HIV Screening for Employment and Work Processes
The Government of Jamaica, the National HIV/STI Control Programme and the National AIDS Committee support the ten key principles of the ILO Code of Practice on HIV/AIDS and the world of work. This includes Principle #6: “HIV/AIDS screening should not be required of job applicants or persons in employment”.
All HIV/AIDS workplace policies and programmes developed for Jamaica are based on the ten principles.
The ILO code of practice on HIV/AIDS and the world of work elaborates further on the issue of testing:
Testing for HIV should not be carried out at the workplace except as specified in the code. It is unnecessary and imperils the human rights and dignity of workers. Test results may be revealed and misused, and the informed consent of workers may not always be fully free or based on an appreciation of all the facts and implications of testing. Even outside the workplace, confidential testing for HIV should be the consequence of voluntary informed consent and performed by suitable qualified personnel only, in conditions of the strictest confidentiality.
Prohibition in recruitment and employment
HIV testing should not be required at the time of recruitment or as a condition of continued employment. Any routine medical testing such as testing for fitness carried out prior to the commencement of employment or on a regular basis for workers should not include mandatory HIV testing.
Prohibition for insurance purposes
HIV testing should not be required as a condition of eligibility for national social security schemes, general insurance policies, occupational schemes and health insurance.
Insurance companies should not require HIV testing before agreeing to provide coverage for a given workplace. They may base their cost on revenue estimates and their actuarial calculations on available epidemiological data for the general population.
Employers should not facilitate any testing for insurance purposes and all information that they already have should remain confidential.
There are many drawbacks to testing:
Testing is complex and costly, and there is the possibility of false positives.
- The incubation period for HIV is 6 weeks to 3 months so a negative test results may not be necessarily accurate.
- The HIV test is a snap shot of today only. The person taking the test whether employee or immigrant may be uninfected today but become HIV infected tomorrow – especially during unprotected sex.
- In an environment where rights are respected, employees are more likely to undergo voluntary testing and change their behaviour so that they can take fewer risks and indeed become active agents for prevention.
The International Organization, the National HIV/STI Control Programme and the National AIDS Committee support the following position:
- Screening is prohibited for exclusion from employment and related situations such as promotion and access to training.
- Testing is permitted in limited circumstances under certain conditions.
- The confidentiality of HIV-related data must be respected.
Voluntary testing is a different matter. People may decide that they wish to test for a number of reasons. Where voluntary testing does take place it is essential that it be confidential and accompanied by professional counselling. This usually takes place before the decision to be tested is made and after the test result is known. This form of testing is confidential voluntary testing or VCT. It is an important component of a comprehensive strategy for tackling HIV/AIDS. Once people know their HIV status they can be helped to manage risky behaviour.
There may be situations where workers wish to be tested. Voluntary testing should normally be carried out by the community health services and not the workplace. Where adequate medical services exist, voluntary testing may be undertaken at the request and with the informed consent of a worker, with advice from the workers' representative. Suitably qualified personnel should perform the test with adherence to strict confidentiality and to disclosure requirements. Gender-sensitive counselling, which facilitates an understanding of the nature and purpose of the HIV tests, the advantages and disadvantages of the tests and the effects of the results upon the worker, should form an essential part of any testing procedure.
Testing for scientific purposes
Policy on HIV/AIDS prevention and care will be more effective if we improve our knowledge of the dynamics of transmission, the impact of the epidemic and the effects of interventions. For this reason it is important to monitor the epidemic, gathering qualitative and quantitative data on the incidence of HIV/AIDS, its patterns and trends. The data need to be gathered by statistical offices and/or independent researchers, in consultation with the social partners. Care must be taken to ensure that this monitoring process does not threaten the rights of workers.
Conditions for Epidemiological Surveillance
Anonymous, unlinked surveillance or epidemiological HIV testing in the workplace may occur provided it is undertaken in accordance with the ethical principles of scientific research, professional ethics and the protection of individual rights and confidentiality.
Where such research is done, workers and employees should be consulted and informed that it is occurring. The information obtained may not be used to discriminate against individuals or groups of persons.
Prepared by the National HIV/STI Control Programme,
Ministry of Health, 2-4 King Street, Kingston
Contact: Faith Hamer, Component Head, Policy/Advocacy
National HIV AIDS Policy [PDF - 225KB]