Richard Howard, ILO Senior Specialist on HIV and AIDS, Asia and the Pacific

I mentioned to an old friend a while back that we at the ILO were carrying out research on discrimination toward lesbian, gay, transgendered people and bisexuals (LGBT) in the workplace. His response – and this was coming from a gay man mind you – was why? Why should the ILO or anyone else care about what a worker does on their own time?

The implication is that what one does in the bedroom — one’s personal sexual behavior — should stay private. There is really no reason for these matters to come up at work.

A few years ago, a group of young, innovative thinkers in the Gender, Equality and Diversity Branch at the ILO thought differently. What they and many others saw was that LGBT people around the world were experiencing discrimination at work because of their sexual orientation and/or gender identity and that this discrimination was based solely on bias. It had nothing to do with their ability to perform their jobs.

Fear of stigma reported by interviewees as a factor that deterred them from seeking information and services about HIV and AIDS, or from accepting free condoms.

It was this group that launched the PRIDE project at the ILO. PRIDE stands for “Promoting Rights, Diversity and Equality” and was made possible thanks to support from the Norwegian government. As LGBT persons are among the most affected by HIV worldwide, one aspect of the PRIDE project was to explore discrimination faced by them due to HIV and AIDS.

In Asia, the PRIDE project has carried out research in two countries: Thailand and Indonesia. It looks at the laws and policies that shape LGBT rights in the workplace and beyond, examining discrimination at all stages of employment, including discrimination due to HIV.

Scene from a training session on HIV and equality in the workplace at a plywood factory in Papuan Indonesia.

The research showed that the majority of LGBT workers choose to conceal their sexual orientation at work, which causes stress and can have negative consequences on productivity and career progression. The conflation of LGBT and HIV can play into stereotypes and confirm homophobic attitudes, exacerbating stigma.

Fear of stigma was indeed a factor reported by interviewees that deters people, including LGBT people, from seeking information and services about HIV and AIDS, or take free condoms.

The studies show several common themes. One very clear message that emerges from both of these countries is that discrimination of LGBT people is, at its heart, perpetuated by gender inequality.

It’s the confining ideas about how men and women should think, dress, walk, talk and behave that make it difficult for many LGBT persons to find decent work, advance in their careers and obtain a general sense of well-being in their workplaces.

Take the case of Sonya, a transgendered woman with a Master’s degree in Business Administration, who successfully passed all recruitment exams to join a leading Thai bank. But on the day of her interview, when the panel noticed her actual gender identity, she was told that only “psychologically normal” people were allowed to work at the bank and that there was no place for her there.

It’s no surprise that most Fortune 500 companies have developed diversity policies in an effort attract and retain talent, integrating the valuable inputs of LGBT people.

Or, another example in Angie, a lesbian working in a bank in Bangkok. She was up for a promotion to senior communication officer, but in the end, her boss told her that she lacked the appropriate image for the job. Her colleagues told her that what this really meant was that she was not feminine enough to represent the company to the public.

The degree of discrimination against gay men varies, but generally men perceived as feminine faced significant discrimination in the workplace. Adi, a former chef in a well-known Jakarta restaurant, explained how he had to quit his job because of the subtle harassment and teasing he received from management and co-workers. He opened his own small restaurant where he could call the shots and be himself.

The PRIDE research shows that rigid ideas about gender and sexuality are forcing people out of their workplace and preventing them from obtaining jobs. This has resulted in a large pool of qualified and talented people moving out of many formal sector enterprises or working more ‘’accepting” industries such as media and design and tourism.

It’s no surprise that most Fortune 500 companies have developed diversity policies in an effort attract and retain talent, integrating the valuable inputs of LGBT people. The productive gains of creating a more inclusive workplace free of discrimination are increasingly evident.

As well, such inclusive workplaces have additional benefits in terms of reducing new HIV infections and ensuring that those living with the virus have access to treatment. Discrimination against LGBT people has served as a major driver of the HIV epidemic. It is time to acknowledge that LGBT people are workers, and create conducive work environments for them. Workplaces need to ensure zero discrimination against LGBT persons, and people living with HIV.

Larisa Savchuk, ILO National Focal point on HIV and AIDS in Ukraine

Ukraine has one of the fastest growing rates of HIV infection in Europe. The highest incidence of the disease is among young, working age people, potentially the most productive sections of the population. Awareness levels are relatively low. Only an estimated 47 per cent of people living with HIV know their status and the frequency of HIV testing is particularly poor among key, high risk populations.

