DEPARTMENT OF LABOR AND EMPLOYMENT

6 steps to
understanding AIDS in the
WORKPLACE

What is HIV?
Human immuno-deficiency virus
Attacks bodys immune system & causes AIDS
Incubation period for HIV infection lasts for
average of 5-7 years
No symptoms
HIV antibodies multiplying
CD4+ cells (white blood cells or lymphocytes that play a key
role in the immune system) decreasing immune system
becoming deficient
Prone to opportunistic infections = infections that
attack person whose immune system is deficient

What is AIDS?
Acquired immune deficiency syndrome
Most serious, later stage of HIV infection
Immune system breaks down
susceptible to many infections
eventually result in death
AIDS is a syndrome, a combination
of signs & symptoms
Cancer, TB & other diseases
caused by protozoa, parasites,
fungi, bacteria

How many are infected in the

World? In the Philippines?
----------------------------------------------- Global Statistics (UNAIDS 2008 Report)

36-40million adults and children estimated to be living with HIV & AIDS
Around 2.5 million are children below 15yrs old
Around 28 million are already dead
15,000 people get infected everyday
95% of those living with HIV come from developing and poor countries

CURRENT EPIDEMIOLOGICAL PROFILE (National Aids Registry and NEC-DOH)

as of APRIL 2010

4,971 total reported HIV positive cases

4,131 (83%) asymptomatic
840 (17%) AIDS cases
319 - (38%) deaths due to AIDS
3,725 (74.9%) males ; 1,235 (25%) females
4,432 (89%) of cases were transmitted through sex
1,389 (27%) OFWs; 1,034 (74%) MALES;
Many more HIV/AIDS cases have been unreported

140 cases
(DAVAO CITY)
Davao -City
Statistics
(Consolidated data from DOH XI,

- 128 males
DMC-HACT,
CHO and ALAGAD Mindanao (as of March 31,
- 12 females
2011) -16 deaths
Davao city prevalence rate: 3.6%

The most Common and Dominant Form of

Transmission

- Sexual Transmission

Step 2: Transmitting HIV

Can you tell if a person has HIV?

Not just by looking!
Person living with HIV appears normal,
like any other person asymptomatic
(shows no symptoms)

He/she looks & feels healthy for years

CAUTION: Someone who looks & feels

healthy can still (unknowingly) pass on
HIV to someone else

How can HIV be passed?

1. There must be HIV present, in high
enough concentration
What body fluids contain
enough HIV to transmit
HIV?
Blood, breast milk, semen
& vaginal secretions
NOT: saliva, sweat,
tears, urine, vomit,
phlegm

How can HIV be passed?

2. HIV must survive & pass into the
bloodstream for infection to occur

Directly (e.g., injection, cuts & sores)

Through mucous membranes

(e.g., lining of vaginal wall, urethra, rectum)

HIV is very fragile outside of human

body
Easily killed by soap & water
Dies quickly in air
Cannot survive in temperatures over 60 deg. C
Intact skin = excellent protective coating

Can HIV spread thru mosquitoes?

NO! HIV does NOT spread through
mosquitoes & insects, water, or food.
Why?
HIV is a human virus; it doesnt survive outside
humans
Mosquitoes take blood out, but it doesnt inject
blood into the next person (it injects its own
salivawhich does NOT have HIV)

What are the main modes of

transmission?
1. Unprotected sexual contact
MOST COMMON globally & in the Philippines
Mostly heterosexual

2. Exposure to infected blood

Via blood transfusions, organ transplant
From instruments contaminated with HIV

3. Transmission from mother to child

During pregnancy (2-3 trimester)
Delivery
Result of breastfeeding

What is high-risk behavior?

