accommodation. A manager’s message about how an employee with HIV infection or AIDS will be treated is critical because it sets a clear standard. Balancing the costs and benefits of accommodation How a company treats one employee with a chronic illness is a clear indicator of the standard it will use in managing other employees. Witnessing support, accommodation, and respect for a coworker with a chronic illness strengthens worker morale, loyalty, and productivity. Disclosing HIV status An employee with HIV/AIDS must manage the overwhelming emotions of facing a chronic and often stigmatizing illness while continuing to be a productive worker. Like employees with many other chronic illnesses, those with HIV infection must adhere to a strict drug schedule and sometimes grapple with side effects and changes in medications. HIV-positive employees must decide who to inform about their health status, how much information to reveal, and when to reveal it. The stigma still associated with HIV/AIDS makes such decisions even more difficult. The decision to disclose HIV status belongs to the HIV- positive individual. It is illegal for an employer to ask a current or prospective employee about HIV status. Nonetheless, the HIV-positive employee may have to disclose some health information to managers or supervisors when seeking an accommodation. Accommodations can be made without the supervisor’s knowing that the individual is HIV-positive or has AIDS; the supervisor may know only that the individual is ill. Intensive workplace HIV/AIDS education may precede or follow a disclosure. Employees may inform managers of their health condition but request that the information be kept confidential; by law, the employer must comply with that request. Coworkers unaware of the circumstances may become suspicious of perceived preferential treatment and become resentful. When the performance of their work groups is called into question by superiors, managers may find themselves unable to adequately explain the situation. In such circumstances, the employee may be uncomfortable as well, knowing that rumors are circulating and feeling the unwanted attention from others. At that point, it may be helpful for the manager to discuss with the employee what, if anything, he or she wants to do to address the situation. The decision to disclose rests with the employee, but the employee may be willing to risk disclosure if the manager is not forcing the issue but, instead, offers support for whatever decision is made. Work can hold deep ethical, economic, and personal significance. The importance of work and the workplace for people with HIV infection and AIDS should be honored.
Employers should be careful not to violate the ADA’s strict rules about maintaining confidentiality of such information. As awareness of the ADA and its employment provisions increases, more employees are disclosing their HIV status to their employers, managers, coworkers, and friends. Disclosure takes courage and needs an environment of cooperation and support. The stigma still associated with HIV means that this disclosure—especially in the workplace setting—too often occurs only when a crisis forces the issue out into the open. Many employers believe that encouraging disclosure may create obligations that might not have otherwise existed. An environment that discourages or is hostile to disclosure, however, may present altogether different problems, legal and otherwise, like those a company experiences when it does not encourage employees with harassment complaints to come forward. Providing an environment where complaints or situations (such as the existence of a disability and the need for an accommodation) can be discussed and remedied without the fear of retaliation is a sound legal as well as business policy. Balancing accommodations with expectations The dual goals of accommodation are to ensure that work assignments are accomplished and that the individual with HIV infection or AIDS continues working as long as possible. Accommodation is a process of ongoing problem solving between an employee with HIV infection or AIDS and his or her supervisor. Because the manifestations of HIV infection and AIDS are different in different people, accommodation is not a one-time alteration of a job or physical structure. Just as each person with HIV infection or AIDS experiences the disease differently, each person will also require different accommodations. An accommodation that is effective for an earlier phase of HIV infection may not be effective for a later phase; an accommodation is an ongoing process requiring ongoing evaluation, in part because the manifestations of HIV infection and AIDS can change over time, and in part because some attempted accommodations may not work for either the employer or the employee. Accommodations as a team effort and their impact on a company’s workforce, managers, and policies Because of the fear and stigma still associated with HIV/ AIDS, accommodating people with HIV infection and AIDS affects virtually everyone in the workplace. A fearful work environment discourages productivity. When providing accommodation for employees with HIV infection or AIDS, an employer might consider addressing coworker attitudes. To dispel unwarranted fears and to ensure cooperation in the accommodation process, managers need accurate information about HIV infection and AIDS. Coworkers and managers can respond constructively in a supportive environment where emotional responses to HIV can be addressed. Leadership is important to effective
OTHER BLOODBORNE PATHOGENS
HIV is one among many bloodborne pathogens, including other viruses, as well as bacteria, parasites, and possibly even prions (which, though usually transmitted through brain material, have been transferred via blood transfusions; CDC, 2022b).
Of most concern, however, are hepatitis B and C (HBV and HCV). Although preventable by vaccination, HBV still infects many people in the United States. HCV, for which no vaccine yet exists, is most commonly spread through sharing needles (CDC, 2020b). HBV and HCV are leading causes of liver cancer (CDC, 2023c).
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