Given this background, Ukraine was an obvious choice to implement the ILO’s Voluntary counselling at work (VCT@WORK) initiative that aims to enhance voluntary HIV counselling and testing in the workplace.

The ILO in Ukraine went to work. A National Tripartite Cooperation Strategy on HIV and AIDS and the World of Work for the Period of 2012-2017 was adopted. The ILO was also, and continues to be, actively engaged in advocacy and capacity building in Ukraine, with particular emphasis on enhancing access to social protection for people living with HIV. We built links between ILO constituents and the All-Ukrainian network of people living with HIV, an advocacy and support NGO.

After some reflection with our partners we thought the best approach was to adopt a regional strategy for the VCT@Work initiative. In collaboration with the regional AIDS center, UNAIDS and the United Nations Population Fund (UNFPA), we implemented a pilot project on VCT@Work in six enterprises of Cherkassy region of Ukraine, employing between them more than 10,000 workers.

Resulting from our combined efforts, over 8000 of workers in Cherkassy region were reached by awareness-raising activities, and 2017 have undergone voluntary counselling and HIV testing at their workplaces.

Vitaliy Legkov, Occupational Safety & Health expert from the Federation of Trade Unions of Ukraine is tested for HIV.

As well, the Federation of Trade Unions signed an agreement of cooperation with the Regional AIDS Centre. It aims to bring the two groups together, to reach out to working women and men in the Cherkassy region and, through the workplace, raise awareness about HIV prevention.

The leadership of the Cherkassy Regional Federation of Trade Unions made a huge difference in the success of the initiative. Petro Shevchenko, Head of the Federation, who is a health worker himself, has become a real leader in the HIV response in the world of work. “Trade unions consider HIV as a social and labour issue and address it in the context of protecting workers’ rights.

VCT on HIV is the only way for workers to know their HIV status and start necessary treatment in order to stay healthy and productive,” said Shevchenko at the launch event of the project. Employers’ organizations at the regional as well as national level also supported this effort through facilitating access to workplaces and promoting the scaling up of VCT@Work throughout the region.

Organizing VCT at workplaces is convenient for workers. It saves their time and costs, and lowers the barriers to taking the test. Personally, I was encouraged to note the change in the attitude of workers towards HIV testing. Initially, workers were apprehensive; anticipating discrimination in case they turned out to be HIV positive.

But after our combined efforts at raising awareness, the change was evident. Workers saw the benefits in knowing their HIV status earlier. At one of the VCT events, a worker told me, “I wanted to get tested but I couldn’t make up my mind to go to the AIDS Centre. Thanks to the VCT@Work initiative, I could take the test; and came to know that I am healthy.”

I feel encouraged at the success of our little effort in the Cherkassy region. We need to build on this positive beginning and expand the VCT@WORK initiative to other regions. I believe the lessons we have learned here it can be game changing in our approach to the AIDS response for Ukraine in coming years.

The ILO is the lead UN-agency on HIV workplace policies and programmes and private-sector mobilization. ILOAIDS is the branch dedicated to this issue.

The world has made tremendous strides in the fight against HIV over the past several years. In most of the world, new infections are down, the average life expectancy of people living with HIV is up and we have good reason to think that 2030 could be the year we declare victory over AIDS.

But that doesn’t mean we can let our guard down. There are still around 35 million people in the world infected with the virus and one in two of them don’t know it.

That’s especially true among young people, young women in particular. Each year, around 380,000 women between 10-24 years get infected with HIV.

HIV/AIDS is an integral part of the ILO’s Decent Work Agenda. ILO is the lead UN agency for HIV/AIDS policies and programmes in the world of work and private sector mobilization. Find out more about ILO’s Programme on HIV/AIDS.

What can we do about it? Voluntary testing and confidential counselling in the workplace, or VCT@WORK, is a proven means of empowering workers to protect themselves and protect the ones they love.

But what’s it like to take the test at work? Is it awkward? Is it scary? Will everyone know the results?

To find out, we talked to three young ILO colleagues who recently took the HIV test right here at the ILO. Here’s what they told us:

Lorraine W.

Getting tested and having protected sex in general is a form of respect for my own body and the person I care about. But I’ve been travelling for the last 6 months and I never knew where to get tested. As soon as I heard about the free HIV test at the ILO, I thought “Perfect! Finally! And I can do it in the building!”

What’s it like to take the test at work? Is it awkward? Is it scary? Will everyone know the results?

