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HIV & AIDS Model Agreement

The HIV & AIDS Model Agreement is a resource to be used for building trade union capacity and awareness to negotiate on HIV and AIDS workplace policies and agreements.

List of Contents

Principles

Aims and Objectives

Application and Scope

Education and Training

Protection against Workplace Accidents

VCT

Discrimination

Employments security etc

Grievance and Discipline

Wellness

Benefits

Design and Implementation Process

Monitoring and Evaluation

Definitions

Principles

The Parties recognize that:

  1. HIV/AIDS is a global crisis and that South Africa is experiencing a devastating HIV/AIDS pandemic. The parties further acknowledge the seriousness of this pandemic and the significant impact it holds for the employees of the company, members of the Union and their families
  2. HIV/AIDS is a workplace issue, and should be treated like any other serious illness/condition in the workplace. This is necessary not only because it affects the workforce, but also because the workplace, being part of the local community, has a role to play in the wider struggle to limit the spread and effects of the epidemic.
  3. The successful implementation of an HIV/AIDS policy and programme requires cooperation and trust between employers, workers and their representatives, with the active involvement of workers infected and affected by HIV/AIDS.
  4. This policy is regarded as a living document that will be further enriched as more clarity emerges surrounding the disease, the management of the disease and medical, academic, occupational and employment developments regarding HIV/AIDS. The parties will accordingly monitor developments and adjust or amend this policy as appropriate
  5. HIV/AIDS affects the profitability of companies and the efficient functioning of organisations; it is in the interests of employers to reduce its effect on their organisations.

The parties agree that their workplace HIV policy and programme will be based on the following principles:

  1. A desire to promote equality and non-discrimination between individuals with HIV infection and those without, and between HIV/AIDS and other comparable health/medical conditions.
  2. A desire to create a supportive environment so that HIV infected employees are able to continue working under normal conditions in their current employment for as long as they are medically fit to do so.
  3. A recognition that the protection of human rights and dignity of people living with HIV or AIDS is essential to the prevention and control of HIV/AIDS.
  4. A recognition that HIV/AIDS impacts disproportionately on women and this should be taken into account in the development of workplace policies and programmes. Women are more likely to become infected and are more often adversely affected by the HIV/AIDS epidemic than men for biological, socio-cultural and economic reasons. The greater the gender discrimination in societies and the lower the position of women, the more negatively they are affected by HIV. Therefore, more equal gender relations and the empowerment of women are vital to successfully prevent the spread of HIV infection and enable women to cope with HIV/AIDS.

Aims and Objectives

The company's HIV / AIDS policy and programme aim to:

  1. Build consensus on how to deal with HIV and AIDS in the workplace
  2. Develop strategies to assess and reduce the impact of the epidemic on the workplace.
  3. Reduce the number of new infections among employees and their families
  4. Strengthen education on and prevention of HIV
  5. Support those individuals who are infected or affected by HIV/AIDS so that they may continue to work productively for as long as possible.
  6. Build solidarity amongst workers in dealing with HIV, preventing unfair discrimination, and creating a supportive environment
  7. Ensure that conditions of employment meet the needs of people with HIV without imposing undue burdens on the workforce
  8. Take into account the special needs of women arising out of the HIV/AIDS pandemic
  9. Provide guidelines for employers, employees and trade unions on how to manage HIV/AIDS within the workplace.
  10. Provide clarity with regard to the extent and source of assistance available to those infected and/or affected by HIV/AIDS.

Application And Scope

  1. This policy covers all workers including casuals in the employ of the company.

Education and Training

Reasons for a Programme:

The parties acknowledge that workplace information and education programmes are essential to combat the spread of the epidemic and to foster greater tolerance for workers with HIV/AIDS. Effective education can contribute to the capacity of workers to protect themselves against HIV infection, significantly reduce HIV-related anxiety and stigmatisation, minimise disruption in the workplace, and bring about changes in attitude and behaviour.

Control of the Process:

  1. The parties further acknowledge that unilaterally imposed or designed education and training programmes do not achieve their objectives. Therefore all education and training programmes, including the designation of trainers, will be developed and implemented under the joint control of the employer and trade union representatives, and integrated into the Workplace Skills Plan.
  2. The parties therefore agree to set up appropriate structures for design and implementation of the workplace HIV/AIDS programme.
  3. All HIV/AIDS workplace structures will contain equal representation from management and unions.

