in the present society. The social environment and entertainment centers such as pub, bar, disco tech, night club were all sexual inductive factors. Other factor was being away from the family. Men usually were the ones who insisted on having sexual relation. If women could not resist, they could talk the men into using condoms to protect them from getting pregnant. women must not give in because men usually did not like using condoms, they fell it was not frrn.
5
.2 Large size facto ries.
Change in knowledge and understanding on AIDS. Majority thought there was a positive change in gaining more knowledge especially about how to use condoms and also they were more positive about living with AIDS patients. To learn about risk in getting the infection. The workers said they were more aware of risk and danger of not having the prevention and were more cautions. Attitude about condoms was they leamed how to use condoms properly from opening the envelope, putting on and taking off properly and used everytime the had sexual relation with high risk persons. Married men said previously they used only to prevent pregnancy and if their wives were taking contraceptive pills then they would not use, without considering the aspect of getting infection. Attitude about sexual relation, they took more precaution. single men said they were more careful in having sexual relation with high risk group.
140
Annex 3.3: Grouo discussion: Male workers
Manied men repofted stopping their visit to prostitutes, those who did not, would use condoms on every visit.
Method of education. Majority thought printed materials were not effective, most workers did not like to read and it was seen being threw away in many places. Lectures were good because it was two - way communication. 'fhey could ask and make themselves understood. Demonstration on the use of condoms was beneficial, easy to understand and could be applied. Water exchange game was effective in explaining the mode of HIV infection and epidemic.
Suggestion on single female workers protection. Such as being conservative was out dated, now pre-marital sexual relation was common. lnductive social environment such as entertainment centers, alcoholic drinks and being away from the family, all lead to sexual relation. For women to resist was difficult if men did not cooperate. Married men said teenagers had more sexual freedom. It was not possible to help each other reach climax without sexual relation, so the best way was to persuade boyfriends to use condoms. Majority thought men still had authority in deciding about using condoms. Single males thought it was not appropriate for single females to discuss about using condoms but they could discuss about getting the infection and pregnancy.
t4l
Annex 4: Results From The Qualitative Study Among Women Workers
Annex 4.
esults From The Qualitative Study
Among Women Workers: Final Project Evaluation Results (Post-intenrention)
Impacts On Women Workers, 199

Knowledge and Perception about HIV/AIDS n) Awareness of HIV/AIDS Risks, III) Communication Skills for Prevention, IV) Intention to Practice Safe Sex, v) Attitudes Toward PLWIIA, VI) Attitudes Toward the Project,
I)
r42
Esrablishing HIV/AIDS Programs in the Workplace
Results From The Qualitative Study Among Women Workers: Final Proj ect Evaluation Results (Post-intervention)':
To evaluate the consequences and the effectiveness of the project, the project's evaluation team conducted 2,000 post-intervention KABP interviews and ten focus-group discussions among men and women working in factories under the project. These tasks were undertaken in the twelfth month of the interventions. The focus group discussions and the interviews were conducted during the factories' regular work hours. The focus group discussion took an average of two hours to finish, and each KABP interview required an average of
twenty minutes to complete. Participants both in the post-intervention interviews and focus-group discussion were current workers in the factories' production lines and they used to attend either a two-hour training or a small goup discussion provided by the Ivlahidol University's HIV/AIDS outreach project to the factories. The discussion guideline was drawn upon the project's primary objectives that are to increase HIV/AIDS awareness, to promote safer sex, to decrease HfV risk behaviors, and to increase acceptance, support, and care of people with HIV/AIDS among factory workers at the project's sites. The discussion emphasized questions aimed to examine workers' knowledge regarding HIV/AIDS, their awareness of HIV/AIDS risks, their ability to communicate and negotiate safe sex, their attitudes toward persons living with HIV/AIDS, their knowledge and ideas about HlV-testing, and their attitudes toward HIViAIDS training programs in their factory.
Data obtained frorn the post-intervention focus group discussions are very important for describing the extent to which the project reaches its objectives after the twelfth month of interventions. In order to compare the project's effectiveness and outcomes between the large and medium-scale factories, between men and women, and between married and unmarried workers, focusgroup discussions were structured according to the size of the factories, gender and marital status of the participants. The followings paragraphs are findings about the impacts of the project on women workers.
lmpacts On Women Workers
The project's evaluation team carried out a total of six focus-group discussions among women workers. Two focus groups were held among women
Suchada Thaweesit, Ph.D Student, Anthlopology Departmnt, The University of Washington
Establishing HMATDS Programs in the Workplace
t43
Annex 4: Results From The Quatitative Study Among Women Workers
workers whom were recruited from six large-scale factories and other four focus groups were held among women workers fecruited from six medium-scale factories. The focus-group discussions involved 42 participants. Similar but separate focus-group discussions were held with married and unmarried women workers. The ages of unmarried women workers participated in the focus-group discussions ranged from l7 to 30 years with most falling between 2I and24yearc while the ages of married women workers ranged from 20 to 45 years with most falling between 22 and25 years. Most participants have an average of 12 years in school. Besides relying on the formal focus-group discussions, the evaluation team draws upon the informal conversations with women workers which took place occasionally throughout the duration of the interventions to assess the impacts of the interventions on women workers. It should be emphasized here that the findings from discussions indicate no differences in HfV/AIDS-related knowledge levels, awareness of HIV/AIDS risks, communication skills, intention to practice safe sex and attitudes toward PLWHA and toward the project between women workers in the large-scale and the medium-scale factories as well as between married and unmarried women workers.
Knowledge and Perception about HIV/AIDS
The outreach project to factories was designed to enhance factory workers' knowledge regarding HIV and AIDS. This knowledge includes a person's understanding about HIV/AIDS transmissions, symptoms, risks, prevention and testing. Data from focus-group discussions and inforrnal conversations with women workers reveal that the HIV/AIDS outreach programs in factories have a favorable impact on women workers' HIV/AIDS-related
knowledge.
Most women workers who participated in focus-group discussions and those who joined informal conversations with the project's evaluation team comprehend most of the basic facts about HIV and AIDS. They know that AIDS is a deadly disease caused by the HfV virus. They also know that a person who is infected with the I{lV virus can stay alive for up to ten years but a person's body is steadily weaken by the vinrs. They understand that the HIV virus will weaken the body's immune system and will make the infected-body become susceptible to other diseases. They believe that most HlV-infected persons die from the AIDS complications rather than from AIDS itself. A large number of women workers participated in this evaluation study has a high level of knowledge regarding HIV and AIDS symptoms. Several participants know that an HlV-positive person and AIDS patient are not the same. They know that an HlV-infected person can appear healthy and can perform regular activities in a daily life as other healthy percons do. They stress that yet, an AIDS patient shows symptoms such as tiredness, losing weight, having white patches or spots on tongues or mount and having constant diarrhea. They also understand that some of AIDS patients have
t44
Arurex 4: Results From The Qualitative Study Among Women Workers
to be hospitalized if their symptoms get worse. However, still some participants have an imagination that the last stage AIDS patients must have a scary look because their body will be covered with sores. Most of what I know about AIDS is that this disease is associated with a virus called HlV. The HfV virus can be transmitted through infected blood, fi'om a mother to her baby and through sexual intercourse. Those persons who have been infected will become very weak since their body's immune system will be destroyed. They can become very sick and can die from another illness that happens during the course of AIDS. Yet, if an infected-person takes a very good care of his/her health by following doctor's instructions, he/she can live up to five to ten years. The most imporlant thing is that he/she has to keep up their hope and confidence to fight off the disease. ( Ms. B, age 19 from a largescale factory)
usually mention three possible ways of HIV/AIDS transmissions when were asked "how can one contract HfV?". They comprehend that a person can be infected with HIV virus if he/she has turprotected sexual intercourse with an infected partner. For most participants,
majority
of participant
sexual intercourse means penetration. Therefore, they perceive sexual intercourse