From pre-counselling to the actual test, the process was fast and easy. The lab technician was very thorough in explaining the procedure to me. I won’t lie: I was a bit nervous before getting my result. But in the end, my fear brought home the importance of “loving carefully”. I had nothing to lose by getting tested and would have felt terrible about waiting any longer.

What I appreciated most about my experience with VCT@WORK is that it made getting tested easy. I think it’s a great way of encouraging young people like me to be aware of our status and make getting tested a regular healthy habit.

Laura S.

I used to think of HIV and AIDS as something which didn’t affect me. Even as someone working in an international environment and being aware of HIV and AIDS, you tend to think: it is far away, I don’t need to worry about it. But then I started asking myself: have I always been careful? Can I be sure that I am safe? So I decided to take the test.

Learning about the ILO’s counselling and testing campaign was the perfect opportunity. We talked about it in my office, and in a matter of days, several people got tested.

Of course, not everyone will want to make a social event out of getting tested for HIV. But in our case, it helped us relax and made the whole thing less scary. After all, everyone was thinking the same thing: what if I’m positive? How would that affect my life?

As working women, it is important for us to say: “Testing starts with us. Follow our lead.”

In the end, the whole process was really easy. It was free, on the spot and everyone involved was really considerate. Even before I got the result, I felt better for having done it.

I think the ILO’s counselling and testing campaign has a great potential to help changing the way we think about HIV and AIDS. We are all part of that process. After taking the test, I found myself talking about it and encouraging other people to do the same. If we want to fight HIV and AIDS globally, we have to start with the people we can reach.

Lis-Marie A.

ILO hosted an event on World AIDS Day, which really got me thinking. And I wondered: with all the information and resources out there, why do so many young people still get infected? One reason is because half of the people who are living with the virus don’t even know it. How could I be sure I wasn’t one of them unless I got tested?

Talking about sex can be uncomfortable, but we need to keep the conversation going. Beyond encouraging people to know making people aware about their status and the risks they might run, it’s important to fight the stigma and discrimination that prevents so many people from getting tested.

Though we’re making important progress in the battle to end the AIDS epidemic, it is still the leading cause of death among women of reproductive age. As working women, it is important for us to say: “Testing starts with us. Follow our lead.”

Alice Ouedraogo is Chief of the HIV/AIDS Programme at the International Labour Organization

Heavy trucks pass through the Chirundu Corridor, one of the major routes connecting Zimbabwe and Zambia in southern Africa. This is a vital transport artery, important for the economies of both countries and their neighbors. It is also a major route for the transmission of HIV.

The mix of long-distance lorry drivers — who go weeks at a time without seeing their families — with widespread poverty existing along the corridor, results in sexual encounters between drivers and women. The risks they take with their health have an impact on the wider community.

This blog post was originally published on Huff Post Impact.

But things are changing, in large part due to the recognition that productive work, and with it, economic empowerment, are important weapons in the fight against AIDS.

On one of my field trips to Zimbabwe, I had the chance to meet Barbara, a young woman who lives along the Chirundu Corridor, where she runs a business making doors and windows. Her company prospered after she received training in business management, and she was given access to credit facilities through an HIV project run by the International Labour Organization, the UN agency responsible for setting international labor standards.

The UN estimates that more than half of the 35 million people living with HIV worldwide do not know that they are infected. Many fear being discriminated against if people find out they are HIV-positive.

The project was founded on the recognition that, in addition to traditional prevention strategies, such as condom use, the underlying causes of risky sexual behavior need to be addressed. Additionally, there needs to be widened access to HIV services if the next generation is to be AIDS-free.

Poverty may lead people to become involved in risky sexual behavior. The project, therefore, involves helping vulnerable populations become economically empowered by helping them start businesses. It also provides care services for transport workers and populations operating along the corridor.

Learn more about ILO’s work to combat the HIV/AIDS pandemic in the workplace.

Barbara employs 10 men from HIV-affected households. Her business is helping to reduce the economic vulnerability of others in her community.

Many other women living along the Chirundu Corridor have also started or improved their businesses and have become economically independent. Beyond bringing them economic security, significant changes have been noted in the behaviors — and the general welfare — of the project’s beneficiaries. They now have access to better information and HIV services. According to a survey on the impact of the project, small successful businesses are flourishing, children are going to school, mothers are being kept alive and the number of women who have stopped engaging in unprotected sex has risen from 56 to 76 percent.

However, results like these can only be reached if stigma and discrimination in employment, education, health care and other settings are tackled at the same time.

Discrimination against people living with HIV is not an issue that exists only in southern Africa. We see it worldwide, in both developed and developing countries. In many instances, people lose their jobs because of it. This, in turn, makes them and their families more vulnerable.

