Hesperian Health Guides
HIV in the factory
It is harder for people with HIV to get treatment and live healthy lives when they face stigma in their communities or workplaces. Stigma means the negative beliefs, attitudes, and behaviors people direct at those who have HIV. Stigma includes shaming, insulting, and gossiping about people with HIV, and even acting violently against them. Stigma comes from fears and misinformation about HIV and pushes people to hide their HIV status.
Workers with HIV also face discrimination from bosses. In some places, employers demand an HIV test before hiring. Others fire workers with HIV or thought to have HIV. When workers with HIV cannot get or keep jobs, they are even less likely to get care or stay healthy.
In factories where people with HIV keep their jobs, they may still face discrimination, such as denial of health insurance, pay raises, promotions, and even denial of permission to use the toilet. For more about discrimination, see Chapter 21.
Activity HIV is not transmitted at work
- Divide the group into pairs and ask them to discuss how they fear HIV spreads in the factory. Have them call out their fears and write them on the board. Be ready with ideas to help start the discussion if necessary.
- Choose a fear from the list to conduct a role play (see how to do a role play). For example, if one fear is "shaking hands," do a role play where a person with HIV greets his or her supervisor by extending their hand in a handshake. What will the person do? Why do people think this contact could lead to HIV infection? Have people explore what is really behind their fear.
- Review as a group the HIV information in the previous sections, focusing on How HIV is passed from one person to another and How you cannot give or get HIV. Ask people to say if they still think each action on the list could spread HIV.
NOTE: "Sharp objects" is the only item on this list where there could be HIV transmission: when a worker is injured and there is blood. If this comes up in your discussion, talk about how HIV spreads through contact with blood and how using gloves or plastic bags can prevent infection. For ways to safely help injured workers who are bleeding, see First aid for machine injuries. People who are raped or coerced to have sex can also be at risk of HIV infection. See First aid after rape.
Activity HIV is a disability, not an inability
Workers living with HIV can continue working without putting other workers at risk. As with with other disabilities, it is possible to make the workplace safe for people with HIV. While dangers such as overwork, unsafe equipment, dirty bathrooms, bad food, lack of ventilation, and others are problems for all workers, these dangers are particularly harmful to workers with HIV. People with HIV can become sick more easily and are more likely to die from common illnesses. Improving conditions for workers with HIV will bring improvements for all workers.
Chemicals and dust
- Make a list of work dangers that workers face in the factory.
- Going down the list, ask workers to compare how each danger affects healthy workers versus workers with HIV. You can also use this activity to talk about how some dangers affect pregnant women, people with physical or mental disabilities, and other vulnerable workers.
|Healthy workers||Workers with HIV|
|Machine injury||Get hurt. Injury. Amputation.||Same as healthy. Other workers can get infected. Maybe nobody will want to help.|
|Chemicals and dust||Irritants. Asthma. Coughing.||Same as healthy immune system. Might get sick more|
|Overwork||Tired. Exhaustion. Stress.||Same. Might get sick more.|
|No Water||Everybody needs water.||Get dehydrated more easily.|
|Dirty toilets||Filth makes everyone sick.||They can get very sick and can die from germs in water or toilets.|
|Eating well||Get hungry. Tired. Dizzy.||Same as healthy. Can become very ill from not eating enough food.|
|TB||Get very sick. Needs treatment.||Gets TB more easily and TB can kill a person with HIV more quickly.|
HIV programs in the factory
Your group or union can educate at work and in the community about how HIV is spread and prevented. Your members can learn how to counter wrong ideas about HIV, distribute free condoms, and publicize organizations that offer HIV tests and medicines. You can help people with HIV get access to treatment and services so they can live long, healthy lives and contribute to the community.
Training peer educators
The Program for Appropriate Technology in Health (PATH) trained us to become HIV peer educators in our factories. We learned about prevention, HIV testing, and condoms. The company gives us a space in front of the factory to distribute condoms, explain how to use them, and hand out pamphlets about HIV programs in our community. Sometimes we also give information to workers’ families in town.
Some campaigns focus on showing employers how they benefit from keeping workers healthy. Others focus on workers’ right to health. In places where many people have HIV, it is clear that HIV programs at work prevent turnover and maintain the quality of production.
A comprehensive HIV program in factories should include:
- free and confidential HIV testing, or time off for workers to get tested.
- confidentiality regarding HIV status.
- a policy prohibiting discrimination against workers who have HIV.
- training in safety and health practices that reduce the risk of infection when accidents happen. If accidents lead to blood exposure, the factory should make available PEP (post-exposure prophylaxis) treatment to prevent HIV (see Where Women Have No Doctor).
- time off for workers with HIV to care for their health or the health of family members.
- free workshops about HIV prevention, transmission, and treatment.
- support for safer sex, such as free condoms.
- health care services — including HIV counseling, testing, and treatment — for all workers and their families.
- tuberculosis testing, treatment and prevention, because TB is common in people with HIV (see Chapter 31).
Factory pays for ART
The Volkswagen car manufacturing company started an HIV program in their factory in Brazil in 1996 to respond to the growing number of their workers and managers who have HIV. Like most HIV programs, it includes HIV testing. For those who test positive, Volkswagen offers a treatment package that includes care by medical specialists, free medicines, and clinical monitoring of ART treatment, home care, and help returning to work after illness.
The Volkswagen program also includes testing, treatment, and support for workers’ families. With this care and support, almost 90% of the workers with HIV are active and without symptoms. Another part of the program is a strong education effort. Workers are invited to trainings about HIV and then supported in sharing information with their co-workers. Many companies are scared of starting an HIV program that includes free or subsidized ART, but this program (and many others around the world) actually saves money by keeping skilled workers with HIV healthy instead of hiring new people all the time.