When Chanse Cox told his boss he was HIV-positive, he never expected to lose his job.

Cox was working as a machine operator at Gregory Packaging, a juice production plant in the US state of Georgia, and found himself at the centre of false rumours that he had an Aids-related skin condition. The skin problem was harmless, but the gossip was sparking unfounded concerns that he could transmit HIV in the workplace. So he decided the best way to put an end to the malicious buzz was to acknowledge to his manager that he was, in fact, HIV-positive.

His condition didn’t affect his job performance so Cox felt his job was safe. Nevertheless, the company fired Cox, citing a government regulation addressing food safety and communicable diseases. He knew he wasn’t putting anyone at risk, so he filed a complaint with the US Equal Employment Opportunity Commission (EEOC). The agency sued the company for violating the Americans with Disabilities Act, which protects those living with HIV from discrimination.

People with HIV have unemployment rates three times higher than national rates

The suit was eventually settled with a $125,000 payout to Cox. In addition, Gregory Packaging agreed to conduct disability discrimination training at its Georgia facility.

“I am glad I stood up for myself, and I hope… we have sent a message that will prevent others living with HIV from facing the kind of wrongful termination I experienced,” Cox said at the time of the settlement in 2015.

Unfortunately, workplace discrimination against people who are HIV-positive persists. There are an estimated 1.2 million people aged 13 and above living with HIV in the US, and around 200 HIV bias complaints are filed annually with the EEOC, with 220 filed last year.

HIV/Aids organisations estimate that, globally, people with HIV have unemployment rates three times higher than national rates. In a 2012 study of nine countries by the Global Network of People Living with HIV, many HIV-positive respondents said they were refused employment because they had the virus.

Many people avoid getting tested because of the stigma of HIV and fear of losing their job

Of the respondents whose employers and colleagues knew of their HIV-positive status, those in Malaysia, Zambia, Nigeria and Kenya experienced the most discrimination. Malaysia had by far the greatest incidence of bias — more than half of the respondents said both their employer and colleagues discriminated against them.

Such discrimination is one of the barriers to reducing the incidence of HIV, experts say. “Many people avoid getting tested because of the stigma of HIV and fear of losing their job — or not getting one they applied for,” says Afsar Syed Mohammad, senior technical specialist in the HIV/Aids programme at the UN’s International Labour Organization in Geneva. “They’re often unaware they’re living with the virus and are exposing others to it.”

Some employers avoid hiring people who are HIV-positive because they fear it would be too expensive to provide insurance coverage, that such workers would often be absent because of medical problems, and that they would make other employees feel uneasy. Indeed, one in five Americans said they would be uncomfortable working with someone who is HIV-positive or has Aids, 26% would be uncomfortable if their child’s teacher was HIV-positive, and 44% would be uncomfortable if their food was prepared by someone with HIV, according to a 2012 survey by the Kaiser Family Foundation and the Washington Post.

“Sometimes companies say they’re going to lose customers if they find out an employee they interact with is [HIV-] positive,” says Christopher Kuczynski, assistant legal counsel at the EEOC. “Of course, that’s not a [legal] basis for discrimination.”

Discrimination and stigmatisation often reflect misconceptions and unwarranted fears about HIV — as well as in the case of gay men, homophobia. “The stigma of having HIV is that people assume you’re gay and promiscuous,” explains Yahir Zavaleta, an activist on HIV-related issues in Mexico. “There’s still a lot of discrimination in Mexico because of the machismo culture and anti-gay sentiment.”

Some people still mistakenly believe HIV and Aids are a sure death sentence, despite medical progress and the fact that the number of Aids-related deaths has fallen by 45% since the peak in 2005, according to the Joint United Nations Programme on HIV/AIDS.

Companies that care

Finding a safe haven at work is possible in some multinational firms...

Companies such as Colgate-Palmolive, Whirlpool, Johnson & Johnson and Levi Strauss, have developed explicit policies to try to prevent discrimination, guarantee confidentiality and provide support to employees who have the virus.

Levi might have been the first company, in 1982, to raise awareness in the workplace of the threat of AIDS, then known as gay-related immunodeficiency disease, or GRID. Some employees wanted to pass out informational leaflets about the mysterious new disease that was ravaging the gay community. But they feared that if they distributed the information alone, “they would be stigmatised,” says Daniel Lee, executive director of the Levi Strauss Foundation.

So senior leaders of the company joined them in handing out the leaflets in the atrium of Levi’s San Francisco headquarters. “These employees understood that senior management had their backs,” Lee says.

