HIV/AIDS AND THE

WORKPLACE

RICARDO T. BALAGOT, MD, FPCOM

HIV AND AIDS

SESSION OBJECTIVES:
General:
To
generate
awareness
and
appreciation of the problem of HIV/AIDS and its
impact on the workplace.
Specific:
describe and explain HIV/AIDS as an illness;
its nature, detection, and prevention;
recognize HIV/AIDS as a workplace issue;
formulate re-entry plans on workplace policies
and programs on HIV and AIDS.

HIV AND AIDS

COURSE OUTLINE:
I. Situationer
II. Basic Information on HIV and AIDS
III. Republic Act 8504 and the National
Workplace Policy
IV. Interventions and Response

HIV & AIDS:

The Global Pandemic
Over 15,000 men, women, and children
are infected with HIV each day (or one
person per second).
Half of all people who acquire HIV become
infected before the age of 25, and most die
before the age of 35.
In 2008, an estimated 11.8 million young
people aged 15-24 live with HIV and AIDS
worldwide.

HIV & AIDS:

The Global Pandemic
95% of people with HIV and AIDS live in the
developing countries, usually from the poor,
ethnic minority groups, or populations that
are socially marginalized.
Worldwide, women account for 50% of
adults living with HIV.
More than half of those newly infected with
HIV are between the ages of 15 and 24
years old.

HIV & AIDS:

The Global Pandemic
More than 25 million people have died of
AIDS since 1981.
In developing and transitional countries, 9.5
million are in immediate need of life saving
AIDS medicines, only 4 million (42%) are
receiving the drugs.

HIV & AIDS:

Global Estimates, 2008
Estimate

Range

People living with HIV/AIDS

33.4 million

31.1-35.8 million

Adults living with HIV/AIDS

31.3 million

29.2-33.7 million

Women living with HIV/AIDS

15.7 million

14.2-17.2 million

Children living with HIV/AIDS

2.1 million

1.2-2.9 million

People newly infected with HIV

2.7 million

2.4-3.0 million

Children newly infected with HIV

0.43 million

0.24-0.61 million

AIDS deaths

2.0 million

1.7-2.4 million

Child AIDS deaths

0.28 million

0.15-0.41 million

Published by UNAIDS in November 2009

HIV & AIDS:

Global Estimates, 2009
Estimate

Range

North America

1.5 million

1.2 2.0 million

Western and Central Europe

820,000

720,000 - 920 ,000

Eastern Europe central Asia

1.4 million

1.3 1.5 million

East Asia

770,000

560,000 -1.0 million

Middle East and North Africa

460,000

400,000 - 530,000

Caribbean

240,000

220,000 - 270,000

South and South East Asia

4.1

3.7 4.6 million

million

Sub-Saharan Africa
Central and South Africa
Oceania
TOTAL
Deaths due to Aids

22.5 million
1.4 million
57,000
33.3 million
1.8 million

20.9 24.2 million

1.2 1.6 million
50,000 64,000
31.4 35.3 million
1.6 2.1 million

HIV & AIDS:

The Philippine Scenario
Doubling Time of HIV and AIDS cases

Number of Cases

1 year
2 years
10 years
4
years

Source: Philippine HIV & AIDS Registry

6
years

HIV & AIDS:

The Philippine Scenario

HIV & AIDS:

The Philippine Scenario
Demographic Data

Dec 2009

Jan Dec 2009

Cumulative Data
1984 2009

Total Reported Cases

126

835

4,424

Asymptomatic Cases

123

806

3,592

29

832

121

732

3,232*

Females

103

1,181*

Youth 15-24 y/o

38

218

724

Children <15 y/o

52

Reported deaths due to

AIDS

318

AIDS Cases
Males

Source: HIV / AIDS Registry, Department of Health, Philippines

* Note: No data available on sex for eleven (11) cases.