as
their greatest risk.
Having sexual intercourse means a man puts his sex organ into a woman's vagina, then his semen can go into a woman's body through her vagina. If the man has AIDS, the woman will certainly become inf'ected. (Ms. B, age 19 from a large-scale factory) When asked if a person can get infected with HIV through kissing an infected person, a majority of participants show their high level of knowledge regarding this mode of HIV transmission, though some still are dubious about it. They consider wed or tongue kissing a potential risk in getting infected with HIV.
t45
Mrs. D: I don't think kissing on the hands or the cheek would be a problem if there are no open cuts on yours and your partner's skin. But,I am not sure about kissing the mount. Mrs. T: It's possible that you can get AIDS from kissing an infected pelson's mount because there are the AIDS viruses in
infected-person' s saliva.
Mrs. S: The HIV/AIDS outreach worker explained to me that this can happen only if you absorbed a liter of infected-saliva or if you have an open cut in your mount or if there is any exchange of blood through mouths when you have that kind of kiss with an infected person.
(Married women workers from medium-scale factories)
Most participants also know that the HIV virus c:ur pass from pregnant women to their babies. While they know that the transmission of HIV from an infected-pregnant woman to her child can happen before birth, during delivery, or through breast-feeding, they are quite well informed that not every infant whose mothers are HlV-positive will be infected by the virus.
Moderator: Will HlV-positive mothers pass the virus to their babies?
Mrs. S: Yes. But, this will not happen with every baby. Mrs. D: I have been told by the HIV/AIDS outreach worker in my factory that infants may not be infected if mother's blood doesn't enter their mount during the delivery. Mrs. A: But I know that babies may be infected by the AIDS virus since they were fetuses. The AIDS virus can pass from infected-mothers to babies via placenta and enter a fetus's body through umbilical cord.
(Married women workers from medium-scale factories)
All women workers participated in discussions know that an individual can contract HIV if sharing a needle with an infected person. They know that persons who are intravenous drug users have a greatest risk of HIV infection. Though they recognize their low possibility in contracting HIV through needles, several women still have a little fear of getting AIDS through needles being used in public hospitals or in private clinics. This particular fear seems to reveal women's distrust in the health care services rather than points to the
146
ineffectiveness of the HIV/AIDS outreach project. This is also true when listen to
women's fear of contracting HIV/AIDS from dental clinics and their fear of having infected-blood be transfused into their body.
Moderator: Do you know what is the most risky way to get AIDS? Everyone: fntercourse (Sex)
Mrs. S: Can persons get AIDS

