HIV and Workers

The human immunodeficiency virus (HIV) pandemic is one of the most critical workplace issues mainly because HIV-related discrimination threatens fundamental rights to work and sustainable employment (International Labour Organization ([ILO], n.d.). Workers diagnosed with HIV are 20 times more likely to develop active tuberculosis (TB), the leading cause of death among people with HIV; these two deadly infectious diseases still present significant risks to workers and global public health (Centers for Disease Control and Prevention [CDC], 2021; World Health Organization [WHO], 2020). Untreated, HIV leads to the acquired immunodeficiency syndrome (AIDS), which has killed over 36 million since first diagnosed in humans in 1981 (HIV.gov., n.d.; WHO, 2021). Worldwide in 2020, an estimated 38 million persons were living with HIV, 680,000 died from HIV-related causes, and another 1.5 million people were diagnosed with the disease (WHO, 2021). In the United States, around 1.2 million people have HIV, including the nearly 162,000 people unaware of their status and credited with transmitting around 40% of new infections (CDC, n.d.)

There is no vaccine or cure for HIV infection. However, early diagnosis and access to care, including treatment for opportunistic infections such as TB, has made HIV a manageable chronic health condition. With treatment to reduce the viral load, people living with HIV can work without fear of transmission to coworkers. However, early diagnosis and treatment is vital, and screening is the first step in that process. Since 2004, the CDC has recommended HIV screening for all persons at least once as part of routine health checks and annually, or more often, for those at higher risk. This CDC website https://www.cdc.gov/hiv/clinicians/index.html offers resources and recommendations for clinicians about HIV screening, prevention, treatment, and pre/postexposure prophylaxis, plus free continuing education opportunities. The WHO (n.d.) guidelines for HIV testing address the five C’s: consent, confidentiality, counseling, correct results, and connection with treatment and other services. The ILO promotes voluntary and confidential HIV testing and counseling for workers through their VCT@WORK campaign, a global public–private partnership between governments, employers, and workers (ILO, n.d.). Their VCT@WORK website https://www.ilo.org/global/topics/hiv-aids/WCMS_215899/lang–en/index.htm offers guidance to close the gap for access to voluntary testing, counseling, and treatment for workers, their families, and communities. Business Responds to AIDS (BRTA) is another free public–private partnership initiative that offers tailored resources and tools to guide workplace programs and policies to reduce stigma surrounding HIV and prevent discrimination against workers with the disease (CDC, 2019).

The occupational health nurse can help control HIV and stop AIDS, by accessing credible sources and staying current with evidence-based information to guide workplace strategies. The BRTA website https://www.cdc.gov/hiv/workplace/empower.html has excellent resources for implementing effective HIV programs for workers. Human immunodeficiency virus education could be part of regular wellness programming. Training could address awareness about HIV, prevention, and strategies for a safe, nondiscriminatory work environment for workers living with HIV and their coworkers. Occupational health nurses could partner with local organizations to offer on-site voluntary HIV testing or post announcements with local addresses for testing sites. This CDC website https://www.cdc.gov/hiv/testing/self-testing.html has information about self-testing, in which workers screen themselves for HIV and get their result at their home; most insurance plans cover the kits. Occupational health nurses can also promote easy access to Employee Assistance Programs plus other community-based organizations that offer treatment and psychological services.

Although the SARS-CoV-2 (COVID-19) pandemic is wreaking global havoc currently, HIV and TB infectious diseases are still major threats in the work environment and for workers. Occupational health nurses can help by educating about HIV, assisting workers to get screened or self-test, and facilitating workers’ access to health care. Treatment allows people living with HIV to continue working as vital members of communities.