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About Human Immunodeficiency Virus (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. HIV infection leads to AIDS (Acquired Immunodeficiency Syndrome) when the CD4 cells, also known as T Cells, of the immune system are destroyed to the point where the body cannot fight off infections and diseases. AIDS in the final stage of HIV infection. Due to improved treatment, many individuals with HIV continue to work without needing any accommodations.
Human Immunodeficiency Virus (HIV) and the Americans with Disabilities Act
The ADA does not contain a definitive list of medical conditions that constitute disabilities. Instead, the ADA defines a person with a disability as someone who (1) has a physical or mental impairment that substantially limits one or more "major life activities," (2) has a record of such an impairment, or (3) is regarded as having such an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).
Accommodating Employees with Human Immunodeficiency Virus (HIV)
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 who are aging 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:
- What limitations is the employee experiencing?
- How do these limitations affect the employee and the employee’s job performance?
- What specific job tasks are problematic as a result of these limitations?
- What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
- 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?
- Do supervisory personnel and employees need training?
Key Accommodations:
Fatigue/Weakness: Individuals with HIV/AIDS may experience decreased stamina or fatigue, making it challenging to perform physically demanding tasks or tolerate extended work hours.
- Accessible facility (Ramps, parking etc.)
- Reduce/eliminate lifting, walking, etc.
- Flexibility to sit or stand (Adjustable workstation)
- Rest area with cot
- Later start time
- Frequent rest breaks
- Shorten work day and extend work week
- Job sharing
- Telework
Chronic Diarrhea: HIV/AIDS may result in gastrointestinal distress and frequent toileting needs.
- Worksite or workstation near restroom
- Flexible work schedule to allow for restroom breaks
- Flexible leave policy
- Telework
Decreased Cognitive Abilities: Impaired cognitive function may result in memory loss, difficulty managing time, organizational limitations, and executive dysfunction.
- Increase levels of job structure
- Provide written job instructions
- Prioritize job assignments
- Flexible work hours
- Rest periods to reorient
- Memory notebook or scheduler (Can be electronic or paper)
- Minimize distractions
- Self-paced workload
- Reduce job stress
- Educate coworkers about psychological implications if needed (Keep the individual with HIV/AIDS and his/her disability confidential)
- Evaluate safety hazards
Vision Impairment: Some individuals with HIV/AIDS may experience eye infections, tumors of the eye, and retinopathy, resulting in a need for various vision-related accommodations.
- External screen magnification
- Screen magnification software
- Larger sized monitor
- Anti-Glare or anti-radiation computer screen guard
- High resolution monitor
- Special computer glasses to reduce glare
- Change font size or contrast in existing software application
- Frequent breaks to rest eyes when fatigue is a factor
- Additional training
- Screen reading software
- Refreshable Braille display
- Dual-channel headset if using a computer with speech output and the telephone at the same time
- Providing a Qualified Reader
- Additional training
- Hand/Stand magnifier
- Improved lighting or task lighting
- Reduce glare on paper copy (Close blinds on windows, change lighting in area, etc.)
- Closed circuit television system (Desktop & Portable models are available)
- Enlarge information on photo copier
- Optical wear (Eye glasses, Low Vision Enhancement Systems, Flip-down magnifiers, etc.)
- Frequent breaks to rest eyes when fatigue is a factor
- Additional training
- Optical character recognition system (Also known as a scanner with speech output - PC based & portable models are available)
- Providing a Qualified Reader
- Additional training
Sensitivity to Light: Photosensitivity can result in difficulty tolerating workplace lighting, as well as driving or performing job tasks in bright outdoor lighting.
- Lower-wattage overhead lights
- Task lighting
- Broad-spectrum lighting
- Install flicker-free lighting
- Optical wear (Protective eye glasses)
- Move work station to another area
- Place blinds on windows
Respiratory Difficulties: Breathing difficulties may be triggered by workplace irritants or poor air quality.
- Good ventilation
- Clean work environment free from dust, smoke, odor and fumes (Air purifier, appropriate ventilation, working windows, etc.)
- Avoid temperature extremes
- Educate coworker to wash hands frequently and to stay at home if sick
- Telework
Neurological Complications: Impaired neurological function could result in dizziness, pain or numbness of extremities, limited motor function, and seizure activity.
- Eliminate need to use sharp objects
- Provide protective clothing/equipment
- Modify job tasks requiring fine finger dexterity
- Reduce noise (Use partitions, white noise, environmental sound machines, headsets and/or move employee to a more quiet environment)
Skin Irritation: Weakened immune function can result in irritation to the skin, including rashes, sores, and lesions.
- Avoid infectious agents and chemicals
- Avoid invasive procedures (activities that could be harmful to people with skin conditions)
- Flexible leave policy
Psychological Implications: Adjusting to having a disability, as well as the impact on one’s life may result in decreased tolerance for stressors in the workplace.
- Identify stressors and reduce stress
- Educate coworkers, but keep person and his/her condition confidential
- Peer counseling
- Allow telephone calls to emotional supports
- Open-door policy to supervisor
- Negotiating time for accommodations
- Time off for counseling or therapy
- Provide praise and positive reinforcement
Weight Loss: A reduction in weight may occur for some individuals with HIV/AIDS, which may necessitate an evaluation of workplace equipment and policies.
- Ergonomic chair with extra padding
- Arm supports
- Alternate working positions to prevent sores from forming (i.e., sitting & standing)
- Have access to refrigerator (To store food supplements or medications)
Other Accommodation Considerations:
- Flexible work schedule
- Time off from work to seek medical care (Many clinics are only open during the day)
- Reassignment
- Health insurance that does not exclude preexisting conditions
- Health insurance that does not single out HIV in order to cap medical benefits
Accommodation Ideas:
Situations and Solutions:
The following situations and solutions are real-life examples of accommodations that were made by JAN customers. Because accommodations are made on a case-by-case basis, these examples may not be effective for every workplace but give you an idea about the types of accommodations that are possible.
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 computer operator was experiencing weight loss and gastrointestinal limitations 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 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.
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