intercourse?
if
they never experienced sexual
Mrs. N: Yes, they can. lhey may get AIDS from a hospital by receiving AlDS-contaminated blood when they have to
undergo an operation.
Moderator: You right. But today, most hospital will carry out HIV testing with every donated blood to make sure that the blood is safe before transfusing it to patients.
Mrs. N:
know but I still have fear. I can not 100% trust the hospital. My doctor wants me to have an heart operation because I have rheumatics. But, I always don't want to since I fear having been given infected-blood. Going to see a
dentist too is dangerous. You might get AIDS from his tools, if he doesn't clean them very well.
Mrs. M: I know dentists usually heat their tools after every use. Or they usually use a disinfectant to kill the AIDS virus. Mrs. S: Can a disinfectant kill the AIDS virus?
Mrs. N:
I don't think dentists will have enough time to disinfect
their tools in every use. There are too many patients come to see them daily. I think they are too busy to think about it. (Married women workers from medium-scale factories)
Unmarried participants are more likely than married participants to address their fear of catching AIDS from activities involve the use of needles. For examples, they talked about their fears of getting AIDS through receiving a shot
or vaccine, donating blood and through blood examinations. They also have a fear of having been in contact with the AIDS virus through devices used in beauty salons. Several married women concern more about their possibility to get AIDS from a dental clinic than about their chance to get from having sexual
it
t47
intercourse with their husbands. All of these also reveal that AIDS has provoked people's distrust of others.
I donated blood once when I was in a high school, but I still have a fear of getting AIDS from it. I also have a feeling like...a person might get AIDS from a beauty salon. (Ms. C, age 2l
from a large-scale factory)
Mrs. L: Though I know more information about AIDS, I still fear I might get AIDS from a dental clinic since you cannot be sure that a dentist will be using clean tools with you. It's not in your
control.
Everyone: I agree.
Mrs. X: Since the spread of AIDS, I have been always reluctant to have my teeth fixed. (Married women workers from large-scale factories)
Howevet, it is very obvious that the HIV/AIDS outreach workers have played important roles in enhancing and correcting women workeis' knowledge regarding the modes of HIV transmission. Many of participants admit that prior to the introduction of the HIV/AIDS outreach project into their factory they feared of getting AIDS from using factory's toilets or sharing eating and drinking utensils with an infected person:
Moderator: It seems to me all of you know very well that a person can contract HIV/AIDS through intercourse, by sharing needles, from mother to her baby and, by receiving infected-blood. Do you have fears of getting the AIDS virus through other courses?
Mrs. Y: Before attending the HIV/AIDS training held in my factory, I used to have fear like I might be infected by sharing foods and glasses with friends who you never know if they are AIDSinfected persons. Is it right that even infected persons themselves may not know they have AIDS in their body if they never have HIV testing? Today, I know more about AIDS. Though there are rumors telling that you can get AIDS from such and such, I no longer fear of getting it from other modes besides what I have heard from the training.
148
Anrex 4: Results Front'fhe Qualitative Study Among Women Workers
Mrs. Z: I used to have a fear that the AIDS virus may spread through breathing. I thought it's dangerous to sit next to infectedpersons. Now, I know it isn't that kind of easy. So, I stop my
fear.
(Manied women workers from large-scale factories)
was very scared whenever
I used the toilet here because you never know who are the HlV-positive persons. My fear was heightened when I was pregnant. I feared that I might get the
AIDS virus from sharing a toilet with other workers and might pass the virus through my baby. Now, I know it is not that easy to get AIDS. I have more confidence to share a toilet with others. (Mrs. F, age26 from a medium-scale factory)
Now, I know that the AIDS virus can not stay alive in an environment outside human's bodies. I am no longer afraid of getting it from sharing spoons, plates, or glasses with others. And if I don't have any wounds on my body, I dare to touch an infected person. (Ms. A, age22 from a medium-scale factory)
Most participants always associate AIDS with sexual intercourse and perceive it as one different kind of the sexually transmitted diseases. Therefore,
when asked how one can protect oneself from AIDS, they congruently replied that using a condom (they usually refer to a male condom) is the best way to prevent
because most nationwide HIV/AIDS campaigns have emphasized condom uses as a primary strategy to fight against AIDS. The HW/AIDS outreach project to factories similarly had incorporated male as well as female condoms into its HIV/AIDS training curriculums. But its primary objective was to demonstrate the correct use of these two kinds of condom. It also aimed to familiarize women workers with female condoms. Participants, however, bring up other potentially pleventive methods recommended by the outreach workers during the discussions..For example, they indicate that to stick to one sexual partner, to know one's sexual partner very well, to frequently wam one's sexual partner about AIDS and to encourage one's partner to use condoms with other women are important options to save oneself from getting infected with HIV.
I{IV
infection. This
is not surprising
149
as if a chain. It can be passed from a partner to another partner and so on. Ifyou don't know your boyfriend's background as well as his sexual behaviors very well, you have a chance to get it. Your boyfriend will not tell you how many women and what kinds of women he has had sex with. He never told you the truth about this thing. You have to find out and watch out him by yourself. (Ms. R, age 22 from a large-scale factory)
It transmitted
Only a small nurrber of participants has a negative view toward having a blood test for HIV antibody. When asked "should you choose to take the test?," several participants responded that they are willing to take the test in order to know weather they have been infected or not. Many of them said if they know they have been infected by the virus, then they will take a very good care of their health as well as will be well- prepared for their future. Still many of the participants think that their employers should provide an Hfv-testing for workers at a factory setting. Yet, they emphasize that the test results must be strictly confidential. It can be observed that there is a growing concem regarding discriminations against those workers whose a blood test has a positive result among female workers. Women workers began to see HfV-testing as to create a problem for those who are tested HlV-positive rather than to help them. They also began to see the test without one's consent as violating an individual's rights. To a great degree, the changed attitude toward HrV-testing among female employees is an outcome of the outreach project to factories. The outreach workers have done a great deal of discussions concerning the HlV-testing issue with workers in every project's site.
I'd like to see people to urdergo a blood test for HfV. Once they know they cany a disease, they wouldn't spread it to others. But, before taking the test, they have to be careful that nobody knows about its result. They also have to be very courage if it came out they have
AIDS. (Ms. C,
age 23
from a medium-scale factory)
fear of being fired from work. My friends also will ridicule and reject me if they found out that I am HIVpositive. (Ms. B, age23 from a medium-scale factory) Usually, HlV-positive persons in need of money to pay for their medical expenses and to take care of their family. I ask that the employers should allow HlV-positive workers to continue working in the company, unless they are unable to work. If these infected people were fired, they will face with serious financial problems. (Mrs. G, age 26 from a large-scale factory)
150
Establishing HIV/AIDS Programs rn the Workplace
I don't want to take the test. I
Many of unmarried participants told that they would like their boyfriend to take a blood test for HfV before making a decision to marry him. However, it is important to note that the women's knowledge level regarding a proper time for undergoing the HIV-test remain low. Only a few of them can correctly explain that the test should be arranged at least three months prior to the marriage. For example, several currently married participants reported that they have asked their boyfriend to undergo a blood test only a week or two weeks before marrying. Also, having been informed by a doctor that their boyfriend is HIV negative, they think that they are always safe.
II. Awareness of HIV/AIDS Risks