Objectives of Education

The parties agree that the objectives of education programmes are to:

  1. Create awareness on HIV/AIDS
  2. Promote safer sex
  3. Strengthen respect for women's rights
  4. Promote solidarity with people with HIV and AIDS
  5. Encourage people to get tested for HIV and to get counselling
  6. Ensure people know about basic options for treatment for HIV and AIDS, including for opportunistic diseases and STDs
  7. Promote understanding of workers' rights, including around health care, testing and conditions of employment.
  8. Remove the stigma and discrimination by co-workers, unions or employers against those infected.

Peer Educators and People Living with AIDS

  1. The parties accept the general consensus amongst HIV/AIDS practitioners that peer educators play a crucial role in any education process, as do people living with HIV or AIDS in any awareness programme.
  2. The parties will endeavour to encourage an appropriate number of employees to volunteer as peer educators; it is accepted that the appropriate number is in the region of 1 peer educator to every 50 employees, or less in the case of smaller workplaces.
  3. Peer educators will receive appropriate and relevant training as outlined above
  4. The parties will encourage people openly living with HIV or AIDS to conduct or participate in education, prevention and awareness programmes

Education and Training Targets

The parties agree that education and training will be provided to:

  • Workers
  • Shop stewards
  • Members of the Health and Safety Committee
  • Managers
  • Supervisors
  • Peer educators

All Management and Employees will receive education and training on:

  • Company policy on HIV / AIDS
  • The provisions of the employment codes on HIV/AIDS and the rights and duties of persons living with HIV/AIDS.
  • Current information regarding HIV/AIDS, including information about transmission, prevention, risk reduction, testing resources, workplace rights and responsibilities, other resources, services and referrals
  • How to assess personal risk and formulate behaviour change plans;
  • The vulnerability of women to HIV and prevention strategies that can lessen this vulnerability
  • The need to support and accommodate people who are HIV-positive and to prevent stigmatisation
  • The prevention and management of STIs and tuberculosis
  • Hygiene and proper nutrition
  • Safer sex practices, including instructions on the use of male and female condoms
  • The higher risk of infection for women and the rights of women both in the workplace and outside it
  • Testing facilities and processes
  • The rights of infected and affected employees (including confidentiality);
  • The rights of employees to health, safety and compensation in the context of occupational exposure to HIV
  • How to treat a co-worker with HIV/AIDS;
  • Treatment, care and support for infected employees
  • Specific staff benefits and entitlements
  • Processes and procedures to be followed in the event of exposure to human blood or body fluids, including:
    • The provision of first aid
      Universal Precautions to reduce the risk of exposure to human blood and other body fluids
      The use of protective equipment
      Rights to compensation in the event of an occupational incident

In addition, education and training will be targeted at, and adapted to, the different groups being trained as follows:

Managers, Supervisors and Shop Stewards

  • Counsel workers to identify and reduce risk factors in their personal lives
  • Explain and respond to questions about the HIV/AIDS workplace policy
  • Understand and comply with legal requirements (such as those relating to testing and confidentiality)
  • Deal with infected and affected employees;
  • Identify and manage behaviour, conduct or practices that discriminate against infected and affected employees;
  • Advise about health services and social benefits;
  • Promote the different aspects of the workplace HIV/AIDS programme
  • Explain reasonable accommodation options to workers with HIV/AIDS so as to enable them to continue to work as long as possible;
  • Ensure that any information that they acquire about workers with HIV/AIDS in the course of performing their functions is kept confidential

Members of the Health and Safety Committee

  • assess working conditions for people with HIV and where appropriate, require the use of universal precautions
  • be sufficiently knowledgeable about the content and methods of HIV/AIDS prevention so that they can deliver information and education programmes to workers;
  • be able to assess the working environment and identify working methods or conditions which could be changed or improved in order to lessen the vulnerability of workers with HIV/AIDS;
  • verify whether the employer provides and maintains a healthy and safe working environment and processes for the workers, including safe first-aid procedures;
  • ensure that HIV/AIDS-related information, if any, is maintained under conditions of strict confidentiality as with other medical data pertinent to workers
  • counsel workers to identify and reduce risk factors in their personal lives;
  • refer workers to in-house medical services or those outside the workplace which can effectively respond to their needs.

