Effect of AIDS in the Workplace - Research Paper Example

HIV/AIDS in the Workplace Introduction Despite the long-standing reality of HIV and AIDS within the greater community, it is apparent that there still exist several misconceptions and glaring shortfalls in how the community, especially the workplace, is responding to the illness. Many employers, especially small employers, have failed to realize the enormity of the disease as well as the guidelines regarding employers’ responsibilities designed to assist employees diagnosed with one of these diseases remain in the workforce as well as to help employees without it become educated about the illness and how to prevent its spread. To combat this lack of information, it is necessary to illuminate the cause, ways of transmission, effects on the immune system and incidence and prevalence of the disease to help educate the business owners about how it could impact their concerns. By enumerating the effectiveness of policies and programs that are currently in place as well as the laws and regulations requiring such programs, employers may be able to identify gaps and shortfalls in their current procedures. Special attention will be given to the context of a small, privately owned retail shop in Texas as a point of illustration how the national and state laws might differ as well as how these policies might relate to the smaller business sphere. Recommendations regarding how to alleviate or reduce some of these issues will conclude the report. Cause of AIDS HIV (Human immunodeficiency virus) which leads to AIDS (Acquired Immune Deficiency Syndrome) is the most infectious disease that has presented itself in more than a century. HIV made an evolutionary jump from chimpanzees to humans. In all probability, the transfer occurred from using chimps as a meat source. The virus originated, however, in two types of monkeys which were consumed by the chimpanzees. A hybrid of the monkey virus (SIV) spread through infected chimpanzees and a mutated form was eventually transmitted to people in the form of HIV-1. As do chimps, humans carry two types of the disease. HIV-2 is the less virulent of the two. According to Paul Sharp of the Institute of Genetics at University in England; “Because of the similarity between chimpanzees and humans, any virus that successfully adapts to spreading among chimps would be a candidate for a further jump to humans, a potential HIV-3” (cited in Lovgren, 2003). To date, one percent of the world’s population has contracted HIV and the disease is responsible for taking the lives of nearly three million people in 2005 alone. Transmission of AIDS Many, including government officials, considered HIV to be a cure for homosexuality rather than a social disease. In 1985, HIV was contracted predominantly by gay sex and by the sharing of infected hypodermic needles during drug use. However, “in 2004 heterosexual transmission accounted for 35 percent of all newly-diagnosed AIDS cases, up from three percent in 1985” (HIV/AIDS, 2004). Drug use by injection is the cause for approximately one-third of all new AIDS cases in the United States each year. Contracting AIDS via blood transfusion is obviously possible but a rare event. The number of HIV infected persons in the U.S. would have been much lower had the government addressed the issue at its onset. The reason it didn’t was, in a word, prejudice. HIV was initially thought to be a ‘gay man’s disease.’ Many, including government officials, considered HIV to be a cure for homosexuality rather than a social disease. The Effect of HIV on the Immune System HIV has not responded by succumbing to the human immune system or to bioengineered drugs which can be directly linked to its ability to rapidly evolve thereby evading natural and man-made antibodies. Typically, a person who has recently contracted HIV will not progress to the stage where AIDS is diagnosed for up to ten years. This lengthy dormant period between the initial HIV diagnosis and full-blown AIDS has been a factor in the numerous problems of in the area of diagnosis, treatment and control of the disease (“Progression of HIV Infection”, 2006). The continuing proliferation of HIV is allowed by the lack of appropriate vaccines and the virus’ ability to evolve as it invades, weakens and finally destroys the immune system. HIV evolves so rapidly that its surface molecules are in a constant state of change; therefore, the human immune system, in addition to the vaccines developed to fight the virus, never catches up. “As it replicates within a single infected individual, HIV accumulates mutations that change the shape of its surface proteins, evolving right out from under the antibodies produced by the victim’s immune system” (National Institute of Allergy and Infectious Diseases, 2007). HIV further diversifies as it is passed through the human community, evolving into numerous strains and acquiring many different variations of molecular surface configurations. All of these differing viral strains spreading throughout the human race present researchers with a great challenge to create a drug therapy that is effective for the innumerable versions of the virus. Incidence and Prevalence The incidence of a disease refers to the extent or rate of occurrence of the disease, especially as it applies to the number of new cases reported within a population over a specified period of time. The prevalence of a disease is closely related to this concept, also referring to the number of cases of a disease within a given population, but differs in that it refers to a specific time period rather than a period of time. Although incidence estimates are more informative about the effectiveness of prevention efforts as well as the likely future course of the illness, they are harder to