HIV

Not everyone can choose to work. For instance, some people could not work because of immigration reasons, such as the restrictions affecting asylum-seekers. And others were not well enough to work. In the early days (1980s and early 90s) people with HIV were sometimes advised to stop work on the basis of illness and sign on for various state benefits. Anti-HIV treatments are now so successful that many people with HIV keep working or want to return to work. 

But being HIV positive often makes people think about their work life. Not everyone was lucky enough to work in an environment that was helpful if you had problems with HIV. People we talked to included those who had stuck with their jobs, changed jobs, reduced their working hours, stopped work or took early retirement.

For many people, working is a central part of who they are, and a source of self-esteem. Not being able to work, whether because of ill-health or legal restrictions because of immigration and rules affecting asylum-seekers, can be distressing. Among African men, for example, there are especially strong expectations on men to work and provide for their families. Migrants, both women and men, are often highly educated and qualified, but face problems having their qualifications recognised in this country.

Some people were determined to carry on with work despite their fears, treatment side effects and even being ill. One man who had just begun anti-HIV treatment said: 'I just wanted to sleep all day long… I didn't take any time off work because I think that could make you worse.' People had different reasons for continuing work including a strong work ethic, needing to provide for themselves and their families, fears of being 'on the scrap heap' and liking their work. Some believed that you should not 'opt out' of work if you can avoid it. It was easier for those who were diagnosed before they got ill to keep working. It was also easier for those who enjoyed their work, worked in good-conditions and were well-paid to keep working: 'Work's very challenging… It's keeping your mind in a good place,' said one man. 

Work could also provide a helpful short-term distraction from worries. One man first dealt with his HIV diagnosis by throwing himself 'Into work… it did actually sustain me for a long time,' and confronted his diagnosis later when he was ready. However some people who tried to work eventually found they couldn't: 'I carried on working for about a year, then my health deteriorated quite a bit, and I had to go on therapies… and other things made it imperative that I stop working and devote more time to home,' said another man.

Illness or the threat of illness meant that some people stopped work: 'Five or six friends of mine died in the early days of AIDS when they were totally stressed out with work,' said one man who decided to stop work early in the HIV crisis. 

One man who had been ill with AIDS said that people around him told him to 'take it easy because I had been through so much,' and he went along with this advice until he felt stronger: 'I have always been one of these people who believe you should work.' 

People sometimes felt they were not well enough to work: 'I am still not capable of doing a 5 day week,' said one man. Where possible these people worked part-time or slowly tried to build towards doing more work. But financial problems and benefit rules can make it hard for people to increase their work-loads.

Several people admitted pushing themselves with too much work, working long hours, doing jobs they hated because of the money or even being 'workaholics'. Some of these people believed that the stress from overwork could damage their immune system and health, including their mental health. But stress did not always harm people's immunity. One man who did a lot of voluntary work and had never been on medication said: 'Maybe I live off stress? At the moment my last T Cell count was 750.' 

Even with effective HIV treatments some people still feared that work stress was deadly and thought that not working keeps you healthy but living with HIV does not automatically make you eligible for any benefits. Some worried about being trapped on benefits, but others pointed out that you have a legal right to claim benefits and should feel entitled to make claims. Some people feared they might not get the same level of benefits if they went back to work and became ill again.

Not working had mixed results including getting more rest, reducing stress, increasing stress, financial problems, feeling guilty, boredom and depression. Work provides most people with structure and routine as well as money. The removal of daily work routines and responsibilities could be a problem. One man said, 'I would do nothing and it was soul destroying in its own right.'

Given that 'doing nothing' could be stressful, people not in paid work often looked for other ways to stay active. Developing a routine also helped people cope e.g. by looking after other people's children, doing creative art, reading, doing courses, going to gym and even moving to London or another major city' 'London was the answer… It didn't give me time to dwell on anything,' said one man. And a woman said' 'I like shops a lot… I am laughing because I don't have much money… I just look around, I like the environment, it's nice.' 

People also did all kinds of voluntary work including HIV counselling, running patient groups at HIV clinics, caring for animals, walking children to school and providing food through the 'Food Chain' to people who were ill. Those who didn't find their work enjoyable could sometimes find pleasure outside of work or by retraining for a different career.

One problem for people we interviewed who had given up work because of HIV (or never worked) was that they could have long periods of not working on their CV that could be hard to explain to potential employers. The thought of working can also be scary, but support, training and education is available to help people get back into the workforce. Some people find that doing voluntary activities can help rebuild confidence and be a 'stepping-stone' back into paid work.

We were also told that returning to work by registering with an employment agency is another way to get back into a job. You have more control over what work you will do than when applying for a regular job. You can choose what work to register for and decide whether to accept a job, the number of hours and days you will work and the pay you will accept. There are relatively few questions to answer from either the agency or the workplace manager. Such work can lead to an offer of permanent work, gets you work experience and can improve your skills and confidence. However there are downsides, including uncertainty.

The Equality Act came into force on the 1st of October 2010. The Equality Act builds upon the existing protections that were in place under the Disability Discrimination Act.  “The act replaced previous anti-discrimination laws with a single act to make the law simpler and to remove inconsistencies. This makes the law easier for people to understand and comply with. The act also strengthened protection in some situations” – Home Office.