Peer Educators and People Living with AIDS

  1. The parties accept the general consensus amongst HIV/AIDS practitioners that peer educators play a crucial role in any education process, as do people living with HIV or AIDS in any awareness programme.
  2. The parties will endeavour to encourage an appropriate number of employees to volunteer as peer educators; it is accepted that the appropriate number is in the region of 1 peer educator to every 50 employees, or less in the case of smaller workplaces.
  3. Peer educators will receive appropriate and relevant training as outlined above
  4. The parties will encourage people openly living with HIV or AIDS to conduct or participate in education, prevention and awareness programmes

Education and Training Targets 
The parties agree that education and training will be provided to:

  • Workers
  • Shop stewards
  • Members of the Health and Safety Committee
  • Managers
  • Supervisors
  • Peer educators

All Management and Employees will receive education and training on:

  • Company policy on HIV / AIDS
  • The provisions of the employment codes on HIV/AIDS and the rights and duties of persons living with HIV/AIDS.
  • Current information regarding HIV/AIDS, including information about transmission, prevention, risk reduction, testing resources, workplace rights and responsibilities, other resources, services and referrals
  • How to assess personal risk and formulate behaviour change plans;
  • The vulnerability of women to HIV and prevention strategies that can lessen this vulnerability
  • The need to support and accommodate people who are HIV-positive and to prevent stigmatisation
  • The prevention and management of STIs and tuberculosis
  • Hygiene and proper nutrition
  • Safer sex practices, including instructions on the use of male and female condoms
  • The higher risk of infection for women and the rights of women both in the workplace and outside it
  • Testing facilities and processes
  • The rights of infected and affected employees (including confidentiality);
  • The rights of employees to health, safety and compensation in the context of occupational exposure to HIV
  • How to treat a co-worker with HIV/AIDS;
  • Treatment, care and support for infected employees
  • Specific staff benefits and entitlements
  • Processes and procedures to be followed in the event of exposure to human blood or body fluids, including:
    • The provision of first aid
      Universal Precautions to reduce the risk of exposure to human blood and other body fluids
      The use of protective equipment
      Rights to compensation in the event of an occupational incident

In addition, education and training will be targeted at, and adapted to, the different groups being trained as follows:

Managers, Supervisors and Shop Stewards

  • Counsel workers to identify and reduce risk factors in their personal lives
  • Explain and respond to questions about the HIV/AIDS workplace policy
  • Understand and comply with legal requirements (such as those relating to testing and confidentiality)
  • Deal with infected and affected employees;
  • Identify and manage behaviour, conduct or practices that discriminate against infected and affected employees;
  • Advise about health services and social benefits;
  • Promote the different aspects of the workplace HIV/AIDS programme
  • Explain reasonable accommodation options to workers with HIV/AIDS so as to enable them to continue to work as long as possible;
  • Ensure that any information that they acquire about workers with HIV/AIDS in the course of performing their functions is kept confidential

Members of the Health and Safety Committee

  • assess working conditions for people with HIV and where appropriate, require the use of universal precautions
  • be sufficiently knowledgeable about the content and methods of HIV/AIDS prevention so that they can deliver information and education programmes to workers;
  • be able to assess the working environment and identify working methods or conditions which could be changed or improved in order to lessen the vulnerability of workers with HIV/AIDS;
  • verify whether the employer provides and maintains a healthy and safe working environment and processes for the workers, including safe first-aid procedures;
  • ensure that HIV/AIDS-related information, if any, is maintained under conditions of strict confidentiality as with other medical data pertinent to workers
  • counsel workers to identify and reduce risk factors in their personal lives;
  • refer workers to in-house medical services or those outside the workplace which can effectively respond to their needs.

