HIV Prevention In The Workplace

Stephen BridgesNational AIDS Fund

April 16, 2004

New Intervention Directions

CAPS Conference

The U.S. HIV Epidemic at a Glance

Men 70%Women 30%BY GENDER:

BY RISK:

BY RACE:

MSM 42%

Heterosexual 33%

IDU 25%

Black 54%

Other 1%

White 26%

Latino 19%

Slide made courtesy of Dr. Cynthia Gomez, UCSF-CAPS

Domestic

• Approximately 40,000 infections occur each year in the United States.

• 50% of these infections occur in people aged 25 and younger, the workforce of the future.

• 1 in every 25 people report engaging in activities that potentially place him or her at high risk for HIV infection.

• Medical breakthroughs and treatments enable people living with HIV infection and AIDS to remain in the workplace longer.

Affected Populations

 

In the United States, HIV/AIDS is having a severe impact upon communities of color, women, and young people in numbers disproportionate to population ratios.

African-Americans make up 12 percent of the U.S. population, they accounted for half of the new HIV infections reported in the United States in 2001 [1].

1. CDC. HIV/AIDS Among African Americans (July 7, 2003), HIV Prevention Saves Lives Fact Sheet

The Hispanic community is also severely affected by the disease. According to CDC estimates in 2000, while Hispanics represent 14 percent of the U.S. population, 19 percent of new HIV cases are within this community

In fact, AIDS is the third leading causeof death for Hispanics ages 25 to 44. [2]. 

2 CDC. HIV/AIDS Among African Americans (July 7, 2003), HIV Prevention Saves Lives Fact Sheet

Women now account for 30 percent ofnew infections. African-Americans aredisproportionably affected within this segment, representing 64 percentof newly infected women.[1]

What is Advancing HIV Prevention?

• Advancing HIV Prevention modifies HIV prevention programs to encourage people to get tested and know their status, provide referrals to care and treatment for HIV +, and provide prevention services for persons at risk of acquisition or transmission of HIV.

Source Data: CDC MMWR April 18, 2003, Vol. 3.

Why a AHP?

• Stable morbidity and mortality (40,000 new infections annually since 1993).

• Concerns about possible increases in HIV incidence (STD increases in urban centers among MSM).

• Lack of knowledge of sero-status.

• Effect of knowledge of sero-status on behavior.

• Availability of a simple, rapid HIV test.

Source Data: CDC MMWR April 18, 2003, Vol. 3.

Strategies of the Initiative

Four priority strategies:

• Conduct HIV/AIDS prevention and education with people who are at high risk of HIV.

• Encourage people to know their HIV status.

• Prevent new infections by working with people who are HIV positive and their partners.

• Lower HIV transmission.

Important Facts Consider

FACT: Since the late 1990s, an estimated 40,000 new HIV infections have occurred annually in the United States.

FACT: From 1999 to 2001, in the 25 states with HIV reporting, the number of newly diagnosed HIV infections increased 14% among homosexual men, and 10% among the heterosexual population.

FACT: The number of persons in the United States living with HIV is estimated to be 950,000, and approximately 250,000 of

these individuals do not know they are infected.[1] FACT: These 250,000 individuals are members of today’s workforce.FACT: The Centers for Disease Control and Prevention recently

introduced Advancing HIV Prevention: New Strategies for a Changing Epidemic – United States 2003, a strategy to identify and provide treatment for these individuals who are unaware of their HIV infection.

1]CDC HIV/AIDS Update “A Glance At The HIV Epidemic” http://www.cdc.gov/nchstp/od/news/At-a-Glance.pdf

Why Should the Business Community Care?

55% of American workers are between the ages of 25 and 44 years of age

75% of reported AIDS cases are in this same age group

Half of all new HIV infections in the United States are among people under the age of 25

U.S. workforce is aging rapidly in both the public and private sectors

• “Overcoming the current barriers to HIV prevention and treatment requires that leaders in the community acknowledge the severity of the continuing epidemic among people of color and play an even greater role in combating HIV/AIDS in their own communities.”

• (Centers for Disease Control and Prevention, 1998: Critical Need to Pay Attention to HIV

Prevention for African Americans)

Role of Business Leaders

As more people get tested and confront the realities of HIV, newly diagnosed workers will turn to their employers and union leadership for:

•Guidance

•Support

•Education

•Reasonable accommodations

•Benefits assistance.

Workplaces as HIV-related Intervention Sites?

By and large employees trust that the information and training provided to them in the workplace is reliable and credible

Accurate information helps maintain productivity Education gives employers and employees the tools needed to

effectively manage risk Reduce stigma and fears associated with HIV/AIDS Educate workers’ families and the larger community

Benefits of HIV/AIDS Workplace Education and Training

• Decrease stigma towards HIV-positive individuals

• Avoidance of interruptions in productivity when an employee is known or believed to have HIV/AIDS

• Reduced anxiety about possible workplace exposure

• Improved employee morale• Heightened safety and use of universal

precautions in first aid at work

How Business and Labor support HIV Prevention

• Working with minority-owned and small businesses and labor unions in highly impacted geographical locations.

• Combating stigma through education.

• Educating the workforce on benefits of knowing your status.

Barriers To Consider

• Deep mistrust of the public health system

• Lack of well-funded, culturally specific interventions

• Low health-care seeking behaviors• Stigma within communities• Poverty, unemployment, discrimination

(NASTAD, Dec. 2001: HIV/AIDS: African American Perspectives and Recommendations)

Barriers continued….

• Evidence that financial hardship, racism and stigma lead to increased risk behavior (Diaz, Ayala et al.)

• Structural issues that impede prevention

• Lack of technical and financial support for African American CBOs and ASOs

Engage in Partnerships for Change

• Combine diverse resources to develop, fund and evaluate innovative programs:– National AIDS Fund’s 29 Partnerships and

300+ community partner agencies

Family Education and Community Mobilization

• Educating and mobilizing the community about the benefits and potential deficits of the AHP

• Assuring HIV education and risk reduction programs for community members

• Engaging and education workers and their families in the discussion of care and treatment for HIV+

• Combat stigma through community education

Conclusions

• It is inevitable that businesses, families, schools and other sectors will feel the impact

of HIV• HIV prevention is most effective when it is

introduced early and reinforced often• University settings provide a means of

reaching many people at once, providing information and access to prevention, treatment, and care options

• Business and labor leaders need to be engaged in HIV prevention for ethical as well as financial reasons