Human Immunodeficiency Virus/HIV
What is AIDS?
Acquired Immune Deficiency Syndrome (AIDS) is a very serious condition caused by a virus which attacks and weakens the body's natural defence system against infection and disease. The virus responsible is known as HIV (human immunodeficiency virus). At present, there is still no cure for AIDS and the disease can be fatal.
What are the health effects of AIDS?
AIDS is a cluster of medical conditions, often referred to as opportunistic infections and cancers for which, to date, there is no cure.
Not everyone who has been infected by the HIV virus has developed AIDS – but they can still pass the virus on to others. There is a long latency period between being infected by the virus and developing the disease AIDS. People with HIV infection may be quite well and able to work normally.
Who is at risk?
The AIDS virus is transmitted in various ways, including by inoculation with blood or body fluids from a person infected with the virus. Extensive studies world-wide have identified only three modes of spreading HIV infection:
- sexual intercourse with an infected person;
- the transfer of infected human blood and body tissues (either from wounds or through mucous membranes of the mouth or eye);
- infected mother to infant.
This means that workers who come into contact with blood may become infected. Any worker who is at risk of a penetrating injury, such as from needles, is at the highest risk. This includes:
- Health care workers, particularly those in infectious diseases wards, emergency rooms and intensive care units
- Emergency service workers – Ambulance, fire brigade and police
- Prison Officers
How the Infection Doesn't Spread
There is no evidence from anywhere in the world that HIV transmission involves insects, food, water, sneezing, coughing, toilets, urine, swimming pools, sweat, tears, shared eating and drinking utensils, clothing and telephones. There is no evidence that HIV transmission occurs with casual, non-sexual, person-to-person contact. This is important to emphasise when allaying fears about AIDS and possible discrimination against high-risk groups such as gay men or those with drug abuse.
There are no specific OHS regulations on HIV/AIDS.
However, employers have a duty under the Victorian Occupational Health and Safety Act (2004) to provide and maintain for employees, as far as practicable, a working environment that is safe and without risks to health. This includes providing a safe system of work, information, training, supervision, and where appropriate personal protective equipment. The employer also has the duty to monitor conditions at the workplace and to monitor the health and safety of employees.
HIV/AIDS is a notifiable disease under the Health (Infectious Diseases) Regulations 2001 - medical practitioners and others must notify the health authorities .
State and Federal Law prohibits discrimination on the grounds of HIV/AIDS infection in employment (and other areas). People with HIV/AIDS have the same rights as other people and should not be discriminated against, and if someone feels they has been discriminated against because of their HIV/AIDS status, they should contact the Equal Opportunity Commission.
Issues in the Workplace
The main issues raised by HIV infections and AIDS in the workplace concern testing for the disease, confidentiality, discrimination and access to social services.
Employers and employees should be involved in developing and implementing workplace policies on AIDS and HIV infections. Unions should be involved at all stages.
Workers with HIV infection who are healthy should be treated the same as any other worker and not be discriminated against. Workers with HIV-related illnesses, including AIDS, should be treated the same as any other worker with a serious illness. Under the Equal Opportunity Act 2010 (Vic), and similar legislation in other jurisdictions, it is illegal to discriminate against someone on the basis of a disability, disease or injury.
In September 2015, the UK's peak union council, the TUC issued a guide 'Tackling HIV discrimination at work' [pdf], to provide basic facts to help unionists deal with issues that might arise. HSRs and workers in Australia should find the guide useful as well. TUC publication alert.
Action plan for health and safety representatives
Identify the hazard and assess the risks
All work areas and tasks should be assessed.
- Find out whether HIV/AIDS is a risk in your occupation. Contact your union for further advice if necessary.
- Determine how many and which workers could be exposed.
- Carry out inspections, observe, evaluate current existing precautions.
- Talk to members of your work group - ask co-workers whether they are experiencing any health problems about which they are concerned.