Focus-group discussions and informal conversations with women workers also demonstrate that the HIV/AIDS outreach project to factories has contributed to an increasing self-awareness of HIViAIDS risks among women employees. Most participants believe that every one has possibilities to become infected with AIDS. While they mentioned a number of their potential risks, they perceive sexual intercourse as their greatest risk. Most participants indicate that working disciplines in factories as well as living environments in the Navanakhon commwrity have contributed to HIV vulnerability of the young women workers in
this area. They admit that because of being very young, having their own incomes, facing with rigid working disciplines and living away from home, they
felt independent but insecure and stressful at the same time. They stress that these feelings have led them to engage in an intimate relationship with boyfriends. They also address leisure activities such as going out at night with their boyfriends to discotheques and pubs involving alcohol drinking as their high possibilities to become infected with AIDS. They believe that between lovers, men are more likely than women to infect another with HIV. They point out that this is so because men are more likely than women to have multiple sexual partners. They also believe that drinking alcohol can lead men as well as women to unprotected sex. Many of participants expressed their worry about men's carelessness to protect thernselves. They realize that men's carelessness and men's negative view towards condoms can heighten women's vulnerability to HfV virus.
Some men are very careless. They tend to think that they are not the one who would get AIDS. Men also usually tend to think that using a condom make sexual intercourse unnatural and less frm. Therefore, they did not protect themselves when they have sex with prostitutes or other women besides their wife. I am terrified of becoming the next HfV-positive woman because of these. (Mrs. P, age 22 from a largescale factory)
151
The HIV/AIDS training in factories has persuaded women workers to recognize their HTV risks within a marriage relationship. This kind of relationship frequently was regarded as H[V-freed by a majority of women. For example, after attending the HIV/AIDS two-hour training offered by the project's outreach workers, a 26 year-old woman who currently married told one of the project's evaluation staffas the followine.
I know better about the spread of AIDS. Before, I never thought that I am at risk because I am not kind of promiscuous. I never have sex with a man other than my husband. I have a trust in my husband too. But, attending this training and participating in a water exchange game make me scared that it might happen to me. The game says to me that monogamous wives are also at risk because they never know if their husband was infected with AIDS from having sex with other women. You cannot be confident that your husband wouldn't bring the disease home. When I come home from work today, I will ask my husband about his previous women. I will tell him what I have leamed from the training and will let him know how much I am worried about the
chance to become infected bv him.
IU.
Communication Skills for prevention
Most women participated in the discussions agree with a recommendation suggesting that women as well as men should get involved in the HIV and AIDS prevention. At the same time, they emphasized that men should take more responsibilities in preventing AIDS because men are those who create the AIDS problem. The women's view emphasizing responsibilities on the part of men regarding the Hrv prevention, however, does not necessarily lead the women to become passive audiences of the HIV and AIDS outreach training. Most women participants recognize their abilities to educate men and to raise men's awareness of AIDS. They think that women should become more encourage to discuss with men about condom use and should criticize men's promiscuity more than in the
past.
I become very afraid than before about becoming infected and died
because of AIDS. I think I have to say more about condom use with my boyfriend. Now, I see telling men to use condoms is not shameful but it is required for every woman. (Ms. o, age 24 from a mediumscale factory)
have facilitated their communications with partners on the issues as well as of desirable and undesirable sexual activities.
The participants point out that the HIV/AIDS activities in their factory of condom usl
152
It is good to have the AIDS project in my factory.
Be Because of this project, I am able to say more about condoms and about sex with my )ut husband without feeling of embarrassments. (Mrs. K,, a1 24 from a age large-scale factory)
Most women show their willingness to delivery safe sex messages and methods to their husbands, boyfriends and friends. Many women reported that they shared their knowledge and information about HIV and AIDS learned from the training with their partners. There are several participants brought HIV/AIDS materials and condoms distributed by outreach workers home to give to their husbands. Several participants indicate that presenting photographs of AIDS patients and symptoms as well as showing I{IViAIDS brochures provided at the training to their husbands enable them to convince their husbands to stop visiting prostitutes. Some women have made use of other existing visual AIDS materials and programs offered through mass media in order to communicate with their husbands about HfV and AIDS. For example, one participant reported to the group that she has persuaded hcr husband to watch a T.V program on AIDS with her on every Saturday moming. Several participants want to know the skills how to avoid sex before marriage and how to say to negotiate condom use with
boyfriends.
IV. Intention to Practice Safe Sex

