Tips and Advice for Employees Living with HIV

Understanding Your Rights While Preserving Your Long-Term Good Health

Photograph © Thomas Barwick/Getty Images

With advances in the treatment and management of HIV, people can now have fully productive lives, which includes setting long-term goals for your employment and career track. There may be times, however, when you feel you need to take time off for medical leave or feel your health may be impacting your day-to-day productivity.

How might this affect your job and the confidentiality you'd prefer to keep?

Are there protections that allow you to maintain your position at work, as well as your good health and well-being? 

There are some facts every working person should know today, and tips one can follow to ensure the best medical care while you are on the job. 

Disclosing Your HIV Status to Your Employer

Whether of not you disclose your HIV status to your employer is entirely up to you. You are under no legal obligation to do so. And because HIV is not transmitted by casual contact, you are at absolutely no risk of infecting your fellow employees.

With that being said, weigh the pros and cons when considering a workplace disclosure. In some cases, it may be beneficial to you. If you feel safe with the people you are working with, the response among your colleagues could very well be "no big deal." After all, disclosure is often the first step to normalizing the disease, allowing you to focus on the big picture—your life and your future—rather than compartmentalizing HIV in its own little box.

Alternately, you might feel that it's no one's concern, or that health in general isn't something the one should discuss in workplace. That's fine, too.

Still, others might tell you that you have a moral obligation to inform your employer if you have a job in which exposure to blood or body fluids is possible.

Maybe it's because your a cook handling food, a dental assistant doing teeth cleaning, or a lab technician drawing blood. The simple fact is that these kinds of beliefs are not only outdated but offensive, reflecting fear and ignorance that further perpetuates HIV stigma and discrimination. The bottom line is that the risk of transmissions by these means is negligible to nil, with few, if any, documented cases of infection. It's akin to demanding that a taxi driver reveal reveal his or her epilepsy for fear that a seizure might occur while you're in the back seat. It's simply nonsense.

It is also illegal for an employer to request or even inquire about your HIV status. If this happen or you feel you're being coerced to make disclosure, contact a local advocacy group or attorney specializing in workplace discrimination. Your regional HIV/AIDS hotline can provide you referrals. 

What Are My Rights as an Employee?

But, then again, what if you're feeling ill because of an HIV-associated illness or having difficulties at work because of a prescribed therapy or treatment side effect?

While there may be benefits of disclosure, it is more important to first understand your rights as an employee. 

In September 1994, Sidney Abbott visited the offices of Dr. Randon Bragdon, a dentist practicing in Maine. This otherwise routine visit would eventually spark a controversy that would end up before the justices of U.S. Supreme Court. According to court documents, Dr. Bragdon refused to fill Ms. Abbott's cavity after she had disclosed she was HIV-positive. After four years of often-contentious debate, the Supreme Court finally ruled that the Americans with Disabilities Act (ADA) did extend protections to people living with HIV. And as a result, employers are now legally obliged to make "reasonable accommodations" for their employees, including those with HIV. 

Under the ADA, employers must allow time away from work to seek medical care. In addition, employers must make reasonable accommodations regarding schedule modification, allow reassignment to vacant positions that are better suited to the person's limitations, and must purchase equipment that will allow the person to better perform his or her job.

It's important to keep in mind, however, that if you do request accommodation under the ADA, you will likely be required to provide medical documentation of your disability. Ethically and legally speaking, your doctor cannot conceal your HIV status if your disability is directly related to HIV.

For advice, contact your local Americans With Disabilities Act Service Center and learn more about how the ADA as it applies to people living with HIV.

Job-Based Health Coverage

Many employees can now get insurance coverage though their employers, particularly now that businesses with 15 employees or more are required to do so under the Affordable Care Act (ADA).

Before accepting any job, inquire about health coverage and ask to see the group policy handbook. This is especially true when it comes to the prescription drug coverage. At some coverage levels, the co-pay for certain antiretroviral drugs can be exorbitant. In such cases, you can either negotiate for a higher level insurance, pay the difference for a higher level insurance, or find ways for co-pay assistance through the drug manufacturer.

But again, remember, you do not have disclose your HIV status in any circumstance unless you choose to do so on your own. Employers are prohibited from making any inquiry about your status or asking any disability-related questions as per the terms of the ACA.

Sources:

U.S. Department of Justice (USDOJ). "Abbott v. Bradgon." Washington, D.C.; accessed January 15, 2015.

USDOJ. “Current text of the Americans with Disabilities Act of 1990 incorporating the changes made by the ADA Amendments Act of 2008.” Updated March 25, 2009.

Jacobs, D. and Sommers, B. "Using Drugs to Discriminate - Adverse Selection in Insurance Marketplace." New England Journal of Medicine. January 29, 2015; 372:379-402.

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