Behavior that can facilitate spread of HIV:
Unsafe sexual relations
Multiple sex partners (serial monogamy is ok)
Sharing needles or other medical
instruments with other people
Transfusion of blood/
transplant of organs that
have not been tested for HIV

What kind of sexual relations are

most likely to spread HIV?
1. Anal sex = highest risk for partner whose
anus is penetrated
Mucous membrane of anus: relatively thin &
more easily irritated than in vaginal wall
More friction than vaginal sex easier to tear

2. Vaginal sex = woman is more at risk than

the man
Mucous membrane of vagina is quite fragile
Sperm remains in vagina for fairly long period
increased chance of HIV entering
bloodstream

Whats the link between HIV & STIs?

A person with sexually transmitted
infection (STI) is more likely to:
Spread HIV
Contract HIV

Why? A person with STI often has

abrasions or swelling & openings that
allow HIV to exit or enter during sexual
relations

HIV is spreading more quickly among

women than men?
YES
Biologically:
Vagina more easily irritated than penis, esp. among
younger women <20 y.o.

Socially, women:
Receive less information on HIV/AIDS & STIs
Cannot negotiate for safer sex
Often have partners who may
be having other relationships

Are sex workers the primary source

of HIV transmission?
No. Sex worker most likely got
HIV from customer
High-risk behavior:
Multiple sexual partners
Increased STI risk
Difficulty negotiating for
condom use

Can worker living w/ HIV transmit to

other people at workplace?
NO, b/c HIV cannot be transmitted thru
casual contact:
Shaking hands, hugging, kissing, sharing clothes, utensils,
toilet, coughing, sneezing, crying, etc., are SAFE!

Mandatory HIV testing for employment =

illegal in Philippines (RA8504)
Overseas companies may require HIV tests

Worker living with HIV: treated as any other

worker w/ chronic illness

What about healthcare workers? Are

they at risk?
Healthcare workers may come into contact
with blood, vaginal secretions, semen
Can be protected thru safety procedures =
universal precautions
Standard hygienic procedures
Wear surgical gloves, gown, mask, goggles
Use only sterilized equipment
Proper disposal of used needles & sharp objects

Universal precautions =
applied at all times!

Can children infected with HIV still

attend school?
YES: Should attend school as
long as health allows
No HIV transmission to other
children thru casual daily contact
If child infected with HIV begins to
show AIDS symptoms: should
stop attending b/c he/she more
susceptible to contracting other
ailments from his/her friends

Step 3: Preventing HIV/AIDS

from spreading

Prevention is BEST
The best way to prevent HIV from
spreading is not to engage in high-risk
behaviour
i.e., prevent infected blood, semen, vaginal
secretions & breastmilk from entering the body

HIV/AIDS 101:

How can sexual transmission of HIV be

prevented? - The ABCs
Abstain from sex
Be faithful to one sex partner, whose
HIV status is known to you & who is
also monogamous
Consistently & correctly
use condoms

Prevention: Blood
Screen blood for HIV before transfusions
Use only sterilized instruments (syringes,
tattoo needles, razors)
Cleaning syringes:
draw up bleach/70% ethanol
solution into needle, discharge
repeat
draw up distillate water, discharge
repeat

Is there a vaccine to prevent HIV?

No. Research is
ongoing, but so far
none.
SOCIAL vaccine
only for now:
modifying behaviors

Quarantine for people living with HIV:

NOT EFFECTIVE!
Public health: HIV does not spread thru casual
contact; no justification for quarantine
Human rights:
Unethical; violation of human rights
Encourage people with risky behaviors to go underground
-> more difficult to reach

Operationally: impossible to identify all HIV-positive

persons
no symptoms
window period: antibody tests wont show who is recently
infected

Is tracing of individuals necessary?

Tracing not effective & unethical
Not required in RA8504
Better approach to encourage partner
disclosure & HIV testing: information &
counselling

Step 4: Testing for HIV

Testing for donated blood vs VCCT

Purpose of testing is different:
Donated blood: testing blood for safety
(protects recipient of blood/organs)
VCCT: testing so that individual can know
their status & take appropriate action
(protects & empowers individuals)

Where can one get an HIV antibody

test?
DOH & many private institutions conduct
tests
Testing must be:
Voluntary
Accompanied by counselling before & after
Confidentiality fully protected

Referred to as VCCT or VCT

What is pre-test counselling for?

