Discrimination Against Workers with HIV


FEATURE STORY

Subjected to so much adverse bias in hiring and firing, patients without active disease but positive for the dreaded virus have to live with this inequity or choose an option of nondisclosure

By Henrylito D. Tacio


While undergoing treatment for tuberculosis (TB), 36-year-old “Kevin” came to know that he was positive for human immunodeficiency virus (HIV) when the doctor told him. A call center agent from Cagayan de Oro City, he didn’t reveal his status to his colleagues.

But TB had taken a toll on his health. With frequent stints in the hospital, his colleagues started talking about the root of his health problems. They were speculating that he had HIV. “I felt discriminated against because when I went inside the office one day, I actually heard people whispering, “That’s him! That’s the guy who has HIV!” Kevin recalled.

It was a matter of time that the company’s human resources office came to know the situation. He was called and was asked bluntly whether he had HIV. Kevin felt he had no choice but to disclose his status. He said that immediately following that disclosure, his coworkers started shunning him and refused to speak to him. That treatment prompted him to quit the job. “I could no longer take it,” he said.

The case of a 26-year-old Elizabeth, another HIV-positive, was even more pitiful. A single mother of a 6-year-old boy, she worked as a cashier at a café in Manila. When she learned about her status, she was totally devastated. “I cried all the time, every time I’m reminded of what happened,” she said, adding that she cried even more “because of the discrimination I’m going through.”

Two years after she was diagnosed of having HIV, Elizabeth started to suffer from double vision and frequent headaches. Her doctor, who could not determine whether she was suffering from an opportunistic infection, suggested that she undergo an MRI on her eyes.

Because the doctor recommended rest, she needed to file a leave of absence from her company. “I told our human resources about my status so I can have a valid excuse for my leave, which was going to take a long time because the doctor wanted me to rest,” she said.

She was fired as a result. “My supervisor said she understood me and would like to help,” she said. The supervisor then referred Elizabeth to the manager of a manpower company that supplies workers for restaurants. The manager told her: “Since there may be people who won’t understand what happened to you, I need to pull you out of the coffee shop.”

The manager then asked Elizabeth to fill out forms, one of which turned out to be a resignation letter from employment agency, not just the coffee shop. “I asked why and he told me it’s because I was exposed to food,” she said. “He was very good at convincing me to resign for my own good, that resigning would reduce my stress, things like that. But it was painful. I know what he was asking me to do was wrong. It felt wrong.”

At the manager’s urging, she signed the resignation letter.

These were just two of the several accounts of workplace discrimination against people infected with HIV compiled by Carlos Conde, the country’s researcher of Human Rights Watch (HRW). The names were changed to protect the privacy of the people interviewed for the report.

“Workers and employees in the Philippines living with HIV who suffer workplace discrimination often do not seek redress,” HRW said in a statement. It added that the government’s response to unlawful firings and harassment is “weak.”

Aside from unlawful firing, workplace discrimination also refers to refusal to hire and forced resignation of people with HIV. “Some employees may also disregard or actively facilitate workplace harassment of employees who are HIV positive,” the statement said.

In most of the discrimination cases that HRW documented, “employees with HIV did not file formal complaints, most frequently due to fear of being further exposed as HIV positive, which could prevent future employment.”

HIV is the microorganism that causes Acquired Immune Deficiency Syndrome (AIDS). It was first reported in 1981 in the United States. “(AIDS) is a syndrome because there are a range of different symptoms which are not always found in each case,” explains Dr. John Hubley, author of The AIDS Handbook: A guide to the understanding of AIDS and HIV. “It is acquired because AIDS is an infectious disease caused by a virus which is spread from person to person through a variety of routes. This makes it different from immune deficiency from other causes such as treatment with anti-cancer drugs or immune system suppressing drugs given to persons receiving transplant operations.”

In the Philippines, the first case of HIV infection was reported in January 1984. As of January 2019, about 42 Filipinos are infected with HIV each day, according to the HIV/AIDS and Art Registry of the Department of Health (DOH). From 2 cases in 2009, it went to 7 cases in 2011, 16 cases in 2014 and 32 cases in 2018. In 2015, the Geneva-based World Health Organization (WHO) pictured the Philippines as “having the fastest growing HIV epidemic in the world.”

“The Philippines faces a double whammy of increasing HIV infection and fears by workers with HIV that they can’t seek justice if they are discriminated against on the job,” Conde said. “The government needs to ensure that people living with HIV get better protection in their jobs and that the public gets more and better information on HIV.”

Actually, HIV is a relatively weak virus outside the human body. But once it is inside, HIV cannot be killed. The virus is spread through the exchange of body fluids with high viral load like cerebral fluid, amniotic fluid, blood, semen, cervical and vaginal secretions and breastmilk. The virus is transmitted by sexual intercourse (vaginal, penile, anal and in some instances oral), blood and blood products (through transfusion) and shared needles.