Many of married participants indicate their intention to insist on condom with their partners in case of if they found out that their partners are having sexual relations with other women or with sex workers. Most women participants frequently express their concerns about how to prevent themselves from HIV.
use
One of the project's evaluation team member observed that many women workers who came to talk with the outreach workers during the period of interventions asked a lot of questions regarding how to gain control and to overcome their HIV risks within a mariage relationship.
Both married and unmaried women participants reported their familiarity with condoms. They said that the condom use demonstrations carried out by workers in the HIV/AIDS training section are very helpful to familiarize them with condoms. Some women participants account that they felt more relaxed and less apprehensive in talking about condoms with their boyfriends. Several of women workers narrate how their attitude toward condoms has been changed by the HIViAIDS programs in their factory.
153
I thought it sort of disgusting to touch condoms even the unused one. I never even took a look at them. After I have been watching the outreach worker in my factory used them to make flowers for many times, I thought condoms aren't kind of dirty things. I asked the outreach worker to teach me how to make a condom flower. Since then, I don't have any negative attitudes toward them. Now, I know how a condom look like and I no longer felt disgusting in touching it. If it is needed I will be not hesitate to use it. (Mrs. A, age 19 from a medium-scale factory) V. Attitudes Toward PLWHA The HIV/AIDS outreach project has diminished fears of living and of coming into contact with PLWHA among women workers. Several participants who joined the trips to the first HIV/AIDS hospice in Thailand organized by the outreach project reported their decreasing fear of touching the body of infected
patients:
Previously, it was unthinking for me to touch or to come into contact with AIDS persons. I thought that their bodies must cover with serious sores and bad blood. And thought that AIDS persons would easily infect others with their disease. But, after I joined factory peer leaders to visit and meet with AIDS patients at a temple in Lopburi province, I dare to touch them since their appearance doesn't look scary and harmful. That was my first experience to get to know how AIDS persons look like. ( Ms. B, age 17 from a large-scale factory)
Also stigmatization as well as negative attitudes toward PLWIIA has been diminished. For example, women's previous knowledge holding that some categories of people such as sex workers, gay men and intravenous drug users are more likely to get AIDS than others is changed. Many of women participants demonstrate their sympathy to those who have been infected by donating their money, foods, clothes to the HrV/AIDS patients living in the AIDS hospice in Lopburi province. some women traveled to visit infected persons there.
154
I know that there is an infected person in my factory. He is my friend but I certainly do not tell other friends who he is. I want him to live and work confidently that no one in the factory know his HIV status.
(Mrs. I, age22 from a medium-scale factory)
I used to think that all those who have been infected with AIDS were prostitutes or were those men who were drug addicts, who visited with prostitutes or who were gays. I, therefore, never had prty on infected persons. Now, I know that not only these kinds of persons whom have been infected with AIDS. There are more good women as well as their children become infected because men brought the disease to families. I had pity on wives who get infected because of their husbands the most. (Mrs. V, age 30 from a medium-scale factory)
After I attended the HIV and AIDS training, I felt that a society should not feel or express their abhorrence at AIDS persons because they hadn't done anything wrong. We should show our sympathy to them instead. Every AIDS person already have a lot of sufferings caused by their illness. (Ms. C, age 21 from a medium-scale factory)
don't think that I will reject my friends if I know they have been infected with AIDS. I still want to eat, have fun and work with them. I know that AIDS persons will have a short life if they are disdained by a society, particularly by a family and a friend. (Ms. H, age 19 from a large-scale factory)
Because there is the AIDS training program in our factory, orr peer leaders coordinately organized workers to visit infected persons at Wat Phra Bat Namphu, Lopburi. They collected money and other necessary things from factory friends to give away to AIDS patients there. I have joined the trip to meet with AIDS persons once. Because of that trip I come to know more that my previous thoughts about infected persons
are incorrect. I saw some AIDS persons looked like other healthy people, though there were some of them looked seriously ill and always stayed in a bed. (l\&s. F, age25 from a medium-scale factory)
VI. Attitudes Toward the Project

Most participants in focus-group discussions and informal conversations indicate that the project has provided them better knowledge and understanding of HIV/AIDS and of other HIV/AIDS related issues. They think that outreach workers and peer leaders have helped significantly in informing and correcting workers' knowledge and urderstanding. For example, some participants point out
t55
that having HIV/AIDS outreach workers and peer leaders in their factory helps reduce fears and stop rumors about AIDS in a Navanakhon area. Since the introduction of the AIDS project into factories, I observed that there have been less rumors about AIDS and about having AIDS infected persons in my factory. In the past, rumors about AIDS and AIDS fears were very widespread among factory workers here. (Ms. J, age 34 from a medium-scale factory) Most participants said that the HIV/AIDS interventions in their factory are very helpful in convincing workers to become consciously aware of AIDS. When asked about what they have leamed from having HIV/AIDS programs in their factory, and what parts of the interventions they like the most, the women participants responded to the questions as the followings. The project provided me with deeper information about the modes of AIDS transmission. (Mrs. K, age 23 from a medium-scale factory)
Having read materials distributed by outreach workers, I leamed a lot about recommended life skills to avoid having sex with boyfriends or to protect myself liom becoming infected with AIDS. I like reading the books called "Men's Love" and "Women's Love" the most. (Ms. Q, age22, from a large-scale factory)
It gets me to know that a woman can get AIDS from having the first sexual experience with her boyfriend. Also, the game make me more aware that wives too are not safe from AIDS. (Ms. V, age 19 from a large-scale factory)
game the most.
I like the water exchange
the VDO tape story called "Risky Lives" the most. I think it is more relevant to our life here. (Ms. E, age 23 from a medium-scale factory)
Because of the project, I no longer felt shy to look at and touch condoms. (Ms. W, age22, from a medium-scale factories)
I like watching
156
Arnex 5: A casestudy: Rohm Apollo Company
Annex
5.
A case study: Rohm Apollo Company.
Location:
M 20 Klong Luang subdistrict Klong Luang district Pathum-Thuti 12120