Peer Educators

Peer educators should receive specialized training so as to:

  • be sufficiently knowledgeable about the content and methods of HIV/AIDS prevention so that they can deliver, in whole or in part, the information and education programme to the workforce;
  • be sensitive to race, sexual orientation, gender and culture in developing and delivering their training;
  • link into and draw from other existing workplace policies, such as those on sexual harassment or for persons with disabilities in the workplace;
  • enable their co-workers to identify factors in their lives that lead to increased risk of infection;
  • be able to counsel workers living with HIV/AIDS about coping with their condition and its implications

When / where / who pays - the logistics and resources

  1. The employer will fund all education and training on HIV and AIDS outlined in this agreement.
  2. Education and training shall take place during working hours, and the employer will provide paid time off, with a minimum allocation as follows:
  • 8 hours a year for every worker
  • 30 hours a year for every shop steward, supervisor, manager and peer educator
  1. Attendance at education and training programmes will be compulsory.
  2. Management will ensure the availability at all times of accurate and easily understandable educational material on HIV in the workplace for all employees.

Protection against Workplace Accidents

  1. The workplace must be equipped to prevent infection in case an accident leads to spills of blood or bodily fluids. (Note: this will differ with different types of workplace).
  2. The employer shall ensure that all protective clothing and equipment required by law is present at all times
  3. The employer shall ensure that all employees are educated and trained in the use of universal precautions and provided with all necessary resources (see Clause 4) The employer shall ensure that if an employee is exposed to HIV infection in the course of his or her work, the employee will receive immediate counselling, with the option of voluntary anti-retroviral treatment, paid for by the employer, as post-exposure prophylaxis within 72 hours.
  4. Emergency care and treatment for medical personnel and people performing First Aid in and after medical HIV exposure will be provided.

Voluntary Counselling and Testing and Confidentiality

  1. All Testing and Disclosure must be Voluntary and Confidential
  2. No actual or prospective employee may be required to take an HIV test, and no employee may be tested without his or her knowledge and informed consent. There will be nothing in any pre-employment examination that requires an applicant to declare his/her HIV / AIDS status.
  3. The employer will not facilitate any testing for insurance purposes
  4. No employee will be required to disclose his or her HIV status to their employer or to other employees.
  5. Where an employee or prospective employee chooses to voluntarily disclose his or her HIV status to the employer or to other employees, this information may not be disclosed to others without the employee's express written consent.
  6. Where an employee volunteers to be tested, the test results will be kept only on medical files and will remain accessible only to medical personnel and fully confidential. Files related to HIV will not be marked or flagged in ways that indicate HIV status. The employer will ensure that health workers performing HIV-associated work on behalf of the company do not communicate an employee's HIV status to anyone without the employee's written permission.
  7. Trustees and administrators of retirement, provident and medical scheme funds may not disclose the identity of an employee living with HIV / AIDS to the company or the Union without the member's / employee's written permission.
  8. Testing will be Encouraged
  9. The parties will encourage all employees to get tested for HIV
  10. The employer will pay for counselling and testing for all employees.
  11. Ensuring Access to Testing facilities and Opportunities
  12. The employer will either provide a voluntary HIV testing and counselling programme in the workplace or will ensure that employees have access to a community facility by providing:
  • Paid time off
  • Transport

Where a testing programme is offered in the workplace it will abide by the rules of confidentiality in Clause 6.1

Counselling Provision


  • All employees who get tested will receive gender-sensitive counselling by a trained counsellor, preferably a shopsteward, before and after the test. This counselling will include:
  • an understanding of the nature and purpose of the HIV tests
    the advantages and disadvantages of the tests
    the effect of the result upon the worker

Counselling will also be provided to all employees following risk of exposure to potentially infected material (human blood, body fluids, tissue) at the workplace as part of the procedure outlined in clause 5.4.

People Living with HIV or AIDS

The HIV/AIDS programme will:

  • encourage workers openly living with HIV or AIDS to conduct and participate in education, prevention and awareness programmes. The employer will allocate paid time off for this activity.
  • Promote the development of support groups for workers living with HIV, including by giving space and paid time off for them to meet
  • Ensure that workers who are open about their HIV status are not unfairly discriminated against or stigmatised.

Testing for Research

Anonymous, unlinked surveillance or HIV testing in the workplace may occur provided that:

  • It is conducted by a reputable research organisation acceptable to both parties
  • Where such research is done, the information obtained may not be used to unfairly discriminate against individuals or groups of persons.
  • Testing will not be considered anonymous if there is a reasonable possibility that a person's HIV status can be deduced from the results.

Discrimination

The parties will work together to end unfair discrimination and stigmatisation against people on the basis of real or perceived HIV status.

