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How Employers Can Support Those Living with and Affected by HIV and AIDS

Published for World AIDS Day – December 1st, 2019

Overview

On World AIDS Day each year millions of people across the globe band together to show support for people living with HIV or AIDS and honor those who have died due to AIDS-related illnesses. Founded in 1988 and commemorated annually on December 1st, World AIDS Day is a worldwide demonstration of community, awareness, and resilience in the face an epidemic that has claimed more than 32 million lives.

Over the last two decades, the intensifying efforts to raise awareness and end global HIV and AIDS have contributed to an overall reduction in the number of diagnoses. According to UNAIDS, there has been a downward trend in overall new HIV infections. Since 1997, new HIV infections have declined 40%—new HIV infections were roughly 2.9 million in 1997 compared to 1.7 million in 2018. Even from 2010 to 2018, there was an estimated 16% decline in new HIV infections overall and 41% decline in new infections among children.

The Facts

Despite the significant progress made in combatting the virus, ending the epidemic is more important than ever. HIV and AIDS continue to affect millions of people across the globe every day. Last year alone, more than 37.9 million worldwide were living with HIV or AIDS, while, tragically, AIDS-related illnesses claimed the lives of 770,000 individuals.

HIV and AIDS disproportionally affect marginalized communities, particularly those with multiple marginalized identities. In the United States, the latest CDC estimates demonstrate that African Americans account for 43% of HIV diagnoses, despite the fact that that they account for 13% of the population. While 1 in 6 white men who have sex with men (MSM) are likely to be diagnosed with HIV in their lifetime, the likelihood is significantly higher for black MSM—1 out of 2 of whom will likely be diagnosed. A recent CDC analysis also shines light on the racial disparities in the transgender community—finding that an estimated 44% of black transgender women have HIV compared to 7% of white transgender women.

Within the United States, rates vary by region. The South has the highest rates of HIV diagnoses in the country and also made up more than half of new HIV cases in the latest CDC research. According to the Williams Institute, more new HIV infections among MSM come from the South more than any other region, while about half of transgender individuals diagnosed with HIV live in the South.

As the virus continues to persist, so too does the stigma that surrounds it. Negative attitudes, prejudice, and discrimination are everyday realities for those living with HIV and AIDS. Many falsely believe that only “certain groups of people” can get HIV (such as sex workers or gay men) while others make moral judgements around HIV status, believing that immoral choices lead to the contraction of the virus. For this reason, many of those living with HIV and AIDS face discrimination or prejudice—such as being refused healthcare or shunned by those closest to them. This affects the emotional well-being of those living with HIV and can lead to feelings of despair, internalized stigma, and isolation. In many cases, the stigma can even prevent some individuals from preventing HIV transmission, getting tested, and seeking treatment.

This stigma makes clear the human and emotional impact of HIV and AIDS, as well as the continued importance of raising awareness, educating others, and fighting for better support of the community.

On this World AIDS Day, here are five key takeaways employers can engage year-round to support those living with and affected by HIV and AIDS:

1) Use Accurate Language: HIV is Not AIDS

While shorthanded references to “HIV/AIDS” are common, it is important in both official messaging and informal conversations to distinguish between human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). Because of the development and wider availability of antiviral treatments, most people in the United States living with HIV will not develop AIDS. Many members of today’s workforce were exposed to headlines and conversations about deaths related to AIDS as their first entrée into the subject. It is therefore imperative to recognize today’s reality that millions of people are living with HIV and to not reaffirm outdated fears or stereotypes implying otherwise.

In framing messages, employers should take care to separate HIV and AIDS by using phrases such as the following:
• “We offer the following benefits and support for those living with HIV…”
• “On this World AIDS Day, we remember those lost to AIDS-related illnesses and we reaffirm our support for all those living with HIV or AIDS around the world today…”
• “For inquiries related to HIV and AIDS-related EAP support, please contact HR…”

Acknowledging the distinction between HIV and AIDS is not simply a superficial language tweak, but a meaningful statement demonstrating an employer or individual’s understanding of the lived realities for millions of people today.

2) Be Part of the Solution: Employer-Provided Health Insurance

Employers play a crucial role in providing healthcare coverage for those living with HIV and AIDS and more broadly in helping to achieve an HIV-free generation. Antiretroviral therapy is part of a standard treatment plan for people living with HIV, according to the National Institutes of Health, and employers should ensure best-in-class in-network providers as well as EAP support that is culturally competent.