determine than prevalence figures and numbers are usually further out of date. “Prevalence data are useful for estimating the current burden of disease in the country and planning for demands on systems providing medical care and social services” (Osmond 2003). Part of the difficulty in obtaining accurate numbers exists in the deficiencies in the system itself. The United States does not have a single surveillance system established to track the infections, so researchers are forced to rely on the numbers that are available through state surveillance systems. Because not all of these systems track along the same criteria, to the same degree, in the same way and not all states require the same degree of reporting, all estimates must be taken with a degree of error presupposed (Osmond 2003). To illustrate this difficulty, Dennis Osmond (2003) indicated the minimum number of HIV-infected persons living in the United States through December of 2001 was estimated to be around 506,154, a number calculated by adding the total number of persons living with AIDS to the number of persons living with HIV as they were reported to the CDC (Center of Disease Control). However, he added that there are probably another 200,000 or more people who are living with HIV who have not been recorded within this system either because they have been tested at anonymous sites, they live in states that don’t require named reporting or because they have the disease but have not yet been tested. “CDC estimated HIV prevalence in the United States in 2000 between 850,000 - 950,000. A lower estimate is obtained if the 650,000 estimate for 1991 (midyear of sample collection) from the adjusted NHANES III data is projected forward to 2002 by the difference between annual AIDS deaths and the estimate of 40,000 new HIV infections each year. That calculation gives a prevalence of approximately 720,000 by the beginning of 2002. The current trend of about 20,000 deaths each year implies that prevalence is increasing by about 20,000 per year if the incidence is 40,000 per year” (Osmond 2003). “Since the infection rate is highest among people in the prime of their working life – 15 to 49 years – the economic and social impact of the epidemic is disastrous” (Hodges 2004). How Does AIDS Affect the Workplace? For many business owners, especially small business owners, the idea of adding one more responsibility to an already overflowing plate in terms of caring for employees seems a little daunting. However, studies conducted over the past 25 years regarding the spread of HIV and AIDS has proven that “where business, government and populations work together, the spread of HIV and AIDS can be slowed and infections reduced” (Roedy quoted in Bloom et al 2006). Mervyn Davies, writing the preface for a special report on business and HIV/AIDS (Bloom et al 2006), says “the stark message from the Executive Opinion Survey is that businesses are doing too little, too late in the battle against HIV/AIDS.” Although half of the companies interviewed said they regarded HIV/AIDS to be likely to affect their workplace at some point in the future, Davies says “the majority of firms questioned do not think about having an HIV/AIDS policy until prevalence in a country in which they operate affects more than one in five people.” The study further suggests that while many companies anticipate HIV/AIDS will have some kind of impact on their business in the future, most have not worked to identify how their workplace will be affected nor have those in less concerned countries, such as the United States, worked to establish formal policies within their organizations to address the issue. Current laws and guidelines Even a small store in Texas is required to follow some basic rules and guidelines drafted by the state to protect those with HIV and AIDS as well as to help prevent the spread of these illnesses among the greater population. All businesses are required to comply with state and federal civil rights laws that often apply to those suffering with HIV or the AIDS infections. These include Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act (ADA) of 1990. “The Americans with Disabilities Act of 1990 (ADA) prohibits discrimination against people with disabilities. Under the law, persons with HIV infection are entitled to the same rights and opportunities as persons with other communicable diseases” (Texas Department on Aging and Disability Services 2004). In addition, employers are expected to make reasonable accommodations so that people with disabilities, including those with HIV/AIDS, are able to remain employed and productive for as long as they can possibly perform the essential functions of their jobs. This could include the assignment or reassignment of job duties, allowing employees to work at home on a temporary basis, allowing both paid and unpaid leaves of absences and accommodating a flexible work schedule (Texas Department on Aging and Disability Services 2004). Although laws forbids anyone to release information of a personal nature identifying those individuals who have tested positive for the disease punishable by law, precedence has been set relieving some of the concerns small business owners have had regarding this information accidentally reaching the remainder of the employees in the workplace. In a recent lawsuit in which an individual sued a newspaper for leaking the information that they had been tested positive for HIV, the Appeals Court ruled that because the newspaper did not have access to the test results themselves, but was merely repeating information gleaned from the individual’s own actions, such as the participation in a band that advertised all of its members had tested positive for HIV, the individual did not have the right to collect any damages (Council 2006). In addition, the law does not provide co-workers with the right to refuse to work with someone on the basis of their disability, again including those individuals suffering from HIV or AIDS (Texas Department on Aging and Disability Services 2004). In addition to these items, Jane Hodges (2004) indicates the ILO (International Labor Organization) recommendations to member states also include a ban on dismissal based on HIV/AIDS until the individual becomes medically unfit to carry out adapted work, a prohibition of non-consensual pre- and post-employment testing, legislation for the prevention and containment of transmission risks, training and re-insertion options, benefits that includes early retirement options, medical and funeral coverage, grievance and disciplinary procedures and assistance for compliance and penalties for violations. Policies and Programs Many companies such as the small shop where I work do not have any kind of policies or procedures regarding HIV/AIDS in the workplace, nor do they have any set form of education outreach programs to help prevent the spread of the infection among its workers, who typically fall within the 18-25 age range that is most commonly affected by these diseases. However, it is recommended that every company does what it can to combat the spread of HIV/AIDS. While community planning groups exist working to create an epidemic profile, assess needs and resources, create and implement community level plans and update and review those plans, this type of service could be further enhanced if businesses became involved in the process. The International Labor Organization (“A Workplace Policy” 2006) specifies several key areas in which designing a workplace policy addressing HIV/AIDS in the workplace is beneficial including ensuring a greater commitment to corporate action, maintaining consistency with national and state laws, establishing a standard of behavior for all employees, providing guidance for supervisors and managers, creating a stable environment for employees so they will be more likely to come forward for voluntary testing and helping to prevent the spread of the virus through education and prevention programs. Recommendations for Improvement A policy specifically addressing HIV/AIDS in the workplace should be included in all companies to help deter the spread of the illness, especially in an area such as Texas where the prevalence of the disease is so high. Although risks might be considered to be low in a store setting, being prepared and having a plan to begin with can help prevent accidents in the future and education programs can go a long way toward keeping current and future employees safer as they achieve a greater understanding of the risks. Every policy should start with a general statement that indicates why the policy is necessary as well as how it relates to the other policies within the company. It should then outline general provisions as they relate to discrimination within the workplace before going into more specific provisions relating to the protection of those with HIV/AIDS, the prevention of the spread of HIV/AIDS through education and training and the care and type of support workers suffering from HIV/AIDS and their families can expect from the company. Once these have been enumerated in detail, the policy should provide a means of implementing and monitoring the policy, even if its something as simple as obtaining full manager and worker support. Where applicable, companies should have a designated budget for education and other initiatives relating to AIDS. However, this isn’t always necessary for smaller companies as there are many free and low-cost programs available. In some cases, small companies can join together through their chamber of commerce or other organization to obtain even greater discounts on training and other materials for their employees. Finally, the policy should have some sort of review process associated with it, enabling it to be updated on a regular and sufficient basis (“A Workplace Policy” 2006). With this type of policy in place, workers and managers know what to expect, know they are expected to take some action and have an increased avenue of communication open to them in the event they need assistance in dealing with new diagnoses. Outline: Introduction Cause of AIDS Transmission of AIDS The Effect of HIV on the Immune System Incidence and Prevalence How does this affect the workplace? Current laws and guidelines Policies and programs Recommendations for Improvement Works Cited “A Workplace Policy on HIV/AIDS: What it Should Cover.” International Labor Organization. Geneva: International Labor Office. (2006). May 8, 2009 Bloom, David; Bloom, Lakshmi; Steven, David & Weston, Mark. “Business & HIV/AIDS: A Healthier Partnership?” World Economic Forum: Global Health Initiative. (2006). May 8, 2009 Council, John. “Texas Appeals Court Sides with Newspaper in $1 Billion Suit Over HIV Disclosure.” Law.com (February 13 2006). May 8, 2009 “HIV/AIDS Surveillance Report.” Centers for Disease Control and Prevention. Vol. 16. (2004). Hodges, Jane. “In Focus Program on Social Dialogue, Labor Law and Labor Administration: Guidelines on Addressing HIV/AIDS in the Workplace Through Employment and Labor Law.” International Labour Organization. Geneva: International Labor Office. (January 2004). May 8, 2009 Lovgren, Stefan. “HIV Originated With Monkeys, Not Chimps, Study Finds.” National Geographic News. (June 12, 2003). May 8, 2009 Osmond, Dennis. “Epidemiology of HIV/AIDS in the United States.” HIV InSite Knowledge Base University of California, San Francisco. (March 2003). May 8, 2009 Texas Department of Aging and Disability Services. “HIV/AIDS and Related Conditions in the Workplace.” (June 2004). May 8, 2009 Read More