Information & education about HIV/AIDS
Risk assessment: review risks client has been
exposed to
Explain HIV test & window period
Behaviour change: help client
plan concrete steps
to protect self & family
Help clients prepare for
positive or negative result

What is post-test counselling for?

Remind client about window period
(if they need to come re-test)

Give result
Provide emotional support
Refer clients to additional services (e.g.,
PLWHA support groups, medical & psychosocial/ psychiatric
services, social services, etc.)

Help client make plans for future

Negative -> how to stay that way = key entrypoint for prevention

What about mandatory testing?

Right to voluntary testing protected (RA8504)
Mandatory testing proven to be ineffective
Provides only temporary picture
Cant account for window period
Stigmatizing
Individuals w/ risk behaviors could go underground
VIOLATION OF HUMAN RIGHTS:
reporters must bring up issue
if it occurs!

Fosters complacency
Very costly; cost-ineffective

Who may know the results of an HIV

test?
Only to person tested & his/her counsellor
Test results may not be leaked to any
other party w/o express informed consent
of individual
Healthcare settings also!
(e.g., not share with other
medical staff w/o informed consent)

Right to confidentiality
protected in RA8504

What are some effects of stigma &

discrimination?
Denial of own risk
Fear of asking questions about
HIV
Fear of getting tested
Isolation, low self-worth, stress
Loss of job, education,
healthcare
Violation of privacy (media
sensationalism)

Step 5: Understanding AIDS

How long does it take before a

person shows symptoms of AIDS?
60% of adults infected with HIV will
develop AIDS within 12-15 yrs
But: range of 2-15 yrstheres a lot of
individual variation

Reminder:
AIDS = only after appearance of certain
infections (opportunistic infections)

What are opportunistic infections?

Infections that attack person with
deteriorating immune system
Healthy human bodies can fight off these
infections (except for TB); immunosuppressed people cannot
Healthy persons can be dangerous to an
HIV-positive person whose immune
system is deteriorating!

Step 6: Treating AIDS

AIDS: Symptoms
Fairly general initial symptoms (not HIV-specific)
WHO/ US Center for Disease Control:
classification of AIDS symptoms for
diagnosis:
chronic cough lasting for >1 mon
itching in several parts of body
repeated appearance of herpes zoster
infection of mouth & throat caused by fungus, Candida albicans
chronic, spreading & worsening herpes simplex
persistently swollen lymph nodes all over body

Can HIV be cured?

There is no cure for HIV
prevention is best!
Anti-retroviral drugs (ARVs)
help keep HIV under control
With access to ARVs, good
nutrition, healthy lifestyle,
emotional & social support, it is
possible to lead a healthy,
productive life with HIV

What are treatment options for a person living with HIV/AIDS?:

Lifestyle & support

Living healthy lifestyle
Exercising, eating well
Avoid stress, situations that cause depression,
emotional instability
Continue with regular activities
Spiritual activities

Seeking emotional support

Support groups for PLWHA
Counselling

What are treatment options for a person living with HIV/AIDS?:

Drugs
Anti-retroviral drug therapy
Not a cure: Helps control HIV
Once started, its for life. If interrupted,
could build drug resistance
(i.e., lose drug effectiveness)
Much support needed for drug adherence: strict
schedules & requirements, side effects

Prophylactics - preventive medicine for OIs

Individual treatment has to be worked out with
own doctor

Can traditional medicines cure AIDS?

So far, none have been recognized as a
specific cure for AIDS
Can be tried as alternative
But should NOT give false hope to person
infected with HIV as a cure

What can families do?