Increasingly, employers are ensuring that employees and covered dependents can access pre-exposure prophylaxis (PrEP) to effectively prevent the transmission of HIV. They can also work with their insurers to assess network coverage and healthcare professionals with appropriate cultural competence to administer and monitor patients on PrEP. Spotlighting these benefits during open enrollment alongside other notable features of plan offerings is both practical and an important signifier of how comprehensively an employer views the evolving needs of its workforce.

Lambda Legal provides a helpful primer for individuals on HIV and Health Insurance.

3) Understand Legal Protections for HIV and AIDS-affected Workers in the United States

According to the US Department of Justice’s Civil Rights Division resource – the federal Americans with Disabilities Act (ADA) which grants civil rights protections to individuals with disabilities similar to those provided on the basis of race, color, sex, national origin, age, and religion – includes protections for individuals with living with HIV and AIDS. It also guarantees equal opportunity for these individuals in public accommodations, employment, transportation, state and local government services, and telecommunications.

Persons who are discriminated against because they are thought to be HIV-positive are also protected. For example, the ADA would protect a person who is denied an occupational license or job on the basis of a rumor or assumption that the individual has HIV or AIDS, even if that is not true.

A best practice for employers is to periodically review and refresh trainings, educational materials, and employee handbooks—especially for hiring managers, customer/client-facing staff, and supervisors—to support consistent awareness of the federal protections afforded to all those living with HIV or AIDS and those assumed or rumored to be living with HIV or AIDS. Employers should also address any flourishing rumors about a client or employee’s HIV status. It is never OK for public speculation about such health matters in the workplace.

4) Support Employees in Travel and Relocation

An ever-global mobile workforce demands supportive infrastructure for employees and/or their family members who are HIV positive. According to UNAIDS, around the world, 48 countries have HIV-related travel restrictions, namely:

1) HIV testing required for work permits.
2) HIV testing required for study permits.
3) HIV testing or disclosure required for certain permits or entry less than 90 days.
4) HIV testing required for residency permits (for stays longer than 90 days).
5) Prohibit entry and stay less than 90 days on the basis of HIV status.
6) Residency permits denied (for stays longer than 90 days) on the basis of HIV status.
7) Non-nationals living with HIV are deported on the basis of their HIV status.

Global employers should ensure that employees are given appropriate contacts—typically within HR—to confidentially discuss any concerns or questions about their or family member’s HIV or AIDS status in relation to temporary assignment, short-term business trips, or indefinite long-term relocation. Managers should proactively note resources available as part of any relocation or travel assignments and ensure that one’s concerns or questions about travel to countries with restrictions do not negatively affect an employee’s career. Global employers may also decide to move employees who wish to leave their home countries because of punitive HIV and AIDS laws, as they would other employee mobility considerations.

5) Support LGBTQ Resource Groups in HIV and AIDS-Related Programming

The first patient of the AIDS epidemic was identified in 1981—which with today’s workforce may very well predate some of your company or organization’s key employee resource group leaders’ consciousness. For others in your ERG, the AIDS epidemic may continue to be a defining part of adult life. World AIDS Day and, more broadly, HIV and AIDS-themed discussions and programming can present valuable opportunities for intergenerational dialogue on how HIV and AIDS has affected their lives and relationship to the broader LGBTQ community.

The following films and events are just a few examples of great centerpieces for programming followed by panels of employees discussing their relationship to the content.

We Were Here (film)
The NAMES Project (event and resource)
Angels in America (miniseries)
Rent (film)
Philadelphia (film)
Last Men Standing (film)
How to Survive a Plague (film)

Prior to World AIDS Day, Speaker Nancy Pelosi, Congresswoman Barbara Lee, and Congressman John Lewis joined congressional leaders at The Library of Congress on November 20, 2019 in a moving ceremony to announce the future of the AIDS Memorial Quilt and Archive Collection. To view the event, click here.

For San Francisco-based ERGs and those visiting the San Francisco area, consider visiting the National AIDS Memorial Grove, a national memorial dedicated to providing, “a place of remembrance so that the lives of people who died from AIDS are not forgotten and the story is known by future generations.”

Closing

Since the beginning of the epidemic, it is the tireless work of both LGBTQ and ally advocates—many of whom were fighting for their lives at the hands of AIDS-related illnesses—that made the difference in raising critical awareness of the virus and pushing for solutions.

On World AIDS Day, we honor their legacy and those who lost their lives by continuing their important work, supporting those still afflicted by the virus, and working together to end HIV and AIDS across the world.