UN agency tracks management of HIV/AIDS in the workplace

HEALTH MATTERS/CODE OF CONDUCT: By December 1996, 22.6 million people were living with HIV/AIDS, 2.1 million of whom were estimated as new cases in that year The laws in France and the US ensure that therapeutic part-time work and compensation are combined, followed by an invalidity pension as AIDS develops

Does your employer have a policy on HIV/AIDS in the workplace? The International Labour Organisation (ILO), the UN agency with special responsibility for the world of work, issued a study entitled HIV/AIDS and Employment in 1998 on the impact of both on the world of work.

Since its publication, there has been a lot of movement on the issue at the ILO, most notably with the publication of a code of practice for HIV/AIDS and the workplace a year ago.

The findings of HIV/AIDS and Employment remain valid, even more so now given the advance of the illness throughout the world, evident at the World Cup where even a bloodied nose now bars a player to the sidelines.

By December 1996, 22.6 million people were already living with HIV/AIDS, 2.1 million of whom were estimated as new cases in that year alone.

The worst affected age category is 20- 40 years, among the most economically active of the population. As well as the emotional and psychological trauma of diagnosis, workers and employers have to deal with the impact of HIV/AIDS in the workplace.

HIV/AIDS and Employment, edited by Louis N'Daba and Jane Jodges-Aeberhard, uses an international comparative study conducted by the ILO on 12 countries, including France and the US. It examines the legal framework and enterprise practices in each place, and the rate of infection of the sexually active adult population.

While countries with a relatively low rate of infection have little inclination to establish regulations for managing AIDS in the workplace, countries with a high rate have to adapt and develop their legal framework, says the ILO. "Some countries less affected so far by the pandemic have anticipated it, while others which are more severely affected have been slow to react."

The ILO study deals with the legislative and regulatory framework, and practices at workplace level such as codes of conduct on AIDS and AIDS agreements made within industrial sectors. It examines the impact of measures taken and recommends practical strategies. Nationally, it proposes a model policy guide to prevent and combat discrimination in employment on the ground of HIV status or AIDS diagnosis.

Written for managers, employers' organisations, workers, trade unions and people with HIV/AIDS, the study highlights positive workplace practices for dealing with HIV/AIDS. Among the admirable practices surveyed, it salutes not dismissing a worker who is HIV positive. It applauds cases in which infected workers can stop working and benefit from good compensation and moral, psychological and medical assistance.

"However, because of labour law and the principle of non-discrimination in employment on the grounds of health, and because of the need for access to medical care, the special features of HIV infection and AIDS require the adaptation of conditions of employment," says the ILO. Moreover, AIDS in the workplace provides an opportunity for preventive educational policies for all workers.

Practices in France and the US are highlighted as excellent examples of positive. The laws in both countries ensure that therapeutic part-time work and compensation are combined, followed by an invalidity pension as AIDS develops. All infected workers with health insurance are covered for medical care. Half of the other countries surveyed enable infected workers to maintain their wages when they stop working and access medical care through public health systems.

For instance, in Jamaica most HIV-positive workers choose to remain at home knowing they will continue to receive their wages and health care reimbursements.

Early retirement for people affected by HIV/AIDS who have completed sufficient service to qualify for a pension can ensure that a worker's dependants are materially cared for after the death of the infected person. In South Africa, workers with AIDS in certain jobs can receive retirement benefits and an invalidity pension.

Ergonomic adaptation of the workplace and changes to job content can be needed, in accordance with what can be a 10-year progression from the onset of HIV infection to the development of clinical AIDS.

In France, companies that do not give effect to ergonomic accommodation for people with disabilities, including people with HIV/AIDS, have to pay a penalty, notes the study. A code of conduct is one of the best guarantees when legislation is inadequate.

The ILO proposes that codes should contain recommendations on HIV/AIDS and the contract of employment; special allowances and benefits; disputes and disciplinary procedures; testing; confidentiality; managing fear among colleagues and managers; management of health care; and support and counselling at the workplace.

Dr Dan Murphy, medical director at the Health and Safety Authority, told The Irish Times that there must be the strictest confidentiality on a need-to-know basis concerning anyone at work with HIV/AIDS.

With the permission of the employee, first-aid personnel should be informed.

Should confidentiality be broken, an intensive education programme should be undertaken.

Website: International Labour Office programme on HIV/AIDS in the workplace: www.ilo.org/aids