102
T el.529 -07
77
-82.
ax. 529
-07 7 5 -6
Product:
Electronic supplies.
Number of Workers: 900; 500 male, 400 female workers.
Working
hour:
Production section 4 days a week, 8:00-20:00 hrs, and 20:008:00 hrs.
1.
Situation and problems:
Project staff on "the outreach program on HIV/AIDS prevention and care" approached and started to conduct education activities in the factory in December 1996. The company had expressed their interest in participating in the project and sent one labour relation staff to receive training to be RP in the factory in December 1996. Then project staff had conducted HIV/AIDS prevention education on Saturday, during production hour, for one hour since January 1997 but the factory did not allow FOW, Mr. Peerayuth Harnchana to carry out small group discussion, saying there was no facility and it would not be orderly. At the end of April, RP informed Project Staff they could not send workers to participate in the education program because
1) It was not necessary,
this problem was not urgent and they rather have their production increased. The company could not waste the workers' time on this project.
Persorurel management staff thought this was the project's business and not theirs, they did not have any part in the planning.
2)
3)
The project would have the benefit, not the factory, but the factory
would have
to
sacrifice workers' time, estimate
to be 35
bahts/hrlworker.
r57
Annex 5: A case study: Rohm Apollo Company.
4)
Personnel staff could not convince production staff that the project was useful to the workers.
When the Provincial Health Office organized lunch program by having one-day exhibition in the factory and having show on "Thai Teenagers fight against AIDS" in May 1997, it was refused by the factory.
2.
Activities on Outreach program.
The project staff, however, had kept contact with RP of the factory even they were not allowed to conduct the education activities in the factory. The
if
factory was invited to participate in the exhibition of volunteers from Fujikura Company located near by and having volunteers from other factories to participate, organizing fancy AIDS walkathon on sports day and having volunteers to participate including distribution of information regularly to show the project would like to help without any returns. In July 1997 Fow were allowed to work in the factory by stationed at nurses' quarter two days a week. The activities was to have exhibition board in every building, distribution of condoms and printed materials and small group conversation with workers. In August 1997, one worker, married male, 17 years old, worked l-8 years in the factory came down with complication and was often admitted in to the hospital. The health insurance budget was exhausted. He had herpes zoster, fungal infection and severe skin diseases. The personnel manager were had to deal with the problem. The factory provided dormitory for male and female workers, they were close by, and sexual behaviour was well exposed. There was concem that there would be more workers being infected because there were 3 other workers who had sexrnl relation with this person. There could be problem living in the same compound.
of the problem. Project staff suggested to prepare the community about HIV prevention and living with AIDS patients, and asked to conduct large group
education. Production section could not understand why there should be AIDS education in the factory, they requested training for managers and assistant managers first in October 1997. Aftet the training, the production manager said this training was different from what they had previously and would be useful to every body. They supported intensive training, twice a day, morning and aftemoon at one and one half hours each. The factory paid overtime for workers. Project staffconducted 33 rounds oflarge group education to 878 workers. Peer volunteers were trained under the sponsorship of the factory including meeting room at AIT, perdium for 2l workers including 2 RP, Miss Nongkran Thanombun. The factory officially appointed Peer Volunteers and advertised for other workers to know.
158
September 1997, the factory asked project staff to plan about taking care
Arnex 5: A
case study: Rohm Apollo Company.
Results.
Resource persons: 2
Khum NongKran Thanombun - Head of Labour Relation. Khum Laddawan Rodruen

- Labour Relation.
o r
Peer
Volunteers:
19
Workers trained: 878
When all workers were trained, the infected person revealed that he had
AIDS and the factory management allowed him to continue his work
and
receiving health care from factory. His colleagues could accept and work along with him. There were 4-5 workers who were afraid they might have contacted AIDS because of their sexual behaviour. Some of them had symptoms similar to AIDS. The Project staff had given the advice and referred them to other health service center. Usually the project staff would talk to workers in their dormitory, or they came for consultation at Navanakorn Friends Forum. Some of them phoned in.
After the volunteers were developed, several activities were conducted such as World AIDS Day in December 17-18, 1997. Advertisement board in the factory, distribution of condorns and information on AIDS in men's room and
Women's room. Conversation and consultation were conducted until the end of the project. The factory allowed project staff to interview and took VDO with management staff, RP and PV. VDO tape of the training and education sessions for 2hrs on 12 February 1998. The factory put up advertisement banner and provided lunch for project staff.
t59
Name of Personnel Participating in the Factories
Name of Executive Board

Chairperson
1.
Dr. Paitoon Boonwat
Government of Pathum-Thani Director, Provincial Health Office Pathrm-Thani
Deputy Chairperson
2. Dr. Veerachai Pitawan
Member
3. tvlrs.Chariya 4. Mrs.Saichol
5. Mr.
Kanthavit Kareepot
Anon Intarasooksri
6. Dr. Pakpimol
7.Mr. Samark Sonngsawang Chairman of Navanakom Personnel Forum,

Pathum-Thani
8. Ms. Rachita Na-PattalungDirector
Prasert
Director, Provincial Health Office Pathum-Thani Office of Provincial IndustryPathum-Thani Office of Provincial labour hotection and Welfare AIDS Divisior5 Ministry of Public Health
of the Population
Technical Assistance
Team
9. Mr. Promboon
10. IvIr. Montree
Panichpak
Director of Care lnternational
Deputy Director, Planned Parenthood Association of Thailand (PPATI{) I l. Assoc.Prof.. Pantyp Ramasoota Deputy Director, AIHD Mahidol Univeristy
Pakanan
Member and Secretariat 12. Assoc.Prof.. Yawarat Porapakkham
Project Director
Name of Factory Outreach Workers (FOW)
l.
3. 4.
I\db.
Wanna Supachaijareankul
2. Ms. Somphet Lawnugoon
Ms. Lawan Pemsukrungrong Mr. Perayot Hanchana
24yearc 24yearc 24yearc 25 years
ol4 B.Ed.
old, B.Ed. old, B.Ed. old, B.Ed.
Name of Health Education Support Team (FIEST)

(from Pathum-Thani Province) l. I{rs. Kruatip Janthaneewat
2. Ms. Kanokporn Trusabungiong
3. Mrs. Sasiporn Rojaya 4. Mr. Neatit Prasertwong
ProfessionNurse, AIDS and STD control division Provincial Health Office Pathum-Thani Disease Contol technical officer, AIDS and STD conhol division Provincial Health Office. Pathum-Thani Health educator, Health education divisioru Provincial Health OfEce, Pathum-Thani Labour relation, hovincial Labour hotection and Welfare Office. Pathum-Thani
r60
Establishing HIV/AIDS Progrms in the workplace
Name ofPersonnel Participating in the Factories
Establishing HIV/AIDS Programmes
Title
Contractor
Establishing HIV/AIDS Programme in the Workplace Ouheach to Factories in Pathum Thani Province .
ASEAN Institute for Health Development (AnD) Mahidol University, Salaya Campus Phutamonthon, Nakorn Pathum,73170 Thailand
Prof. Dr. Som-arch Wongkhomthong
Director of AIHD
Manager of EC/AIHD AIDS Project

Asst. Prof. Dr. Boongiun Tragoolvongse
Assistant manager of EC/AIHD AIDS Project Mrs. Somjai Pramanpol
Project Staff:
hof. Yawarat Porapakkham Mrs. Wilaiwan Koykaewpring Mrs. Chongkolnee Chutimatawin Mrs. Varapom Pinitpuvadol
Assoc. Ms. Hatairat Suda Ms. Jittiya Patip
Project Director Project IVlanager

Proj ect monitoring&Strpervision
Project researcher Field Coordinator Project Secretariat
l6l
Nmre of Personnel Puticipating in the Fadoris
Name of Personnel Partic
Fujitsu (Thailand) Co.,Ltd.

