The stigma of AIDS in the workplace is a global issue

The stigma of AIDS in the workplace is a global issue

Meredith Lepore of TheGrindstone, a blog about women and the workplace, questions whether companies and employees are prepared to deal with the stigma of AIDS at the office.

It has been 18 years since Tom Hanks won an Oscar for portraying a gay man who was fired after he contracted AIDS in the film Philadelphia. But as we approach AIDS Day 2011 this Thursday, the negative stigma surrounding AIDS in the workplace has not come as far as we might have hoped. The epidemic has plateaued in the US, but there are still about 1.1 million people infected with HIV here. And about 20 percent do not know they are infected.

Those are the ones that more likely will infect other people. Since the world’s first AIDS case was reported 30 years ago, the US has seen close to 600,000 AIDS-related deaths. These numbers indicate that you will, in one way or another, know someone or know of someone who has HIV or AIDS and it may very well be in your place of employment. Are companies doing enough to prepare for this?

Today it was announced that guidelines on managing HIV cases at the workplace will be changed early next year in Singapore, in a bid to remove at least some of the stigma surrounding the virus. The plan to change the workplace guidelines were announced yesterday by Dr. Amy Khor, Minister of State for Health and chairman of the National HIV/Aids Policy Committee, at an event to commemorate World Aids Day, which is this Thursday. Dr Khor said there have been cases of workers who were dismissed because they were found to be HIV-positive.

“If they are treated and cared for, they can continue to work and contribute to the company and the economy constructively and productively,” she added.

HPB chief executive Ang Hak Seng said that revamping the workplace guidelines will help target working adults aged 30 to 49 years old, who are typically more sexually active. He added that adults in this age group form the bulk of those with HIV, based on figures released by the Ministry of Health (MOH) yesterday. MOH revealed that 48 percent of those with HIV are aged between 30 and 49 years old. In the first 10 months of this year, there were 370 new HIV cases reported among Singaporeans and permanent residents.

Though it sounds like Singapore is taking a stance on improving conditions of AIDS in the workplace, this is a worldwide problem. South Africa has made major strides in dealing with the problem a big concern for many experts like Dr. Thembisile Xulu is that the very tough economic situation may lead to companies thinking they can cut corners in dealing with HIV-positive employees.

“Employers are better off retaining the employees who are already part of their value systems. In my view, testing and identifying people who have chronic illnesses, including HIV, and intervening only adds to the eventual bottom line of the employers…HIV and other chronic diseases cost employers money, and they need to take it seriously and invest not just in testing, but also disease management and follow-up, and through reducing absenteeism and increasing the number of days people are at work, they can increase productivity. Stay committed to the health and wellness of your employees.”

Xulu is the managing director of Right to Care Health Services and also a board member of Right to Care, the country’s biggest HIV/Aids non-profit organization. The organization tests about 330,000 patients a year and treating more than 125,000 HIV-positive patients at more than 170 sites.

“I think companies have got better over the years in promoting these issues, but it’s still not enough. There are still issues of workplace discrimination against people with HIV, so there are some employers who are not yet as engaged and committed.”

As for the state of HIV in the workplace in the US, according to the Center for Disease Control and Prevention, approximately 1.2 million people in the US are living with HIV infection. In 2009, an estimated 42,011 people were diagnosed with HIV infection in the 40 states with confidential name-based HIV infection reporting since at least January 2006. In that same year, an estimated 34,247 people throughout the US (50 states and the District of Columbia) were diagnosed with AIDS. The majority of people infected with HIV/AIDS are between the ages of 20 to 45 and are employed, many by small- and mid-sized businesses. Despite the fact that ramifications of HIV/AIDS in the workplace, few companies have an established policy to guide their response to this issue. Here is a breakdown of the current conditions of HIV/AIDS in the workplace according to

  • At the federal level, there are two principal laws that protect individuals with HIV/AIDS. The first is the Rehabilitation Act and the second is the Americans with Disabilities Act.
  • When making hiring or promotion decisions, you may not discriminate against an individual who is believed to be HIV/AIDS-infected. Several states prohibit HIV/AIDS testing as a condition of employment, while others permit HIV/AIDS testing when the employer can show a legitimate reason for doing so. To establish a legitimate reason, there must be some connection between HIV/AIDS and job performance or safety. This connection may exist when the job involves a risk of transmitting the disease. An employer who tests for HIV/AIDS without a legitimate reason, or who does so merely because of suspicion that the employee is a homosexual or drug user, may be liable for an invasion-of-privacy claim by the job applicant.
  • Certain federal laws allow employees to discontinue working when they have a reasonable belief that their working conditions are unsafe. Given the consensus in the medical field that HIV/AIDS cannot be transmitted through casual contact, it would be difficult for an employee to refuse on these grounds to work with an HIV/AIDS infected co-worker. The reasonableness of the employee’s demand may depend on how the employer has educated employees about HIV/AIDS. If the employees have been taught that HIV/AIDS cannot be transmitted through casual contact, their refusal to work may be found to be “unreasonable” and they could be discharged.
  • Federal legislation not only prohibits discrimination against handicapped persons, but also requires employers to make reasonable efforts to accommodate handicapped applicants and employees where obstacles exist that would impede their employment opportunities. Insofar as an employee with HIV/AIDS is considered handicapped, an employer must make reasonable accommodations for him or her.
  • In addition, if your company is covered by the Rehabilitation Act and an employee has HIV/AIDS or develops it, you must make reasonable accommodations that permit the employee to continue working in the position. Such accommodations can include leave policies, flexible work schedules, reassignment to vacant positions and part-time employment. The criteria used to determine whether an employer is making reasonable accommodations for an HIV/AIDS-infected employee include the cost of the accommodation, the size of the business and the nature of the employee’s work.

In 1987, the US Surgeon General suggested that, when dealing with HIV issues, employers should:

  • Adopt an up-to-date HIV/AIDS education program that discussed how HIV is transmitted and explains the company’s policies regarding employees with HIV/AIDS;
  • Treat HIV/AIDS infected employees in the same manner as other employees suffering from disabilities or illnesses are treated under company health plans and policies;
  • Allow HIV/AIDS-infected employees to continue working as long as they are able to perform their jobs satisfactorily and their continued employment does not pose a safety threat to themselves, other employees, or customers;
  • Make reasonable efforts to accommodate HIV/AIDS-infected employees by providing them with flexible work hours and assignments; and
  • Protect all information regarding an HIV/AIDS-infected employee’s condition.

Photo: bonsai/


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