The parties will ensure that no employee or employment applicant with HIV experiences unfair discrimination in:

  • recruitment procedures, advertising and selection criteria;
  • appointments, and the appointment process, including  job placement;
  • job classification or grading;
  • remuneration, employment benefits and terms and conditions of employment;
  • accommodation
  • employee assistance programmes;
  • job assignments;
  • training and development;
  • performance evaluation systems;
  • promotion, transfer and demotion;
  • termination of services.
  1. A manager, supervisor or other employee who discriminates, harasses or otherwise mistreats an employee with HIV shall face normal disciplinary procedures.
  2. Co-employees are expected to continue working relationships with employees living with HIV/AIDS. Employees who refuse to work with a fellow employee with HIV/AIDS shall be counselled and provided with adequate access to information on HIV/AIDS transmission. Following such education and counselling, if an employee continues to refuse to work with an HIV/AIDS infected employee, that employee may be subject to disciplinary action.
  3. The parties will work together to create a supportive environment to ensure that employees with HIV are able to continue working for as long as they are able to do so and to ensure that employees living with HIV / AIDS are protected from victimization and harassment.

Employment Security, Leave and Duty to Accommodate

  1. No employee may be dismissed or retrenched because of their HIV status.
  2. All employees living with Aids will receive 10 days annual sick leave and six weeks disability leave in addition to their normal entitlement.
  3. All employees who must care for a person with HIV shall receive ten days' family leave a year in addition to their normal entitlement. 
  4. If an employee with HIV cannot perform his or her normal duties because of opportunistic diseases, the employer must attempt to find reasonable alternative accommodation for him or her. Reasonable accommodation may include, but is not limited to:
  • flexible or part-time working schedules
  • leave of absence,
  • work restructuring
  • Adapting existing equipment or acquiring new equipment including computer hardware and software;
  • Adapting existing facilities to make them more accessible
  • Re-organising workstations
  • Re-structuring jobs so that non-essential functions are re-assigned
  • opportunities for additional rest breaks
  • time off for medical appointments
  • Time off for medical appointments
  • flexible sick leave
  • part-time work
  • reassignment.
  1. The employer will explain reasonable accommodation options to workers with HIV/AIDS so as to enable them to continue to work as long as possible
  2. If HIV permanently disables an employee, and all possibilities of reasonable accommodation have been exhausted, the employer shall apply standard company procedures for termination of employment due to disability, without unfair discrimination.

Grievance and Discipline

  1. The parties agree to negotiate the integration of the rights of employees with regard to HIV/AIDS, and the remedies available to them in the event of a breach of such rights, into existing grievance and discipline procedures. The parties will publicise the new procedure among all employees.
  2. The grievance procedure shall be the same for an employee with HIV as for all other employees, without discrimination
  3. The parties agree to assist vulnerable employees, particularly women to use grievance procedures.
  4. If an employee's HIV status is at issue in a grievance procedure, the proceedings will be held in private, the parties to the grievance procedure shall not communicate the HIV status to anyone who does not need to know it as part of the grievance procedure.
  5. If a party to a grievance procedure communicates an employee's HIV status unnecessarily, she or he shall be subject to disciplinary action.

Wellness Programme

The employer will support adequate healthcare for all employees with HIV and their families, including:

  • General assistance to help people with HIV stay healthy, by providing nutritional support and immune boosters
  • Assistance with primary health care and referrals for treatment for opportunistic diseases, including Sexually Transmitted Illnesses (STIs) and TB
  • Access to provision of anti-retroviral treatment for infected employees and their spouses or life partners on an affordable and sustainable basis.
  1. The employer will ensure that an employee with HIV is protected from unhealthy working conditions.
  2. The employer will not discriminate against the use of accepted traditional medical practitioners in symptomatic relief.
  3. The employer will make freely available at the workplace both male and female condoms.

Benefits

  1. All benefit schemes will be reviewed jointly by the parties to ensure that they:
  2. do not discriminate against people living with AIDS
  3. make provision for the specific needs of infected people and their families, including:
  • anti-retroviral treatment
  • disability and retirement support
  • benefits for widows and orphans
  1. are economically viable schemes
  2. The employer will assist any employee who is infected with HIV as a result of an occupational exposure to infected blood or bodily fluids:
  3. to apply for benefits in terms of Section 22(1) of the Compensation for Occupational Injuries and Diseases Act, No. 130 of 1993.
  4. To collect information which will assist with proving that the employee was occupationally exposed to HIV infected blood.