60/90 Moo 19 Navanakorn Zone3Phaholyothin Rd. Klong Luang Distict TeL529'263U5 Fa:<: 529-2581 -Thani
Province.12120
ist of Executive
Mr. Norachai List
Koykaeupring Viroiphan
Langpaatarachanveng
Sr.Human Resource lvlanager Admin.
of
Resource Person
Mrs. Poolsinn Miss Patama
Chief, Personnel & Welfare Division Administation Section
Seiko P&C (Thailand) Co.,Ltd.

104 Moo
l8 Navanakom Zone3 Phatrolyothin Rd. Klong Luang District
Pathnm-Thani Province. List of Executive
12120
Tel.529-2162-56 Fax 529'2167
Mr. Veeraphat
Ketsung
Personnel Manager
List ofResource Person Ms. Kanokpomm Burapan Assist. Chief, Personnel Section
Matsushita Electric Works (Thailand) Co., Ltd.

106 Moo I 8 Navanakom Zone 3 Phatrolyothin Rd. Klong Luang Disfiict
Pathnm-Thani Province.
12120
Tel. 529-1671 Fax:529-1674,529-2944
ofExecutive Mr. Chaovalit
Piyatat Boonloan
Personnel Manager
ist ofResource Person
Mr. Watchara
Ms. Potiaman
Sonserrn
Persormel Senior Staff
Personnel Senior Stafr
162
Esablishing HIV/AIDS Ptogrms in thc Watplace
Name ofPersonnel Participating in the Factories
WC Manufactoring Co.,Ltd.
107 Moo 18 Navanakom Zone 3 Phaholyothin Rd. Klong Luang
Pathum-ThaniProvince. List of Executive Mr. Samark
12120
Distict
Tel.529-2105-9,529-2238-40 Fax: 529-2241-3
Songsawang
Personnel & Administration Manager
List ofResource Person
Mr, Somsak Maon Mr. Noroarat Ponekam
Personnel Senior Staff General Atrairs Statr
Tostem Thai Co.J-td.

60/2 Navanakom Zone Pathnm-Thani Province.
12120
Phaholyothin Rd. Klong Luang Dishict
Tel.529-0474 For: 529-059E
of Executive
Mr. Chongkol
Kaewkamsan
Personneal Manager
ist of Resouce Person
Mrs. Soonfa Mrs. Somsri
Ruedeeniyom Ngamsanai
Admin Personnel Staff

Nurse
Fujikura (Thailand) Co.,Ltd.

101/2 Moo 20 Navanakom Zone
Pathum-Thani Province.
12120
Phaholyothin Rd. Klong Luang District
Tel.529-3523 Fax: 5294606
List ofExecutive Mr. Boonthan
Thonthong
Personnel lvlanager
ofResource Person
Mr. Tawatch Pimkkam Ms. Kalaya Wongkaenchan
SafetY Officer
Senior Staff
r63
Narne of Personnel
Prticipding in the Factorics
KDK Fujikura (Thailand) Co.,Ltd.
'ThaniProvince.l2t20
List of Executive Mr. Kavin
60/73 Moo 19 Navanakorn Znne 3 Phaholyothin Rd. KlongLuangDistict Tel.529-1794-9,529-1800 For:529-1793,529-1801
Chatusart Klinktrajorn Sueunnakam
Adminishation & Persomel lvlanager
List ofResource Person

Ivh. Samart
SeniorEngineer Staff
Ms. Ketkaew
Officer
H.R.Silvine Electronic (Thailand) Co.,Ltd.

60/74 Moo 19 Navanakom Tnne 3 Phatrolyothin Rd. Klong Luang District Thani Frovince.12120 Tel. 529{948-51 Fa:r: 529-0952
ist of Executive
Mr. Anusorn
Tepsam
Personnel Managsr
ofResource Person
Ms. Ratharinya Hansakul Mr. Tawee Chantree
Training Offcer Staff Safetv Officer
TAKACOM (Thailand) Co.,Ltd.

60/82 Moo 19 NavanakomZone 3 Phalrolyothin Rd. Klong Luang District
Thani Province.12120 ist of Executive
T el.
529-2124-8 Fa:r: 529-2129
Mr.Siam
Kaeochantranond
Deparhent Manager Finance & Adminishation
ofResource Person Mr. Suoan Pongpaew Mrs. Boonchoo Musopin
AssistManager Penonnel
Senior Leader Production Division
Establishing HIV/AIDS Programs in ihe Wokplacc
Name of Personnel Participating in the Factories
Nitsuko Thai Co.. Ltd.

60/82 Moo 19 Navanakorn Zone 3 Phaholyothin Rd. Klong Luang Distict 12120 Tel.529-2112-4 Fax:529-2115
List of Executive Mr. Jullakrieng
Dejpotiyanon
Personnel Manager & General Affairs Section
List ofResource Person Ms. Supaporn Utsa

Ms.
Products Section Staff

Personnel
Aim-on Yimoi
Admin Staff
Carton Optical (Siam) Com.Ltd.

