Improved HIV treatments are allowing many people to live longer, healthier lives. Some people who gave up their jobs because of their illness are now feeling well enough to consider returning to work.

Returning to work and feeling productive can improve your self-image and make you feel better about yourself. However, the idea of re-entering the workforce can also trigger fears and concerns. Before you start, here are a few simple questions to help you assess where a job fits into your life:

• What does your health care provider think about you and a job? Hint: the answer will involve trends in your CD4 count and viral load.
• How have you tested your stamina (energy level)? Many job counselors recommend volunteering for a while to build up to full-time work. If you volunteer for an organization that you like, you might be offered a job there in the future. Start with a limited schedule and build.
• Why do you want to have a job? “I need the money” is a good reason to job hunt, but not the only one. Many working HIV+ people report that the structure of a job helps with adherence to medications and maintaining a healthy lifestyle. What do you want it to do for you?
• Do you have enough support at home, or in your close circle of friends? If work makes it more difficult to fit in some of your daily chores, will you have help from family or friends?
• How will work affect your eligibility for benefits, i.e., Social Security?

Start with an attitude check. If you expect to drag yourself to a hateful job with hateful people, you’ll probably get that. If you expect to learn, expand your skills, and enjoy the benefits of working, you’ll probably get that. Some considerations:

• Consider your personality and skills: Try to make a good match between what you like to do and the job description. 
• Consider a basic fact about jobs: Work you enjoy gives you energy. Work you dislike robs you of energy.
• Talk with other HIV+ working people – ask about their jobs, their routines, their challenges.
• Some people may be feeling better but not well enough to return to their usual line of work. Think about returning to school or being retrained. Each state has a vocational rehabilitation program that helps people with disabilities be retrained or find appropriate work.

Your HIV status is confidential information. You have no obligation to disclose to a prospective or present employer. Here are the potential bumps in the road:

• The application form. It asks whether you have any medical condition that might interfere with your job. Check that impulse to “confess!” Many people work productively for years without HIV becoming an issue. The application form is looking for conditions that would prevent you from doing the job. Do not apply for a job you know you cannot do. For all other jobs: the answer is “no.”
• The interview. A sloppy interviewer asks: “Tell me about any medical conditions.” A reasonable interviewer asks, “Why were you out of the workplace for five years?” Questions that dig for specific information about a diagnosis are not legal. Reply that there is no barrier to your doing the whole job. Questions about an employment gap are scary, but you can manage. Simply say, “I was dealing with a family health problem.”
• The pre-employment health survey that asks you to list all medications. Take the form to your doctor and ask him or her to complete it. Encourage your doctor to write something like, “(Your name) is under my care and takes no prescription medications that would interfere with her fulfilling the essential functions of this job.” Do not list all your medications. They are none of the employer’s business.
• The pre-employment physical. If your new job requires a pre-employment physical or lab test, it’s probably because the employer is trying to find out if you use street drugs. An HIV test would require your written consent and be a pointless expense. Talk with your pharmacist before you have the physical. Ask whether any of your HIV drugs would yield a false positive drug test. If so, ask for the name of an alternate test. Tell the tester that you need the alternate test for a valid result. Do not disclose the medication or your diagnosis.
• Signing up for employee benefits. If you find a job with benefits, do not lie on application forms for health, life, or disability insurance. That is called insurance fraud. If you find a direct question about HIV or other diagnosis questions, ask how your privacy is protected. Turn in the form when you get a satisfactory answer.

Once you find a job, remember that you were hired for your skills. Whatever you believe about disclosing your HIV status at work, keep the focus on your performance. Many HIV+ people who want to disclose at work keep a lid on the information for a few months. That gives you time to figure out how you’ll be treated if you do disclose.

There are no automatic triggers for disclosing your HIV status at work. You are not required to disclose at work, even if:

• You’re bleeding.
• You need a reasonable accommodation.
• Side effects made you late for work.
• You’re up for a promotion.
• You need leave time to adjust to new medications.

Surprised? Here are the disclosure rules.

1. You don’t have to disclose.
2. A supervisor or manager is legally bound to keep your information private. But that is not a guarantee that he or she will obey the law.
3. The HR director, a shop steward, or the company officer in charge of employee relations must by law keep your diagnosis private. But not everyone in those roles follows the rules.
4. If you tell a co-worker, you might as well post the information on the company bulletin board. Tell all co-workers or none.

Live with these ideas as you prepare your transition to work. Preparing yourself and your mind for the workplace can make your life easier when you’re there. And remember, go slowly. A return to work takes time and planning.

1		Rubenstein, W.B., et.al. (1996). The rights of people who are HIV positive: The authoritative ACLU guide to the rights of people living with HIV disease and AIDS. Southern Illinois University Press.
2		Senak, M.S. (1996). HIV, AIDS, and the law: A guide to our rights and challenges. New York: Plenum Press