Risk Control – Prevention
Generally speaking, precautions adopted in the health services to protect staff from other sources of infection are appropriate to prevent infection with the HIV/AIDS virus. The precautions should emphasise the following measures:
- Ensuring that equipment used in the workplace will not, so far as is practicable, present a risk of cutting, abrasions or puncture wounds;
- Anyone who sustains an injury that may result in bleeding should cover the wound;
- Spillages of blood or body fluid should be cleared up as soon as possible by someone using disposable protective gloves, using a bleach solution (10% solution in water) or with an approved 'hospital disinfectant';
- First-aiders should be trained in, and be provided with the necessary equipment for preventing contact with body fluids when administering first aid or disposing of clinical waste.
All workplaces should follow 'Universal (or Standard) Precautions' (See below).
- Ensure that any puncture wounds, cuts and abrasions from sharps, or contamination of broken skin, mouth or eyes should be reported immediately and recorded.
- The worker involved in any incident should consult a doctor immediately to assess the need for testing for blood borne viruses, and referral to other specialist services (for example, counselling).
- Negotiate an HIV/AIDS policy (perhaps as part of an Infectious Diseases Policy), and ensure that personnel policies prevent discrimination in employment and respect confidentiality.
Universal (or Standard) Precautions are a set of guidelines which have been developed to protect workers who are exposed to blood and other body fluids. Workers work on the presumption that all blood and body fluids are in fact infectious, and follow the "rules" whenever in contact with them. The precautions involve hand washing immediately there is contact, the routine wearing of protective clothing and gloves, following such infection control measures that are designed to place a barrier between potentially infectious blood or body fluids and employees, adherence to work practices, and procedures for the transport and handling of infectious materials.
Whether or not a person is known to have the HIV/AIDS virus, all workers coming into contact with blood and body fluids should cover exposed cuts and abrasions (especially on the hands and fingers) with waterproof dressings and take care to prevent puncture wounds, cuts and abrasions from sharps. Such accidents should be treated immediately by encouraging bleeding and liberally washing with soap and water.
Uniforms, overalls, aprons, and gloves are forms of protective clothing and offer a degree of protection against contamination from blood, body fluids or contaminated articles. Spillages contaminated by blood and body fluids should not be tackled without suitable protection and the work should be done strictly in accordance with health and safety procedures.
All clinical health waste must be properly bagged and identified, and all contaminated sharps must be disposed of in a properly constructed sharps container, not put down where they may find their way into plastic rubbish bags and laundry bags which they can easily puncture.
- The National Code of Practice for the Control of Work-related Exposure to Hepatitis and HIV (blood-borne) Viruses [NOHSC: 2010 (2003) 2nd Edition], was declared in December 2003, and is available to download from the Safe Work Australia. The code provides practical guidance for the management of exposure to HBV, HCV and HIV in the workplace. The code is designed to be applicable to all workplaces.
- The International Labour Organisation has a specfic website ILO/Aids which details the ILO programme, initiated in 2000, on HIV/AIDS and the World of Work. A number of 'resources can be accessed on this site, including:
- the ILO Code of Practice HIV/AIDS and the World of Work. The COP is designed to provide workers, employers and governments with global guidelines, based on international labour standards, for addressing HIV/AIDS and its impact at the enterprise, community and national levels. It can be downloaded in several languages
- ILO Recommendation concerning HIV/AIDS and the World of Work (2010). This labour standard is the first human rights instrument to focus on HIV and AIDS in the world of work, and was adopted - by an overwhelming majority - by governments, employers' and workers' representatives from ILO member States at the International Labour Conference in June 2010.
- ILO AIDS Update, October 2012
- Agenda, a free magazine in five languages from the ITF (International Transport Workers' Federation) for those working in transport or the field of HIV/Aids worldwide. Designed to pool and disseminate information and encourage best practice, the annual publication is part of the ITF's anti-Aids campaign, which was launched on World Aids Day 2006 and promotes HIV prevention, campaigns for counselling and testing, for anti-retrovirals and against prejudice.
(This Hazard Sheet is based on a section of 'Hazards at Work - the TUC Guide to Health and Safety')
Last amended October 2015