Preventing HIV Discrimination in Work Environments
People living with human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS) may face a complex set of challenges in the work environment.1 Stigma of HIV and misconceptions about HIV infection and transmission by employers and coworkers can manifest itself in many ways.
Individuals living with HIV may feel HIV discrimination while looking for employment or while on the job, and fear of rejection or loss of benefits may inhibit disclosure of HIV status.1 Licensing restrictions imposed on certain individuals, such as health care workers, may also perpetuate this stigma and other discriminatory workplace issues.
Although antiretroviral therapy (ART) has improved longevity, people living with HIV infection may still have concerns about their health in the future and whether employers will make reasonable accommodations for their HIV-related disabilities.1,2
Select workplace obstacles for people living with HIV1:
HIV discrimination and stigma against job applicants
Reasonable accommodation for HIV-related medical conditions and disabilities
Fear of disclosing HIV status because of potential violence by coworkers or loss of benefits such as health insurance for HIV medical care
Know the employment rights of people living with HIV
Several federal, state, and local laws, as well as company-specific regulations, protect the rights of people living with HIV/AIDS.
The Americans with Disabilities Act of 1990 (ADA) broadly prohibits discrimination against individuals with AIDS, AIDS-related complex, and both symptomatic and asymptomatic HIV.3,4 Protections encompass job application procedures, promotions, discharge, training, compensation, and miscellaneous terms and conditions of employment.5 The US Equal Employment Opportunity Commission ensures people living with HIV have privacy rights regarding their medical information, are protected from HIV discrimination and being harassed, and have reasonable accommodations to help them perform the duties of the job, such as flexible work schedules or permission to work from home when needed.6
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) protects small groups and businesses by helping them obtain and keep health insurance coverage.4
The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) allows employees to extend their health insurance coverage after employment ends.4
The Family Medical Leave Act of 1993 (FMLA) allows employees to take up to 12 weeks of sick leave for serious medical conditions or to care for a family member with a serious medical condition, including HIV/AIDS.4
Learn more about the legal rights of people living with HIV in the work environment:
Implement policy to reduce HIV discrimination and stigma in work environments
Businesses and employers, including healthcare providers, can take actions to reduce HIV discrimination and stigma to protect the health and safety of employees living with HIV in the work environment.7,8 Employers can address HIV stigma by developing workplace policies and educational programs on HIV and AIDS that promote the health and protect the rights of individuals living with HIV.
Developing HIV/AIDS policies in work environments can benefit employers, workers, and communities by8:
Creating a supportive and inclusive environment for people living with HIV
Mitigating employee fear and work disruption
Serving as a corporate role model for social responsibility, leadership, and commitment to workers and communities
Complying with federal, state, and local laws on disability and antidiscrimination requirements per ADA and other statutes
Learn more about developing HIV/AIDS policies to prevent HIV discrimination and related issues on the Centers for Disease Control and Prevention (CDC) website:
Initiate education programs to prevent HIV discrimination in the work environment
An educated workforce with increased HIV awareness may help create a fair, healthy, and safe work environment for all.9 Knowledge about HIV/AIDS, including facts about the risk of HIV and transmission of HIV, may help end HIV discrimination and promote a compassionate and productive work environment. Informed leadership and employees can ensure company policies are followed and take the necessary steps to protect themselves and educate their families and coworkers.
Ways to take action against HIV discrimination in work environments9:
Host a brown bag lunch series on HIV education and HIV prevention
Offer employee training on stigma reduction and non-discrimination approaches
Initiate a peer-based program where trained employees can help teach coworkers about HIV/AIDS, how to protect one's own health and safety, and the impact of HIV workplace policies
Collaborate with a local community-based organization (CBO) for an on-site HIV testing event where employees can take a voluntary HIV test and learn more about HIV prevention
Create a referral system to CBOs for assistance with health care and counseling services
Steps to prevent occupational HIV exposure
Occupational HIV transmission is rare.10 According to the CDC, the risk associated with needle-stick injury is less than 1%, and the risk associated with body-fluid splashes—even when blood products are involved—is extremely low to near zero.
However, companies should follow standard occupational health and safety precautions at all times to prevent exposure.10 Provide written policies and training on HIV infection-control procedures, promote safe practices to prevent injuries from sharp instruments, and instruct employees to report immediately any possible exposures if they occur.
