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Accommodation and Compliance Series:
Accommodation Ideas for HIV/AIDS

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Introduction

JAN’s Accommodation and Compliance Series is designed to help employers determine effective accommodations and comply with Title I of the Americans with Disabilities Act (ADA). Each publication in the series addresses a specific medical condition and provides information about the condition, ADA information, accommodation ideas, and resources for additional information.

The Accommodation and Compliance Series is a starting point in the accommodation process and may not address every situation. Accommodations should be made on a case by case basis, considering each employee’s individual limitations and accommodation needs. Employers are encouraged to contact JAN to discuss specific situations in more detail.

For information on assistive technology and other accommodation ideas, visit JAN's Searchable Online Accommodation Resource (SOAR) at http://askjan.org/soar.

Information about HIV/AIDS

What is HIV?

HIV (Human Immunodeficiency Virus), the virus that causes AIDS, is a life-long disease that compromises the body’s immune system, making it difficult to fight-off illnesses and other diseases. People with HIV have what is called HIV infection. Some people with HIV infection will develop AIDS, but not all (CDC, 2006). HIV disease progresses in stages. A person with HIV disease can be asymptomatic during the course of the disease and appear healthy while living with HIV. As the virus slowly weakens the body’s immune system, a variety of symptoms and limitations can develop. Depending on the stage and treatment of the disease, a person with HIV may experience flu-like symptoms; skin rashes; fatigue; mild to severe weight loss; ulcers; fevers; diarrhea; and opportunistic infections that can cause severe pneumonia, damage to the nervous system, vision loss, and AIDS-defining cancers (The Body, 2008).

What is AIDS?

AIDS (Acquired Immunodeficiency Syndrome) is the diagnosis an HIV-infected person receives after developing one of the AIDS indicator illnesses defined by the Centers for Disease Control. A diagnosis of AIDS is made by a physician using specific clinical or laboratory standards (CDC, 2006).

How is HIV or AIDS transmitted?

HIV or AIDS is passed from one person to another through blood-to-blood and sexual contact. HIV transmission can occur when blood, semen, vaginal fluid, or breast milk from an infected person enters the body of an uninfected person.

Following are the most common ways that HIV is transmitted from one person to another:

HIV can also be transmitted through transfusions of infected blood or blood clotting factors (Since 1985 all donated blood in the U. S. has been tested for HIV therefore the risk for transmission is extremely low) (CDC, 2006).

According to the CDC, HIV is a fragile virus. It cannot live for very long outside the body. As a result, the virus is not transmitted through day-to-day activities such as shaking hands, hugging, or a casual kiss. A person cannot become infected from a toilet seat, drinking fountain, doorknob, dishes, drinking glasses, food, or pets (CDC, 2006).

How is HIV/AIDS treated?

In the past decade, advances in the treatment of HIV have slowed the progression of the disease. These advances, including highly active antiretroviral therapy (HAART), have helped extend the lives of thousands of people living with HIV and AIDS (The Body, 2007). Antiretroviral drugs do not provide a cure for HIV or AIDS, but can slow the progression of the disease. The side effects of treatment may cause various limitations.

HIV/AIDS and the Americans with Disabilities Act

Is HIV/AIDS considered a disability under the ADA?

The ADA does not contain a list of medical conditions that constitute disabilities. Instead, the ADA has a general definition of disability that each person must meet on a case by case basis (EEOC Regulations . . . , 2011). A person has a disability if he/she has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or is regarded as having such an impairment (EEOC Regulations . . . , 2011).

However, according to the Equal Employment Opportunity Commission (EEOC), the individualized assessment of virtually all people with HIV/AIDS will result in a determination of disability under the ADA; given its inherent nature, HIV/AIDS will almost always be found to substantially limit the major life activity of immune function (EEOC Regulations . . . , 2011).

Accommodating Employees with HIV/AIDS

Note: People with HIV/AIDS may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with HIV/AIDS will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.

Questions to Consider:

  1. What limitations is the employee experiencing?
  2. How do these limitations affect the employee and the employee’s job performance?
  3. What specific job tasks are problematic as a result of these limitations?
  4. What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
  5. Has the employee been consulted regarding possible accommodations?
  6. Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
  7. Do supervisory personnel and employees need training??

Accommodation Ideas:

Fatigue/Weakness:

Chronic Diarrhea:

Decreased Cognitive Abilities: (Problems with concentration, memory, etc.)

Vision Impairment: Reading information from computer screen (For those who benefit from magnification and other modifications)

Vision Impairment: Reading information from computer screen (For those who do not benefit from magnification)

Vision Impairment: Reading information from printed materials (For those who benefit from magnification and other modifications)

Vision Impairment: Reading information from printed materials (For those who do not benefit from magnification)

For a more detailed description of accommodation ideas for vision impairments, please go to Work-site Accommodation Ideas for Individuals with Vision Impairments at http://askjan.org/media/Sight.html.

Sensitivity to Light:

Respiratory Difficulties: (Problems breathing)

Neurological Complications: (Problems with numbness in fingers, legs, feet or difficulties with seizures, headaches, noise, dizziness, mood swings and concentration)

Skin Infections: (May include open sores, bruises, lesions and rashes)

Psychological Implications: (Difficulties adjusting to having a disability, stress, etc.)

Weight Loss:

Other Medical Considerations:

Situations and Solutions:

A computer operator was experiencing weight loss and chronic diarrhea as a result of having HIV. She was provided with an ergonomic chair with extra padding and began to change seating positions often.  This prevented her from getting sores from sitting in one position for prolonged periods of time.  Employee’s workstation was also moved closer to a restroom to provide her better access.  Total cost to move employee to another workstation was virtually nothing. 

A pharmacist was having difficulties standing for eight hours a day on a tile floor.  This employee was responsible for filling prescriptions for medication.  The work area was carpeted using extra padding, which assisted in reducing fatigue and a sit/stand/ lean stool was purchased to assist employee when standing.  Employee was also permitted to take frequent rest breaks throughout the day.  This was possible since the employee cut his lunch hour down to 30 minutes, which provided him with 30 minutes that could be used at other times of the day whenever a break was needed. Also another pharmacist was available to cover his breaks. 

A secretary with HIV could only go to the HIV clinic during work hours.  The employer provided the employee with a flexible work schedule, so that she could go to the clinic for medical attention and counseling.  The employee made up the hours throughout the week by staying later and by coming in early. 

A machine operator was experiencing difficulties remembering the steps involved in changing a part on his machine.  The employer provided the employee with a step by-step checklist and directions explaining how to do this.

An accountant was experiencing eye sensitivity to fluorescent light in her office. As a result, she was unable to clearly view her computer screen or written materials due to glare. The accommodation solutions were to lower the wattage in the overhead lights, provide task lighting, and a computer screen glare guard.

Products:

There are numerous products that can be used to accommodate people with limitations. JAN's Searchable Online Accommodation Resource (SOAR) at http://askjan.org/soar is designed to let users explore various accommodation options. Many product vendor lists are accessible through this system; however, upon request JAN provides these lists and many more that are not available on the Web site. Contact JAN directly if you have specific accommodation situations, are looking for products, need vendor information, or are seeking a referral.

Resources

References

Updated 02/27/2013

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