HIV & AIDS:

The Philippine Scenario
Demographic Data

Dec 2009

Jan 2010

Cumulative Data
1984 2009

Total Reported Cases

126

143

4,567

Asymptomatic Cases

123

141

3,733

834

121

125

3,357*

Females

18

1,199*

Youth 15-24 y/o

38

47

771

Children <15 y/o

52

Reported deaths due to

AIDS

318

AIDS Cases
Males

Source: HIV / AIDS Registry, Department of Health, Philippines

* Note: No data available on sex for eleven (11) cases.

HIV & AIDS:

The Philippine Scenario
Reported Mode of
Transmission

Dec.
2009
n=126

Jan-Dec
2009
n= 835

Cumulative Data:
19842009
N=4,424

119

804

3,994

Heterosexual contact

16 (13%)

216 (27%)

2,214 (55%)

Homosexual contact

81 (68%)

336 (42%)

1,171 (29%)

Bisexual contact

22 (19%)

252 (31%)

609 (15%)

Blood / Blood Products

19

Injecting Drug Use

Needle Prick Injury

Mother-to-Child

49

No data available

29

351

Sexual Contact

HIV & AIDS:

The Philippine Scenario
Reported Mode of
Transmission

Dec.
2009
n=126

Jan.
2010
n= 143

Cumulative Data:
19842009
N=4,424

119

89

4,083

Heterosexual contact

16 (13%)

23 (26%)

2,237 (55%)

Homosexual contact

81 (68%)

43 (48%)

1,214 (30%)

Bisexual contact

22 (19%)

23 (26%)

632 (15%)

Blood / Blood Products

19

Injecting Drug Use

50

58

Needle Prick Injury

Mother-to-Child

49

No data available

355

Sexual Contact

HIV & AIDS:

The Philippine Scenario
Demographic Data

Aug. 2011

Jan Aug. 2011

Cumulative Data
1984 2011

Total Reported Cases

196

1,416

7,413

Asymptomatic Cases

189

1,350

6,501

66

930

Males

182

1,309

6,006

Females

14

107

1,414

Youth 15-24 y/o

56

413

1,627

Children <15 y/o

58

Reported deaths due to

AIDS

13

337

AIDS Cases

Source: HIV / AIDS Registry, Department of Health, Philippines

* Note: No data available on sex for eleven (11) cases.

HIV & AIDS:

The Philippine Scenario

HIV AND AIDS

H- Human

A- Acquired

I- Immunodeficiency

I- Immune

V- Virus

D- Deficiency

virus which causes AIDS

S- Syndrome
serious and usually fatal condition
in which the bodys immune
system is severely weakened and
cannot fight off infection.

HIV AND AIDS

People with HIV DO NOT mean
they have AIDS.
HIV remains dormant in the body
for several years before some
unknown factors trigger the
infections associated with AIDS
Median incubation period for adult
can be as long as 10 years.
During this period, the people with
HIV may look healthy and being
unaware of their infection status.

What is HIV infection?

A lifetime infection
No vaccine to prevent it
No cure
No signs and symptoms
Destroys the immune system
Can be detected with HIV-antibody test
Virus does not live long outside the body

What is AIDS?
A condition where signs and symptoms
appear as a result of various
opportunistic infections
Life threatening
HIV causes AIDS

How does a person with

HIV look like?
!!! You cant tell if a
person has HIV by
merely looking at
him/her.

How HIV infects ?

CD4

CD4 cell helps us to fight against various infections

How HIV infects ?

HIV

Is
HIV attacks CD4 cell, multiply inside and gradually kills them.
Once CD4 are destroyed our bodys resistance to fight infections
goes down and person suffers from lots of infections

Modes of Transmission
Unprotected penetrative sex
semen, blood, vaginal secretions
Blood transfusion on infected blood and blood products
Sharing needles among
I.V. drug users
Vertical/perinatal
mother to infant
Breastfeeding

Body Fluids with High

Viral Load

Blood
Semen
Vaginal and cervical mucus
Breastmilk
Amniotic fluid
Cerebrospinal fluid

HIV is NOT transmitted

through casual contact in any setting schools, workplace,
or social settings.
through shaking hands, hugging, or a casual kiss.
through insect, food, water, clothes, toilets, swimming
pools, and drinking and eating utensils.

