A Romanian abroad who, on a social media group, inquired about how easy it would be for him to find a job in his native country if he is infected with HIV, sparked a real debate on the subject of the confidentiality of the diagnosis.
Access to people with HIV-AIDS is limited in certain areas PHOTO: Pixabay
People infected with HIV can benefit, from the moment the diagnosis is confirmed, from certain social measures. The new generations of patients, in particular, says the executive director of UNOPA (National Union of Organizations of Patients Affected by HIV/AIDS), Iulian Petre, largely choose to work and lead a normal life, out of the total number of HIV-AIDS patients alive, about half being active on the labor market. On the other hand, things can get complicated for them if they want to be active in areas where the diagnosis imposes restrictions on them, or if confidentiality has been violated and information that they chose not to communicate reaches the ears of colleagues or the employer.
A person diagnosed with HIV, who said he lives abroad, inquired on the public social media group UNOPA if he would have a problem with employment in Romania if he chooses to communicate that he is infected. “I would like to come to the country and I’m thinking of getting a job as a driver, but now I don’t know what and how.” the person wrote. He received dozens of responses, with other members of the group either recounting their own experiences or trying to help him with information. Thus it turned out, on the one hand, that the legislation in the field is little known, and on the other hand, that the fear of the negative reaction of those around is great and many choose not to reveal their diagnosis.
A member of the group reported that, although this diagnosis is confidential, she found that the occupational medicine doctor from a company where she applied for employment had her medical history in detail, the suspicion being that that doctor would have had access to the database data of a county hospital. “Theoretically it’s confidential, it shouldn’t be seen, even the family doctor doesn’t see it. He may see diagnosis codes on prescriptions or medical letters, but the diagnosis is not so easily revealed.”stated Iulian Petre, executive director of UNOPA.
On the other hand, there are areas in which people diagnosed with HIV-AIDS (and not only these, the list of conditions that restrict access is, by the way, much larger) do not have access.
“There are some medical norms that have been relaxed recently. In SRI, judge and prosecutor, as far as I know, you cannot be, and I understand that it is premised that the infection affects the cognitive capacity and you do not judge fairly”, Peter explained. Until recently, people with HIV-AIDS did not even have access to the army and the institutions of the Ministry of Internal Affairs, but the rules have changed, the director of UNOPA also said.
“HIV infection has disappeared from there, it is no longer a criterion for being unfit, but I have not had anyone go through the medical board and see that this is so. Two years ago, a newly diagnosed firefighter was transferred to the reserve, retired, basically, for this reason. But I know they worked and in the new order last year it no longer appears. The testing is done, but it is no longer a criterion for unfitness”, Iulian Petre continued.
Another area in which there are restrictions, among other categories and for people diagnosed with HIV-AIDS, is that of transport, targeting both drivers who drive vehicles for public transport, as well as drivers who transport goods or drive heavy machinery.
A delicate situation is that in which taxi drivers may find themselves. In the case of HIV infection, certain parameters are monitored every three months, and if the stage of AIDS is reached, the person can no longer hold such a position, being declared “unfit”. “For the rest, you can also be a surgeon, operate on the strip. Now the Occupational Medicine commission is working on an update of the medical criteria related to the more delicate professions, because they were completely unclear and somehow depended on the good understanding you found in the hospital management. But the law did not forbid. From outside, through the countries that have dealt with this subject, they say that you can practice any kind of medicine, only in the medicine of bleeding surgery, in which you put your hand in the patient’s body, you have the obligation to be undetectable with HIV infection, otherwise not you have no limitation in medicine”, Iulian Petre also specified.
Another area that many people know they would have restrictions to activate is that of public food. It’s just that these restrictions don’t exist, says Iulian Petre. “It’s a legend from urban folklore that if it’s food, you’re not allowed to have HIV infection. I kept explaining to them that you don’t put your fingers in the food, and if you do, the virus is destroyed in the stomach by gastric acid anyway. The infection is not transmitted through the digestive tract, only if there is a lot of blood, sores in the mouth, but it is not the same as through sexual intercourse, for example”explained the UNOPA representative.
“Information is lacking and religious fundamentalism is increasing”
People diagnosed with HIV-AIDS since childhood have the hardest time integrating into the labor market, while the new generations of patients are mostly people in the workforce, Iulian Petre says. The danger of discrimination still exists today and, moreover, the danger of increasing the number of infected people is expanding. It happens because, after a period when things were somewhat normal, in recent years health education has become almost impossible to achieve in schools, and people infected with HIV or AIDS face discrimination.