The CDC recommends these steps to prevent occupational HIV transmission10:
Wear gloves, goggles, and other protective barriers when anticipating contact with blood or body fluids
Wash hands immediately and other skin surfaces after contact with blood or body fluids
Take caution when handling and disposing of sharp instruments during and after use
Use safety devices to prevent needle-stick injuries
Dispose of used syringes or other sharp instruments in a sharps container
Risks associated with the COVID-19 pandemic are reshaping the ways people manage and perform work.11 Remote work (eg, work from home) has become more common, and mask wearing, social distancing, and limitations on gathering sizes have transformed the work environment. It is unclear how long these transitions may persist or whether they will alter the workplace landscape in permanent ways.
Based on recent studies, people living with HIV appear to have a greater risk than the general population for severe outcomes with COVID-19, especially those with comorbidities, a weakened immune system, and/or advanced HIV.12 According to the CDC, the best strategy to reduce the risk of becoming sick is to avoid exposure to COVID-19.13
Identifying general safety hazards and preventative approaches is recommended in traditional and remote work environments.11,14 The CDC provides information about COVID-19 for people living with HIV, which may be helpful to share in the workplace.
Encourage all employees to minimize COVID-19 risk14:
Maintain 6 feet of distance from others, especially those who are at a higher risk of becoming very sick
Wear a face mask that covers the mouth and nose
Wash hands frequently with soap and water
Avoid large gatherings and poorly ventilated indoor spaces
Avoid sharing towels or eating utensils and wash utensils thoroughly after use
Keep surfaces clean and disinfected
Recognize any changes in health
1. Employment. The Center for HIV Law & Policy website. Accessed April 25, 2021. https://www.hivlawandpolicy.org/issues/employment
2. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. Department of Health and Human Services. Accessed April 25, 2021. https://clinicalinfo.hiv.gov/sites/default/files/inline-files/AdultandAdolescentGL.pdf
3. Fighting discrimination against people with HIV/AIDS. ADA.gov website. Accessed April 25, 2021. https://www.ada.gov/hiv/index.html
4. HIV, employment discrimination, and the law. HIV.gov website. Accessed April 25, 2021. https://www.hiv.gov/hiv-basics/living-well-with-hiv/your-legal-rights/workplace-rights
5. The ADA: your employment rights as an individual with a disability. US Equal Employment Opportunity Commission website. Accessed April 25, 2021. https://www.eeoc.gov/publications/ada-your-employment-rights-individual-disability
6. Living with HIV infection your legal rights in the workplace under the ADA. US Equal Employment Opportunity Commission website. Accessed April 25, 2021. https://www.eeoc.gov/laws/guidance/living-hiv-infection-your-legal-rights-workplace-under-ada
7. HIV stigma and discrimination. Centers for Disease Control and Prevention website. Accessed April 25, 2021. https://www.cdc.gov/hiv/basics/hiv-stigma/index.html
8. Understanding policy. Centers for Disease Control and Prevention website. Accessed April 25, 2021. https://www.cdc.gov/hiv/workplace/policy.html
9. Implementing BRTA. Centers for Disease Control and Prevention website. Accessed April 25, 2021. https://www.cdc.gov/hiv/workplace/empower.html
10. HIV and occupational exposure. Centers for Disease Control and Prevention website. Accessed April 25, 2021. https://www.cdc.gov/hiv/workplace/healthcareworkers.html
11. Guidance for businesses and employers responding to Coronavirus Disease 2019 (COVID-19). Centers for Disease Control and Prevention website. Accessed April 25, 2021. https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html
12. Interim guidance for COVID-19 and persons with HIV. Clinical Info HIV.gov website. Accessed April 25, 2021. https://clinicalinfo.hiv.gov/en/guidelines/covid-19-and-persons-hiv-interim-guidance/interim-guidance-covid-19-and-persons-hiv
13. What to know about HIV and COVID-19. Centers for Disease Control and Prevention website. Accessed April 25, 2021. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/hiv.html
14. How to protect yourself and others. Centers for Disease Control and Prevention website. Accessed April 25, 2021. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html
HVUWCNT210009 June 2021
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