by Martin Choo, MMedSc
Martin Choo runs the Kuala Lumpur AIDS Support Services Society (KLASS) which delivers community-based services in Malaysia. He is a researcher and an HIV treatment advocate. He has been researching on issues concerning HIV in the workplace in partnership with UN Plus since 2014. He will be contributing to this newsletter through a series of articles about key facets of HIV in the workplace. The articles ranges from access to treatment, stress management, confidentiality, disclosure and advocacy in the work settings.
Performing with HIV: accessing treatment and managing side effects at work
There has been a quiet revolution in HIV science over the last decade. HIV treatment today is so effective that people can lead healthy and productive lives. Crucially, they can even realistically attain a normal lifespan. Despite these medical advances, however, living with HIV still presents many challenges that affect whether people access treatment or will be retained in care. Some of the most persistent complaints are the fear of side effects from HIV medication causing PLHIV to put off starting treatment, and the inability to manage treatment side effects causing them to fall out of care.
Particular to the context of work, being treated for HIV poses two legitimate concerns: first, whether accessing treatment will cause the loss of privacy among work colleagues; and second, how treatment side effects can affect work performance and draw unwanted attention to their health. Managing these concerns are therefore pivotal to ensure the promise of treatment can be had without harming their prospects at work. The most common issues underlying these concerns are unpacked below with practical ways forward.
My boss may notice my frequent visits to the hospital
Initiating HIV treatment may require more clinic visits than usual. If you are not comfortable disclosing the reason to your boss, consider not taking medical leave every time you need to visit the clinic. Also consider getting the clinic to pack as many procedures as possible in one day to minimise the number of days you will be off-work.
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The company providing my medical insurance will inform my company about my HIV status
Check your insurance policy to confirm how information will be shared and what protections are available. In most countries the confidentiality of medical information is protected by law. If protection is unavailable or you have good reason to believe that confidentiality will be breached, consider seeking legal advice.
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I have to travel often or work different shifts and cannot keep up with taking medication
Consider switching to a newer HIV regimen that is more tolerant of poor adherence. Also consider taking your medication in line with periodic activity (eg. before sleeping) regardless of the actual time or time zone.
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I will wait as long as I can before starting treatment
Studies have shown that treatment initiation as quickly as possible after infection will minimise complications and improve treatment outcomes. Consider speaking to your doctor about options to maximise your health and well-being.
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I’ve heard so much about side effects that am not willing to risk taking medication
Find out more about the stories you have heard; in particular which medications were involved, what were the side effects and for how long. Side effects from HIV medication is common but in many cases these were mild and subsided after a few months. Include this expectation when deciding whether to start treatment.
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Treatment affects my ability to function optimally at work
HIV treatment can affect the way we feel and think. If you experience poor concentration or lethargy, for example, consider taking your medication at night so that your body will have time to metabolise the medication while you are asleep. Similarly, if you have trouble falling asleep, consider taking your medication in the morning. Reach out to peers living with HIV to learn if they have side effects and, if they do, how they manage their side effects.
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I really cannot stand the side effects and wish to stop treatment
Before you stop treatment, consider speaking to your doctor about ways to minimise side effects or switch to a different HIV regimen. Keep your doctor informed about the severity of side effects or if they persist longer than expected.
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colleague may see me going to an HIV treatment centre
If you can choose where to receive treatment, consider a centre that is not near your place of work or one that offers general medical care rather than exclusively HIV care.
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Hope this article has helped to address the most common work-related barriers to access and retain in HIV treatment. If you have any questions and would like to talk to us, please feel free to contact us. Confidentiality is guaranteed. Also, if you are experiencing a situation that is not reflected in this article, please share your case anonymously with usfor consideration and inclusion in future articles.
If you are working in the UN system and need any further information about UN system’s policy regarding HIV, we encourage you to visit the UN Cares website.