“There was a time when we looked more normal, but we’re taking it back. We are taking it back because information is lacking and religious fundamentalism is on the rise. The religious current has manifested itself in schools for about 10 years now, you can no longer penetrate schools very easily with health education, with prevention, with sex education, for reasons strictly related to the involvement of the church in the school. The new generations are uninformed, even if they have access to all the information in the world, they don’t find it on the Internet, they don’t read it, they avoid it, and they still judge the world based on their primary opinions and instincts. When I hear about HIV, AIDS, what was like 15-20 years has been lost”says Iulian Petre. Education in schools is absolutely necessary to achieve awareness and prevent infections. “Without education, the number of new cases will increase again”, Peter also said.
On September 31, 2024, there were 18,560 HIV/AIDS patients alive in the Romanian medical records, most of them (18,290) being people over 20 years old. In the first nine months of last year, 562 new HIV/AIDS cases were detected, while 8,695 deaths were recorded between 1985 and September 2024.
What you need to know if you have HIV-AIDS and are looking for a job
On the UNOPA website you can find a lot of information that can be very useful for people diagnosed with HIV/AIDS who want a job. There are certain fields in which the HIV test may be recommended by the occupational medicine physician, but HIV testing does not imply that a person cannot practice in that field.
“There are areas, for example the sanitary ones, where there is a risk of HIV infection, in these situations HIV infection is considered an “occupational disease” and it is important to know whether it was contacted at work or not. In other fields, it is considered that a certain state of health is needed to be able to respect the working conditions and to ensure the safety of the employee, such as the case of TIR drivers, who have an extended work schedule – it is not recommended to employ people in AIDS stage”UNOPA experts mention, on the organization’s website.
Also listed here are the categories obliged to keep the diagnosis confidential. Thus, employees of the health network (including occupational medicine doctors, who are not allowed to transmit the diagnosis to their employers), employers (the human resources department is obliged by law to keep the diagnosis confidential and not to inform co-workers) and civil servants who have access to this data are bound by law to maintain confidentiality.
On the other hand, there are a number of fields in which HIV testing is required upon employment, or periodically after employment, but a positive result does not necessarily imply that the person is unfit for the job.
According to the information on the UNOPA website, in Romania, HIV testing is required upon employment for the following fields: the pharmaceutical industry; the staff from the hairdressing, barbershop, massage, cosmetics (manicure and pedicure) units; basic health personnel, nursing staff; the staff who take care of the disabled person and the maternal assistant; higher and middle health personnel; road transport personnel.
In the first stage of the hiring process, the employer prepares the employee file, and in this file you will find documents related to the skills, abilities and qualifications of the employee for the respective position: CV, diplomas, skills sheet from the occupational medicine doctor, etc.. In order to obtain the skills sheet, the employer can recommend an occupational medicine doctor with whom the institution/company collaborates or the future employee is looking for an occupational medicine doctor.
“On the basis of a medical examination, the occupational medicine doctor analyzes the health status of the future employee in accordance with the job specifications and issues a form from which he selects “APT, APT WITH RESTRICTIONS, TEMPORARY UNFIT or UNFIT” for the respective position. It is important to know that a person can declare his HIV status to the occupational medicine doctor or he can have access to information about a person’s HIV status through the documents requested from the family doctor, but the occupational medicine doctor does not have the right to inform the employer regarding the HIV status and is not allowed to pass any information about the person’s medical situation in the documents for the employer. The only information that can be found in the documents issued by the occupational medicine doctor refer to the ability to work (APT, APT WITH RESTRICTIONS, INAPT, etc.) and the working conditions”the cited source also mentions.
Only the person diagnosed with HIV-AIDS can decide whether to disclose this diagnosis at work. “One advantage of disclosing your status at work is that you can create a support network with your colleagues. In Romanian law, if you submit your disability classification certificate to human resources, you are exempt from paying income tax of 10% of your net income and employers have certain tax benefits. On the other hand, telling people you have HIV or AIDS can put you at risk of discrimination and stigma. That is precisely why you are the only person entitled to self-disclose or not.” is UNOPA’s advice.
An IRES and CNCD study conducted in 2019 revealed that “58% of Romanians fear everything that is different and show a high degree of mistrust towards people living with HIV/AIDS. The social distance scale, represented in the study mentioned above, shows that 27% of Romanians do not accept as a person living with HIV/AIDS to be their relative, and 23% do not accept them in their network of friends”, UNOPA experts also say.