Design and Implementation Process

The parties agree to be guided by the following process in developing and implementing an HIV and AIDS policy and programme:

  1. Establish an interim workplace HIV / AIDS structure comprising equal representation from management and workers.
  2. Identify and understand the risk posed by HIV/AIDS by conducting an impact assessment of HIV and AIDS on your organisation
  3. Establish commitment from management and employee representatives for workplace responses
  4. Appoint a company AIDS Champion from amongst senior management.
  5. Draft an HIV/AIDS policy
  6. Establish an implementation structure that comprises equal representation from management and employees.
  7. Ensure good internal and external company communication and create an environment that minimises the fear, stigma and discrimination surrounding HIV/AIDS
  8. Ensure compliance with all legal obligations
  9. Establish partnerships with NGOs, government and other groups able to assist the workplace programme
  10. Establish plan of action, with timetable, lines of responsibility and budget to implement the workplace programme, seeking funds from outside the enterprise if necessary
  11. Run awareness and education interventions
  12. Encourage and assist behavioural change that will prevent HIV infection
  13. Encourage voluntary HIV testing and provide counselling
  14. Facilitate access to wellness programmes, HIV/AIDS treatment and care
  15. Extend relevant programmes to the families of employees and the community
  16. Monitor, evaluate and review the company programme.

Monitoring and evaluation

A baseline prevalence study will be conducted to establish the present impact of HIV in the company as soon as possible, in consultation with the union; periodic risk assessment and Knowledge, Attitudes, Practice/Behavior Studies (KAPB) studies will continue to be conducted on a regular basis:

  • to ensure that the objectives and principles in the policy remain relevant to new research and approaches in respect of HIV/AIDS
  • to ascertain if the programmes have the desired effects in changing behaviour, attitude and perceptions regarding HIV/AIDS

The parties will evaluate progress in implementing the workplace policy and programme at least every three months.

Definitions

Affected employee
an employee who is affected in any way by HIV/AIDS eg if they have a partner or a family member who is HIV positive

AIDS
AIDS is the acronym for 'acquired immune deficiency syndrome'. AIDS is the clinical definition given to the onset of certain life-threatening infections in persons whose immune systems have ceased to function properly as a result of infection with HIV.

Counselling
Counselling is defined as a confidential dialogue between a client and a trained counsellor aimed at enabling the client to cope with stress and take personal decisions related to HIV/AIDS. Counselling may be provided by a professional or a lay counsellor.

HIV
HIV is the acronym for 'human immuno deficiency virus'. HIV is a virus which attacks and may ultimately destroy the body's natural immune system.  

HIV testing
taking a medical test to determine a person's HIV status. This may include written or verbal questions inquiring about previous HIV tests; questions related to the assessment of 'risk behaviour' (for example questions regarding sexual practices, the number of sexual partners or sexual orientation); and any other indirect methods designed to ascertain an employee's or job applicant's HIV status.

HIV positive
having tested positive for HIV infection.

Infected employee
an employee who has tested positive for HIV or who has been diagnosed as having HIV/AIDS.

Informed consent
a process of obtaining consent from a patient which ensures that the person fully understands the nature and implications of the test before giving his or her agreement to it.

Occupational Exposure
Exposure to blood or other body fluids, which may be HIV infected, during the course of carrying out working duties

Opportunistic infections
Infections that occur because a person's immune system is so weak that it cannot fight the infections

Peer education
Sharing of information by people of similar backgrounds and experiences (for example, similar ages, occupations or life experiences).

Policy
a document setting out an organisation's position on a particular issue.

Reasonable Accommodation
means any modification or adjustment to a job or to the workplace that is reasonably practicable and will enable a person living with HIV or AIDS to have access to or participate or advance in employment.

STDs
acronym for 'sexually transmitted diseases'. These are infections passed from one person to another during sexual intercourse, including syphilis, gonorrhea and HIV.

Surveillance Testing
This is anonymous, unlinked testing which is done in order to determine the incidence and prevalence of disease within a particular community or group to provide information to control, prevent and manage the disease.