The UN estimates that more than half of the 35 million people living with HIV worldwide do not know that they are infected. Many are afraid of getting tested because they fear being discriminated against if people find out they are HIV-positive. As a result, too many people are not seeking the treatment they need, and they risk passing the virus on to others.

The vast majority — over 90 percent — of those who are living with or are affected by HIV, either work for a living, or have links to the workplace. Through the workplace, we can reach these people, their families and communities with HIV-related information, treatment, care and support services. In the same way, the impact of efforts to eliminate HIV-related discrimination in the workplace environment will have a ripple effect beyond the workplace that will affect larger society. The fact that Barbara employs HIV-positive men in her business not only provides them with vital income, which will help make their families less vulnerable, but it also sends a powerful message to her community that people with HIV should not be discriminated against.

The UN has set 2030 as a goal for ending the AIDS epidemic. Seeing how people’s lives are changing in the Chirundu Corridor makes me believe that the goal can be reached if we include the workplace as an essential component of that vision.

Margherita Licata and Kofi Amekudzi, Technical Specialists ILOAIDS

The more we learn about the challenges of responding to the Ebola Virus Disease  in West Africa, the easier it becomes to discern parallels to the HIV epidemic —  another health crisis , which we’ve been battling for over 30 years now. The HIV response has some valuable lessons for the way we confront the disease in general, particularly in the workplace. Here’s an example.

About four years ago, we were working in southern Malawi with the ILO Programme for HIV/AIDS on a project targeting workers at the Lujeri Tea Estate. Though the rate of new infections has slowed, Malawi still has some of the highest HIV infection rates in the world, affecting one in every four people who lives there.

If we at the ILO have learnt anything in 15 years of combatting HIV, it’s that the workplace can provide a powerful bulwark against an advancing epidemic.

Our job was to work with the management and workers to decrease their own risks of exposure while making sure that those living with HIV had access to treatment and protection from discrimination.

It was a daunting task. The workers, who lived away from their families in compounds, typically had multiple sexual partners, consisting largely of women who would offer them sex for money. They generally lacked enough information to protect themselves and met with stigma and discrimination when they got infected.

Find out more about ILO’s respone to the Ebola Outbreak. Copyright: AFP/Issouf Sanogo

All of this will sound familiar to anyone engaged in the fight against Ebola. Fear and misinformation fuel the spread of the disease while making survival and recovery harder for those infected.

It’s true that the Ebola outbreak in West Africa is first and foremost a public health crisis. But if we at the ILO have learnt anything in 15 years of combatting HIV, it’s that the workplace can provide a powerful bulwark against an advancing epidemic.

Protection of rights

Another important lesson is to follow a human-rights-based approach. We developed the HIV workplace response based on a policy environment that promised non-discrimination and protection of rights.

The same approach which helped to inform and protect workers at the Lujeri Tea Estate can empower workers in West Africa to help stop the spread of Ebola.

At the Lujeri Tea Estate, we worked with management and employees to set up an education programme that reached over 5,000 people with information about how to reduce the risk of transmission and how to access health services if they got infected.

A committee comprised of both workers and management was created to encourage all employees to know their status. Workers, who felt more comfortable receiving this information from their peers rather than from an official source, became more likely to get tested and more likely to seek treatment when they tested positive.

Workers at the Lujeri Tea Estate in southern Malawi, where an ILO-supported project helped to reduce the rate of HIV infections.

In the meantime, the company made clear that it wouldn’t tolerate discrimination against workers living with HIV.

As examples like this one illustrate, the workplace provides a strong entry point for reaching workers and whole communities with information that can save lives. The same approach which helped to inform and protect workers at the Lujeri Tea Estate can empower workers in West Africa to help stop the spread of Ebola.

Dispelling the stigma

It can help to establish common principles for how to avoid infection while dispelling the stigma which continues to haunt survivors. As health workers are on the frontline of the Ebola response, their working conditions are of utmost importance. They should have  decent work conditions, get paid on time and have adequate training and equipment.

Fundamentally, we must continue to tackle underlying factors like poverty and inequality, which are driving the spread of the disease.

Traditional authorities, faith-based organisations, civil-society groups, employers’ associations, workers’ organisations and leadership at every level of government all have a role to play.

Experts agree that with climate change and growing urbanization, public-health emergencies like the Ebola outbreak may only become more common. If that’s true, then we must be ready to use the lessons and experiences we’ve learned from fighting HIV to deal with them, in the workplace and beyond.