Detection of HIV
Antibody
The HIV antibody test
Detects HIV antibodies in the blood, not HIV
Antibodies develop 3-12 weeks to 6 months
after infection
WINDOW PERIOD antibodies cannot be
detected in blood, but patient infective during
this period

HIV- antibody Test Results

POSITIVE HIV-antibody
Detection of antibodies in the blood indicates that infection
has occurred
The person can infect others
A positive HIV-antibody test result does not mean that a
person has AIDS

NEGATIVE HIV-antibody
HIV antibodies were not detected in the persons blood
May indicate that the person is not infected OR
The person may be infected but has not produced detectable
quantities of HIV antibodies

Prevention of HIV
Infection
REMEMBER ABCDE!
Abstinence
Be

Faithful
Correct and
consistent condom
use
Do not use Drugs
Education

Medical Treatment
Today there are medical treatments that
can slow down the rate at which HIV
weakens the immune system.
There are other treatments that can
prevent or cure some of the illnesses
associated with AIDS.

National
Response

Goals of DOLE National Workplace

Policy

Prevention and control of

Objectives of the ILO Code

HIV/AIDS

Protection of workers rights &

dignity

Recognition of individual

responsibility

Provision of benefits in high-risk

settings

Prevent spread of HIV

Combat stigma &
discrimination
Mitigate the impact of
HIV/AIDS
Provide care & support

Rationale of RA 8504

Prevention and control of HIV/AIDS

Establishment of Secretariat

Protection of rights and dignity of PLWHA

Recognition of role of PLWHA in prevention and

control

Provision of control measures in high-risk

settings

REPUBLIC ACT 8504

The Philippine HIV

and AIDS Prevention
and Control Act of
1998
RA 8504 enacted on February
13, 1998
IRR was promulgated on April
13, 1999

REPUBLIC ACT 8504

Promulgates policies and prescribes measures

Institutes a nationwide HIV and AIDS information
and education program
Establishes a comprehensive HIV and AIDS
monitoring system
Strengthens the Philippine National AIDS
Council

REPUBLIC ACT 8504

Provisions Relevant to the
Workplace
Article I
Article II

:
:

Article III :
Counseling
Article IV :
Article V :

Education and Information

Safe Practices and Procedures

Testing, Screening &

Health and Support Services
Monitoring

Article VI : Confidentiality
Article VII : Discriminatory Acts and
policies
Article VIII :

The Philippine National AIDS

REPUBLIC ACT 8504

Article I. EDUCATION &
INFORMATION
(Section
6. HIV/AIDS Information in the Workplace )
All government and private employees shall be
provided with standardized basic information and
instruction on HIV/AIDS
Shall be integrated into orientation, training,
continuing education, HR devt programs, etc.
Each employer shall develop, implement, evaluate and
fund a workplace HIV/AIDS education and information
program.
In collaboration with the DOH, DOLE shall oversee the
anti-HIV/AIDS campaign in all private companies

REPUBLIC ACT 8504

Article III: Testing, Screening &
Counseling

(Section 16. Prohibition on Compulsory HIV Testing)

Compulsory HIV testing

as a precondition to
employment,
admission to
schools, provision of
medical service or any
kind of service
shall be deemed

REPUBLIC ACT 8504

Article VI:
CONFIDENTIALITY
Section 30. Medical Confidentiality
All health professionals, medical
instructors, workers, employers,
recruitment agencies, insurance companies,
data encoders, and other custodians of any
medical records / test results to observe
strict confidentiality particularly the
identity and status of persons with HIV.

REPUBLIC ACT 8504

Article VII. DISCRIMINATION ACTS &
POLICIES
Section 35. Discrimination
in the Workplace

Discrimination in any form from preto post-employment, including hiring,

promotion or assignment, based on the
actual, perceived
or
suspected HIV status of an individual is
prohibited.

