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Ungrounded Fears and Real Risks

In the early stages of the AIDS epidemic, there was a tremendous fear of being exposed to AIDS patients and HIV carriers. With education, this fear is diminishing, but it is still present in many workplaces, and it must be considered when managing HIV carriers in the workplace. Any effective program for managing HIV in the workplace must include a general education program on the methods of transmission of HIV. Fellow employees must be taught that there is no risk of contracting HIV in the usual course of work. Employers must be taught that there is no risk of their customers' becoming infected with HIV by an employee. Conversely, employers and physicians must recognize the real risks of HIV in the workplace.

Many physicians speak of their patients' right to privacy as though it transcends society's right to protect itself from the consequences of disease and impairment. This attitude threats the ability of employers to achieve a proper balance between individual rights and workplace safety.

Employers must not be cowed by threats from plaintiffs' attorneys. Plaintiffs' attorneys were first excited about antidiscrimination litigation. This interest is already shifting to concern for persons injured by HIV carriers. But plaintiffs' attorneys follow the dollars: a family injured by a demented truck driver makes a much more financially attractive client than does the truck driver who wants to protest his exclusion from the workplace.

Many persons infected with HIV suffer substantial mental impairment before they manifest signs of physical illness. Persons with dementia suffer cognitive, motor, and behavioral disabilities. "Early symptoms ... include difficulty with concentration and performance of complex sequential mental activities. ... Difficulty in reading or carrying out more demanding mental efforts at work ...."[155] These mental impairments are persistent and may appear soon after infection with HIV. Some persons progress to complete mental deterioration and death without developing any other symptoms of AIDS. Once dementia is grossly apparent, the person must be removed from any workplace activity where mental acuity is necessary: operating machinery, making complex decisions, and other activities that pose a risk of injury to the worker or others. In general, dementia disqualifies an employee from performing any activity in which being drunk or under the influence of other drugs would be a disqualification.

[155]Price R; Sidtis JJ; Rosenblum M: The AIDS dementia complex: Some current questions. Ann Neurol 1988; 23(suppl):S27-S33.

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