100 Moo I 8 Navanakom Zone 3 Phaholyothin Rd. Klong Luang
Pathnrr-ThaniFrovince. List of Executive Mr. Sattaphol
12120
Distict
Tel.529-2346-8.529-1649 Fax:529-2338
Wittayapak
Personnel and General Af,fair Manger
List of Resotuce Person

Mrs. Amoai Chalernrit Chief Personnel Admin
Rohm Apollo Electrics (Thailand) Co.,Ltd.

102 Moo
20 NavanakomZone
12120
Phaholyothin Rd. Klong Luang Disfrict Tel.529-0777-82 Fa:c 529-0775-6
List of Executive Mrs. Sirimarn
Boonkasem
Human Resource Manager
List of Resource Penon Ms. Laddawan Rodrean Mrs. Yanisa Thanomboon
Supervision Labor.r relation Assist.Manager Labour Relation
165
Reference
l.
Chai-Podnisita and Uwaporn Pattaranavich, Youth in contemporary in Thailand: Result from family andyouth suwey,IPSPe Mahidol 1995.
2. Hubley, Understanding behaviour: The key to successful health education., Tropical Doctor, 1988. 3. Susan M.L.Laver. AIDS is our problem: A guide to effective communication about AIDS trainers of farm health workers., 1993. 4. Departrrent of Welfare and Labour Protection, Ministry of Labour, Law on Laborn Protection, 1998, P.23. 5. Department of Epidemiolory, Ministry of Health. Surveillance of risk behaviour in specific area for factory workers in Thailand. Round l. Weekly surveillance report 17 (May 1996\ 6. ibid. Rotmd. 2.2 (May 1997)
7. National Policy on Prevention and Alleviation of AIDS. t997-2002.
8. Outreach program on HIV/AIDS prevention education. Report on factory survey, November 1996. 9. Yawarat Porapakarm, Project on Graduate AIDS Volunteers factories in Bangkok. AIIil), Mahidol University, 1996.
10. Virachai Pitwan, Lecture in the Seminar
in
Industrial
for Management Staffof Factories in
Navanakorn Industrial Park.

11. Provincial Health
2, No.5,
12.
Office of Pathum-Thani. Summary on AIDS situation, year May 1996.
ibid. year 4 No. 5, 1998.
r66
Establishing
HMAIDS
Programs in
tte Wodqlaoe
fsBN 97 4-662-939-5

Establishing HIV - AIDS Programs in The Workplace - Outreach To Factories in Pathum Thani Province

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ffiffi.

The European Communiryt Program on HIV/AIDS in Developing Countries

Establishing HIV/AIDS Programs in the Workplace: Outreach to factories in Pathum-Thani province.

Yawarat Porapakkham Wilaiwan Koykaewpring Varaporn Pinitpwadol

With support of the European Community's Programme on HIV/AIDS in Developing Countries

ASEAN Institute for Health Development

Publishedby ASEAN Institute for Health Development Mahidol University, Salaya

Fint published: 500 Copies

Cataloguing in Publication Data

'- Prevention & Control

503 E79 1999

Project on the establishing HIV/AIDS Programes in a workplace.

II Project strategies. .....................................................-..........-.--.....--....

Strategies and results...............................................,.-...............-......25

interview... (Post-intervention)........... company...

Establishing HIV/AIDS Progrms in the Workplace

Programs in the Workplace

The investigators wish to express their appreciation to the following

The governor of Pathum Thani Province especially Khun Ying

Establishing Hw/AIDS Pmgrams in the Worlglace

Yawarat Porapakkham Wilaiwan Koykaewpring Varaporn Pinitpuvadol Hatairat Suda

Establishing HIV/AIDS Programs in the Workplace

Clear, Clean, Convenience, Creating and Hygienic and Crealing

Establishing HIV/AIDS hograms in the Wortglace

Establishing HW/AIDS programs in the Workplace

Chapter I: Project on the Establishing HIV/AIDS Program in Workplace

Establishing HIV/AIDS Programs in the Workplace: Outreach to Factories in Pathum-Thani Province.

A Cooperative Project between the

Supporting Agency Project Site

The European Community's Program on HIV/AIDS in Developing Countries.

Navanakorn Industrial Estate. Pathum Thani, Thailand.

Establishing HIV/AIDS Programs in the Workplace

Chapta I: Project on the Establishing HIV/AIDS hogram in Workplace

Project on the Establishing HIV/AIDS Program in the Workplace.

HIV/AIDS problem in factory workers.

Establishing HIV/AIDS hograms in the \Vorkplace

Chapter I: Project on the Establishing HIV/AIDS hogram in Workplace

HIV/AIDS Prevention and Alleviation of AIDS.

Chapter I: Project on the Establishing HIV/AIDS Program in Workplace

2l Snategy in the development of the social environment to be

3) Strategy in the development of social psychology to allow the

6) Strategy in the development of knowledge

and research in the

7) Strategy in the development of international cooperation in the

Strategy in the development of management mechanism prevention and alleviation of AIDS.

Establishing HIV/AIDS Progams in the Workplace

Project on the Establishing HIV/AIDS Program in Wo*place

to have consultant lervice in

Establishing HIV/AIDS Progruns in the Workplace

Chaper I: Project on the Establishing HIV/AIDS hogranr in Workplace

was the promotion

cooperation among govemment, academic, private,

to participate in the development of the intellectual capacity and promotion of

AIDS Situation in Pathum-Thani.

Establishing HIV/AIDS Progrms in the Wodplacc

Chaptcr I: Roject on the Establishing HIV/AIDS Progam in Wo*place

No. increased withinl years

Sept. 1994-May 1996

No. ofAIDS Patients 249

No. HIV of infected persons

Office. Summary of AIDS situdion 4:5 Msy lgg87

Establishing HIV/AIDS Progams in ihe Workplaoe

Chapter I: Project on the Establishing HIV/AIDS Program in Workplace