Termination from work on the sole

basis of actual, perceived or suspected
HIV status is deemed unlawful.

HIV/AIDS and the

Workplace

Why Business Should Care

It is mandated by law
It will contribute to the attainment of the MDG
It is good for the country
It impacts business

Impact in the Workplace

Stigma and Discrimination
Tension among workers
Gender inequalities
Pressure on health & social security systems
Threatened occupational safety and health
benefits of workers

Impact in the Workplace

The Business Case for
an HIV and AIDS in the
Workplace Program
(based on the
Shell experience)

Reduced
Productivity
(assume 50%)/yr
Care &
Maintenance/yr
Exit Costs (One
Time)

Running Cost
of Programme:
$50/employee/yr

Vs.

Medical
Redundancy
or
Death
+
Lost Training
+
Recruitment
TOTAL

Sr. Leadership

Managerial
&
Supervisory

$ 47,000

$ 13,000

$ 6,000

$ 10,000

$ 10,000

$ 10,000

240,000

35,000

14,000

350,000

51,000

28,000

30,000

8,000

2,000

10,000

4,000

1,000

$ 280-390,000

$ 47-63,000

$ 17-31,000

Support Staff

What can be done in the

workplaces?

The workplace can help

limit the spread
and alleviate the
impact of HIV and AIDS.

Enterprises can respond to the

HIV and AIDS problem:

1. Through policy development guided by

existing labor laws and standards
RA 8504 and the National
Workplace Policy
2. Implementing specific workplace
programs on HIV and AIDS prevention

What companies need to do

Create company policy on HIV and

AIDS prevention

Policy to be disseminated to all

workers

What companies need to do

Provide information and education, training if
needed
what is HIV and AIDS
what are the effects of HIV and AIDS to the person
as a worker, to the company, to the community
how it can be prevented
what are the available services-within
and outside of the company

Benefits of HIV Prevention

Program
Minimize workplace disruption and
lost productivity
Reduced health care costs by
preventing
new infections
Company demonstration of
concern for
the welfare of workers
and families
Assurance that HIV (+) workers
receive appropriate counseling,
medical and social support

BITS - DOLE

Bureau of Labor Statistics Integrated Survey

Non Agricultural Establishments Employing 20 or more w
June 2008

Companies with HIV and AIDS

Policy and Programs

6,368
24, 457

26%

Documenting Programs:
Workplace Interventions on
HIV and AIDS Prevention

What companies are doing

information and education
(participants became HIV and AIDS
educators)
Nondiscriminatory policy statements
Integration of HIV policy in their OSH policy
and program
Corporate social responsibility activities

Documenting Programs:
Workplace Interventions on
HIV and AIDS Prevention
Companies reported the following
problems in their policy and program
implementation:
Lack of management and worker support
Lack of technical capability to implement
their policies and programs
Focal persons have other functions
STI, HIV and AIDS discussions not well
accepted by both management and workers

Sample Workplace Policy of a Philippine Company

Policy Statement
Respect the individual rights and
dignity of people with HIV and AIDS
Promote non-discriminatory
employment regardless of HIV status,
gender, sexual orientation
Encourage maximum participation of
its employees in HIV and AIDS
education program

Sample Workplace Policy of a Philippine Company

Policy statement on continued employment

In order to manage employees HIV status more
effectively, the company aims to assist employees
who are HIV positive to remain well for as long as
possible. Employees, however, need to make a choice
as to whether they wish to carry on in the same
position or accept a position which is less stressful.
This would be dependent on availability of alternative
positions.
When an employees performance decreases, they will
be treated equitably and in a non-discriminatory
manner, resolving issues of sick leave, pension
benefits and medical aid as for other employees with
a life threatening disease.

THE WAY
FORWARD!
MANAGEMENT and WORKERS shall jointly
develop HIV and AIDS policies to be translated
into programs made known to all workers.
Actions should focus on how to strengthen
preventive measures despite existing limitations.

THANK YOU.