Talk about HIV/AIDS within context of
health, gender & sexuality in an ageappropriate manner
Promote compassion & understanding
about HIV/AIDS & related vulnerabilities
Nurture responsible
behaviour in children
& parents

Why should workers be concerned

about HIV/AIDS?
---------------------------------------------------------------------------------------------

All available figures about HIV/AIDS cases show

that most of those who are positive are in their
most economically productive age like workers.
This group therefore needs most attention in
HIV/AIDS prevention work. Workers and
Employers must be made aware of this so that
they can protect themselves and others through
correct information about the control and spread
of the virus

What can private sector/business

do?
Raise awareness among its workers about
HIV/AIDS and STIs
come up with a comprehensive policy
HIV/AIDS to include provision for
(discrimination, health coverage, employment
non-termination and
others)
Regard the response to
HIV/AIDS in workplace as
part of good management
practices

What does R.A. 8504 require at the

workplace?
-----------------------------------------------------------------------------------------------

It requires that all offices, both government

and private, institute HIV/AIDS awareness
and prevention programs.
Under the law, the DOLE and DOH are to
oversee the anti-HIV/AIDS campaign in all
companies in the private sector. The Civil
Service Commission is responsible for all
government offices and agencies.

What about discrimination and

restrictions at the Workplace?
---------------------------------------------------------------------------------------------

Discrimination is prohibited in any form from

pre-employment to post-employment.
This includes hiring, promotion or
assignment based on actual, perceived or
suspected HIV status in a person.
It is unlawful for an employer to terminate
anyone from work solely on the basis of
actual, perceived or suspected HIV status of
an individual. (Article VII Section 35)

What are the penalties for

discriminating against person with
HIV/AIDS?
-------------------------------------------------------------------------------------------

It is punishable by imprisonment of 6
months up to 4 years with a fine of not
more than 10,000 pesos. Additionally, the
operating license of the offending agency
maybe revoked.
(Article VII Section 42)

What can teachers and healthcare

workers do?
Talk about HIV/AIDS, sex, sexuality & gender
with students, young people
Provide accurate information in understandable,
youth-friendly language & manner
Ensure confidentiality
Refer young people to appropriate services
Healthcare workers: provide
youth-friendly services

What can religious leaders do?

Talk about sex, sexuality & gender
with young people
Including discussion of HIV/AIDS in couple
counseling (e.g., discordant couple, where one
spouse is HIV-positive--how do they decide
about sex?)
Raise awareness regarding HIV/AIDS
Promote compassion & understanding, nontolerance of discrimination for PLWHA
Care & emotional support for those affected by
HIV/AIDS

DOLE
Department Order 102-10
Guidelines for the Implementation
of HIV and AIDS Prevention and
Control in the Workplace Program

DO 102-10
Is in accordance and response in
implementing the provisions of Republic
Act 8504 other wise known as:
THE PHILIPPINE AIDS PREVENTION
AND CONTROL ACT OF 1998

ILO highlights the importance of

having a policy on HIV/AIDS
o Makes an explicit commitment to
corporate action;
o Ensures consistency with appropriate
national laws,
o Lays down a standard of behavior for all
employees
o gives guidance to supervisors and
managers

ILO highlights the importance of

having a policy on HIV/AIDS
o helps employees living with HIV/AIDS to
understand what support and care they
will receive, so they are more likely to go
for VCT
o help to stop the spread of the virus
through prevention
o assist an enterprise to plan for HIV/AIDS
and manage its impact

Policies that do not

o blame
o discrimination and stigmatization
o compulsory testing
o isolating people living with HIV/AIDS
o marginalizing affected population

IMAGES OF
SEXUALLY TRANSMITTED
INFECTION

Candidiasis

Vulva

Vagina

Trichomonas

Gonorrhea

Genital Wart

Pubic Lice

Syphilis

Genital
Herpes

AIDS
Kaposis sarcoma

oral candidiasis

REMEMBER:
Awareness and Education
are the best ways to protect
yourself. For your safety, dont
hesitate to ask people who
know more about the virus and
its infectious state.

Daghang
Salamat!