Today, Levi offers interactive online HIV prevention and anti-stigma training to employees and a 24-hour HIV information and resource telephone line for workers and their families in the US. There is also a benefit plan to reimburse people for the cost of HIV-related health services not covered by other insurance or government programs.

In some countries where HIV is prevalent, employers encourage their workers to be tested for the virus. Colgate, for example, has provided employees in South Africa with the opportunity to get tested, and if the results were positive, they could then receive counselling at the company's clinic and participate in a medical aid HIV program.

In South Africa and other countries, Johnson & Johnson has offered special accommodations to employees with HIV/AIDS and those whose dependents suffer from the disease. “We would allow them to work part-time or use flextime,” says Catharina Van Eck, occupational health director for Europe, the Middle East, Africa and Asia Pacific.

Whirlpool not only has a non-discrimination policy for its own employees, but it also requires its global suppliers to follow its code of conduct and not discriminate against people because of their HIV status.

Chris Rice, a Whirlpool brand manager, shared Whirlpool’s efforts to make employees feel comfortable and supported at work with other companies last fall at an Out & Equal Workplace Advocates conference with the training program, How to Make Your Workplace More HIV Friendly. “I’ve been surprised by how many people have stigmatised information about HIV and AIDS from 30 years ago,” says Rice, who is closely involved in Whirlpool’s Pride Network employee group. “That’s why it’s so important to talk about it at work.”

Discrimination is especially prevalent in healthcare and food-preparation companies

The first cases of Aids were reported more than 35 years ago, yet many people still don't understand how HIV is transmitted. In the UK, 30% of adults believe HIV can be transmitted by sharing a toothbrush, while 20% think they could become infected through kissing, according to a survey of more than 2,000 people last year by the Terrence Higgins Trust, a UK provider of HIV and sexual health services. And in the US, the Kaiser study found that 27% of people didn’t realise that the virus cannot be passed on by sharing a drinking glass, while 17% didn’t know that it cannot be picked up by touching a toilet seat.

Discrimination is especially prevalent in healthcare and food-preparation companies. For example, last month, a Texas healthcare centre agreed to a $70,000 settlement after being sued for firing an HIV-positive nursing assistant. Lawyers had argued that his basic duties, including feeding and bathing patients, didn’t pose any risk of transmitting the virus.

Such bias occurs in other types of organisations, too. An applicant for a teaching job in China excelled on his teacher qualification examination but was denied a job when a pre-employment health check revealed he was HIV-positive. He sued the local education department, which ended up paying him 45,000 yuan ($6,538) to settle the case.

In Greece, a jewellery manufacturer was sued after it dismissed an employee because he was HIV-positive. He had made the mistake of telling some fellow employees about his condition, and they immediately asked that he be fired. The company brought in an occupational health doctor to try to quell the employees’ fears of HIV transmission in the workplace, but that didn’t appease them. Managers eventually succumbed to the growing employee pressure and fired the man.

The employee sued the company, and eventually won the case in 2013 when the European Court of Human Rights held that his firing violated two provisions of the European Convention on Human Rights: the right to respect for private and family life and the prohibition against discrimination.

Some employees like Chanse Cox decide to reveal their HIV status to employers, but that clearly can be risky.

I think very few people are out about their HIV status at work

“We don’t encourage people to disclose that they’re [HIV-]positive to employers,” says Scott Schoettes, a lawyer and HIV project director for Lambda Legal, a US organisation focused on protecting the civil rights of LGBT people. It advises employees to consult a lawyer before disclosing their HIV status at work, given the continuing discrimination and widespread lack of knowledge about HIV.

“I think very few people are out about their HIV status at work,” says Rachel Rubin, deputy director of Out & Equal Workplace Advocates. “We hear from people saying they’ve been out about their LGBT status for 15 years, but would never tell people at work that they’re HIV-positive.”

Employees or job applicants can generally keep their HIV status private unless they may actually pose a safety risk or they’re requesting a “reasonable accommodation,” such as a schedule change to go for medical appointments or more breaks to rest or take their medication.

“It’s a very narrow category of occupations, like thoracic surgery, where there could be a safety risk,” Schoettes says. “The actual standard has to be not just the presence of blood, but a way to get into the body of the HIV-negative person. Those would be extremely rare situations.”

These days, Schoettes doesn’t see as many blatant types of discrimination against people with HIV. But when it comes to knowledge of how HIV is transmitted, he says, “There is still a lot of work to do.”

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