2.2.2 Key References and Supporting WHO Guidelines

Asia-Pacific Network of People Living with HIV/AIDS. (August 2009). Research Finding Highlights: Access to HIV-related services in positive women, men who have sex with men (MSM), transgender (TG) and injecting drug users. Report.

Connelly P, & Rosen S. (2006). Treatment of HIV/AIDS at South Africa's largest employers: Myth and reality. South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde, 96(2), 128-133.

Corbett, L. (2007a). Health worker access to HIV/TB prevention, treatment and care services in Africa: Situational analysis and mapping of routine and current best practices. Unpublished manuscript.

Dahab M, Charalambous S, Hamilton R, Fielding K, Kielmann K, Churchyard GJ, Grant AD. (2008). "Thant is why I stopped the ART": Patients' & providers perspectives on barriers to and enablers of HIV treatment adherence in a South African workplace programme. BMC Public Health, 8(63).

Dieleman M, Biemba G, MphukaS, Sichinga-Sichali K, Sissolak D, Kwaak A, Wilt GJ. (2007) We are also dying like any other people, we are also people: perceptions of the impact of HIV/AIDS on health workers in two districts in Zambia. Health Policy and Planning. 22(3):139-148.

EngenderHealth: Reducing stigma and discrimination related to HIV and AIDS: training for health care workers. New York: EngenderHealth; 2004.

Gostin, L. O. (2000). A proposed national policy on health care workers living with HIV/AIDS and other blood-borne pathogens. JAMA : The Journal of the American Medical Association, 284(15), 1965-1970.

Horizans, SHARAN, Population Council: The PLHA-friendly achievement checklist: A self-assessment tool for hospitals and other medical institutions caring for people living with HIV/AIDS (PLHA). New York. 2003.

Huerta, S. R., & Oddi, L. F. (1992). Refusal to care for patients with human immunodeficiency virus/acquired immunodeficiency syndrome: Issues and responses. Journal of Professional Nursing : Official Journal of the American Association of Colleges of Nursing, 8(4), 221-230.

Kagan, I., Ovadia, K. L., & Kaneti, T. (2008). Physicians' and nurses' views on infected health care workers. Nursing Ethics, 15(5), 573-585.

Mahendra VS, Gilborn L, George B, Samson L, Mudoi R, Jadav S, Gupta I, Bharat S, Daly C. (2006). Reducing AIDS-related stigma and discrimination in Indian hospitals. Population Council: New Delhi.

Medical Expertise Retention Programme (Sept 2009). HIV-positive and "high risk" untested healthcare workers survey. The American Association of Physicians for Human Rights. http://www.aids.org/atn/a-135-03.html

Morolake O, Stephens D, Welbourn A. (2009) Greater Involvement of people living with HIV in health care. Journal of the International AIDS Society. 12(4):

Morrison K, Negroni M. (2006) A stigma reduction programme for health professionals in Mexico: MoKexteya. Futures Group. Poster Abstract 294. PEPFAR Annual Meeting. Durban, South Africa.

Nyblade L, Stangi A, Weiss E, Ashburn K. (2009). Combating HIV stigma in health care settings: what works? Journal of the International AIDS Society. 12(15).

Public Services International. Retrieved Jun 2, 2009, from http://www.world-psi.org/TemplateEn.cfm?Section=Health2&Template=/TaggedPage/TaggedPageDisplay.cfm&TPLID= 115&ContentID=12005

Taegtmeyer M, Suckling RM, Nguku PM, Meredith C, Kibaru J, Chakaya JM, et al. (2008). Working with risk: Occupational safety issues among healthcare workers in Kenya. AIDS Care, 20(3):304-310.

UNAIDS: Reducing Stigma and Discrimination: a critical part of national AIDS programmes. Joint United Nations Programme on HIV/AIDS: Geneva; 2007.

UNAIDS. HIV stigma and discrimination: A summary of recent literature. August 2009.

Welbourn A. Balancing on Wheels of Hope. Open Democracy News Analysis. Sept 30, 2009, from www.opendemocracy.net/article/50-50/balancing-on-wheels-of-hope

Wheeler M. (2009). Development of policy guidelines for health worker access to prevention, treatment, care and support for HIV/TB (TREAT): A preliminary review of the published literature. Unpublished manuscript.

Supported by Existing Guidelines:

ILO/WHO guidelines on health services and HIV/AIDS, 2005-

  • Glossary p. XI 21, 25: Discrimination: In these guidelines, defined in accordance with the ILO Discrimination (Employment and Occupation) Convention, 1958 (No. 111), and includes HIV status. It also includes discrimination on the basis of a worker's perceived HIV status, including discrimination on the ground of sexual orientation.
  • 21: The scale of occupational risk in the health sector is unclear, in part because of the stigma and blame attached to the reporting of sharps injuries and the lack of available post-exposure prophylaxis.
  • 25: Stigma and discrimination - by health-care workers towards other health-care workers, towards patients, or by employers towards health-care workers - are a serious issue in many health-care settings, undermining the provision of care as well as programmes for prevention. They take a variety of forms and can result in treatment being delayed, inappropriate or withheld, and in breaches of confidentiality, inappropriate and unethical behaviour and the use of excessive precautions.

ILO/WHO PEP guidelines, 2008- Sections 2.2.1, 2.2.2, 2.2.3:

  • 2.2.1 Non-discrimination A non-discriminatory approach to service accessibility, information provision and education is critical and must underpin any policy or operational guidelines on HIV PEP. The ILO code of practice on HIV and the world of work and several other international human rights instruments provide detailed guidance regarding consent, confidentiality and access to information and health care services on a non- discriminatory basis. The policy for eligibility for PEP should always be founded on the principle of equity. Decisions about whether or not to offer post-exposure prophylaxis should be based purely on clinical considerations of risk and should not be tied in any way to a person's decision to file a police report or to pursue legal action. Individuals should be assessed for PEP regardless of their involvement in any activities considered to be illegal by national legislation, such as injecting drug use, sex work or men having sex with men. Nor should there be any barriers to access for financial or administrative reasons. Non-citizens (such as refugees, asylum-seekers and stateless people) should have equal access to health care, including PEP, in the country in which they are currently residing or staying.

UNAIDS International guidelines on HIV and Human Rights:

  • 30. States should also ensure that their laws, policies, programmes and practices do not exclude, stigmatize or discriminate against people living with HIV or their families, either on the basis of their HIV status or on other grounds contrary to international or domestic human rights norms, with respect to their entitlement or access to health-care goods, services and information
  • 61. States should take measures to reduce the vulnerability, stigmatization and discrimination that surround HIV and promote a supportive and enabling environment by addressing underlying prejudices and inequalities within societies and a social environment conducive to positive behaviour change. An essential part of this enabling environment involves the empowerment of women, youth and other vulnerable groups to deal with HIV by taking measures to improve UNAIDS OHCHR 56 their social and legal status, involving them in the design and implementation of programmes and assisting them to mobilize their communities. The vulnerability of some groups is due to their limited access to resources, information, education and lack of autonomy. Special programmes and measures should be designed to increase access. In many countries, community-based organizations and NGOs have already begun the process of creating a supportive and enabling environment in their response to the HIV epidemic. Governments must recognize these efforts and lend moral, legal, financial and political support to strengthen them.
  • 62: States should promote the wide and ongoing distribution of creative education, training and media programmes explicitly designed to change attitudes of discrimination and stigmatization associated with HIV to understanding and acceptance.

Book navigation