A woman infected with HIV may spread the virus to her child during pregnancy, during birth or shortly after birth, and through breastfeeding.

From the first time HIV infection was reported in the country in 1984 to 2006, the predominant mode of transmission was male to female sex, according to the health department. “From 2007, the trend shifted to sexual contact among MSM as the predominant mode of transmission and has remained such to the present.”

MSM stands for men having sex with men. “From January 2014 to January 2019, 83 percent (38,925) out of the total (46,802) diagnosed HIV cases were among MSM,” the health department reports.

From 1984 to 2009, HIV transmission through sharing of infected needles were less than one percent of the total cases reported, the health department points out.

A glaring fact, however, is that most of those infected with the virus in recent years were young people. “From January 1984 to January 2019, 17,935 (28 percent) of the reported cases were 15-24 years old,” DOH reports. “Ninety-seven percent (17,349) were infected through sexual contact.”

Those who work abroad are not spared from being infected. In fact, 90 overseas Filipino workers (OFWs) within the past five years were diagnosed in January 2019. “They comprised 7 percent of the total newly diagnosed cases for the month,” DOH reports. Majority of those infected were males and they were infected through sexual contact among MSM.

The grim reaper has taken its toll among HIV infected Filipinos. “A total of 3,076 deaths were reported from January 1984 to January 2019, 92 percent (2,784) of whom were male,” the DOH notes. “Twenty-three (1 percent) were less than 15 years old at the time of death, 470 (15 percent) were 15-24 years old, 1,519 (49 percent) were 25-34 years old, 856 (28 percent) were 35-49 years old, and 206 (7 percent) were 50 years and older.”

According to the United Nations health agency, HIV targets the immune system and weakens people’s defense against infections and some types of cancer. “As the virus destroys and impairs the function of immune cells, infected individuals gradually become immunodeficient.

Immune function is typically measured by CD4 cell count,” the WHO explained. Immunodeficiency results in increased susceptibility to a wide range of infections, cancers and other diseases that people with healthy immune systems can fight off, the WHO pointed out.

AIDS is the most advanced stage of HIV infection. “This can take from 2 to 5 years to develop, depending on the individual,” the WHO said. It defines AIDS as “the development of certain cancers, infections, or other severe clinical manifestations.”

A person with HIV will never know he is positive of the virus unless he or she undergoes an HIV test. “Having an HIV test is the only way to know for sure whether you have HIV,” said the website, www.aidsmap.com. “If you have HIV, it’s very important that it’s diagnosed. This will give you the best chance of getting the treatment and care you need to stay well.”

Unlike in the past, being HIV positive is no longer a death sentence. “There’s no cure for HIV, but treatment options are much better than they were a few decades ago,” www.WebMD.com says. “Because of medical advancements, many people now live long, active lives with HIV.

“The medicines that treat HIV are called antiretroviral drugs,” the website says. “There are more than two dozen of them, and they fall into six main types. Each drug fights the virus in your body in a slightly different way.”

Research shows that a combination, or so-called “cocktail,” of drugs is the best way to control HIV and lower the chances that the virus becomes resistant to treatment. A doctor can recommend a patient to take three different medicines from two of the groups.

“Which specific ones your doctor prescribes depends on what other medical conditions you have or are likely to get, how well your immune system is working, and even how many pills you want to take each day,” WebMd.com says.

Once an HIV-infected person starts having treatment, he should not stop doing so. “Keep taking your HIV medications,” reiterates WebMd.com. “It’s dangerous to change how you’re taking them – or to stop altogether – if you’re unhappy with how you feel or how they affect you. That can make it easier for the HIV to become resistant to drugs and harder to treat.

“Continuing treatment is the key to not only preventing the development of AIDS, but is key to maintaining a relatively normal lifestyle. It is possible, with the correct treatment, to obtain a normal life expectancy,” the website says.

Despite this good news, people living with HIV are still struggling to find jobs. “Keren,” 39, used to work as a warehouse supervisor for a sports brand but he quit his job after he was diagnosed with HIV in 2012. More than five years and four job applications later, he is still jobless, a situation he attributes to the refusal of employers to hire an applicant who discloses their HIV status.

“It’s difficult to find a job these days with my condition because I have to disclose my status so I can have a schedule that is good for my health, that fits my medical condition,” he says. “But if I disclose my condition, chances are I won’t get hired.”

Damned if you do, damned if you don’t!

“From January 2014 to January 2019, 83 percent (38,925) out of the total (46,802) diagnosed HIV cases were among MSM (men having sex with men)”

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