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COSATU Booklet on the Campaign Against HIV / AIDS
By the end of 1998, there were 33 and a half million people living with HIV / AIDS in the world. Nearly every country is seeing new infections every day, and the epidemic is out of control in many places. It is estimated that in Africa 800 000 children, 12 million women and 10 million men have HIV or AIDS. More than 11 million Africans have already died, and another 22 million are now living with HIV / AIDS.
In South Africa, 3 and a half million people are infected with HIV. By the year 2000, if the epidemic continues to grow, as much as 20% (one fifth) of South Africa's working population may be HIV positive. At some time, alsmost every workplace will have to deal with a worker who is living with HIV / AIDS.
The rapid spread of the disease is related to poverty and the lack of access to socio-economic rights such as housing, clean water, sanitation and health care.
Everyone and anyone can get HIV / AIDS, but those most at risk are youth, women, migrant workers, long-haul truck drivers and sex workers.
The following socio-economic factors help to spread the epidemic in South Africa:
- Migrant labour increases the spread of the disease by breaking families apart.
- Single sex hostels
- Overcrowded housing
- Poor access to health care
- Lack of recreation facilities
- Lack of information
- Illiteracy and poor education
- High unemployment
- Exploitation and inequality of women (this makes it difficult for women to demand safer sex)
- Other poverty related diseases such as TB
- Sexually transmitted diseases
HIV stands for the Human Immune-deficiency Virus. HIV is the cause of AIDS, which stands for Acquired Immune Deficiency Syndrome.
There are cells in your body which protect you from invasion by bacteria, viruses, fungi and parasites. They also destroy cancer cells. The HI Virus attacks and destroys these cells in your body so that they can no longer fight diseases.
After you have been infected for a long period, usually 3 - 7 years, many of these cells will have been destroyed and your body will not be able to defend itself against infections and cancers. This is the phase of HIV - infection when you become sick, and is known as AIDS.
HIV must get into a person's blood to infect them.For you to transmit it to another person it has to pass from your body in your blood or your sexual fluids, into their body through a break in their skin.
If you are infected, the HI Virus is in:
- Vaginal fluids
- Mother's milk
You can get HIV from sex
HIV can be spread through sexual intercourse. Many infected people have no symptoms and have not been tested. If you have sex with one of them, you put yourself in danger.
If you have a sexually transmitted disease, the virus can pass much easier into your body during sexual intercourse because you will have open sores that allow the virus through. Women are infected more easily through sex, because the lining of the vagina breaks easily, and allows the virus into the body.
Most people in South Africa get infected with the AIDS virus by practicing unsafe sex. If you want to protect yourself from AIDS you must have safer sex. Sex is safer if:
- You use a condom
- The penis does not penetrate the vagina or anus
- You have sex with only one partner in your lifetime, and your partner only has sex with you - this is a faithful relationship
- You and your partner have an HIV test which shows negative and then you only have sex with each other - this is also a faithful relationship
You can get HIV from sharing needles
Sharing needles or syringes, even once, is a way of becoming infected with HIV and other germs. HIV from an infected person can remain in a needle or syringe and then be injected into the bloodstream of the next person who uses it.
HIV and babies
A woman infected with HIV can pass the virus on to her baby while she is pregnant, while she is giving birth or when she is breastfeeding. Any woman who wants to have a baby and who thinks she may have been exposed to the virus - even a long time ago - should go for counselling and testing for HIV.
In the past, some people became infected with HIV from receiving blood transfusions. Now all blood for transfusions is checked for antibodies to the HI Virus. There is very little chance that a person could get an AIDS infection from a blood transfusion. There is also no chance of getting AIDS by donating blood, because a brand new, sterile needle is used for each person who donates.
HIV infection does not "just happen". You cannot catch it like a cold or 'flu. HIV is not spread by coughing or sneezing. You only get HIV by receiving infected blood, semen or vaginal fluids from another person. HIV is not easy to get.
You will not get HIV through everyday contact with infected people at school, at work, at home, or anywhere else
You will not get HIV from clothes, telephones, computer keyboards or toilet seats. It cannot be passed on by things like cups, knives and forks
You cannot get HIV from eating food that has been prepared by an infected person
You will not get HIV from a mosquito bite. HIV does not live in a mosquito. You also will not get it from bedbugs, lice, flies or any other insects
You will not get HIV from sweat or tears
Four Important Facts about HIV / AIDS:
HIV infection can be prevented
HIV is only transmitted in a few specific ways
HIV does not discriminate - it can infect people of any race, age, gender or sexual orientation
There is no cure for HIV / AIDS
Stage 1 HIV infection
This is when the virus enters the body. There are no signs or symptoms of infection.
Stage 2 Window period
The virus is present in the body but has not yet produced antibodies which can show up in an HIV test. There are no signs or symptoms of disease. This stage usually lasts from 2 to 12 weeks, but may last months.
Stage 3 Seroconversion
This is when antibodies develop in the blood and an HIV test will detect them. In other words, it is when you convert from being HIV-negative to HIV-positive. Some people have a flu-like illness for a few days - slight fever, tiredness, aching muscles and joints.
Stage 4 HIV infection with no symptoms
There are no signs or symptoms of illness, although infection is present. This period may last from a few months to many years.
Stage 5 HIV / AIDS related illnesses
The immune system (the cells which fight disease) has been damaged by the virus. Symptoms of diseases increase but as yet they are not severe enough to threaten life. Examples of symptoms are a low-grade fever that lasts several weeks, diarrhoea, extreme tiredness, weight loss, skin rashes, swollen glands and night sweats. Women may get vaginal infections (thrush) that never seem to clear up, even with treatment. Infections gradually become more frequent and more serious. This period may last for months or years.
Stage 6 AIDS
Serious infections and cancers invade the body because the immune system is now very weak. Typical infections are pneumonia, skin cancers, "slim's" disease and TB. The patient could die at this stage from an untreatable condition.
There is very little chance that HIV can be transmitted in your workplace. Unless there is blood present, there is no danger of catching the virus from being around people who may be infected. Even if a person sneezes or coughs, there is no blood present so you cannot catch the virus. A worker with HIV / AIDS does not have to be isolated, and needs the support, sympathy and understanding of his or her co-workers.
In workplaces where there might be blood or other infectious fluids around, you are at risk of catching the HI Virus. You can get stuck with a needle with blood on it, get cut with a sharp instrument or get splashed in the eyes, nose or mouth with infected blood. Workers who may come into contact with blood include:
- Health-care workers such as nurses, laboratory workers, laundry workers and dental assistants
- Police officers
- Emergency workers such as ambulance drivers and firefighters
- Prison workers
- Mental health workers
In the workplace, use "universal precautions" whenever you come into contact with:
- body fluids
- cuts, wounds, or other kinds of "open skin" or lesions
Universal precautions means treating all blood and other body fluids as if they were infected with HIV. Universal precautions include:
- washing your hands between each patient or each task
- after using the bathroom
- after taking off your gloves
- wearing gloves when you touch blood or other body fluids
- wearing a gown, mask, or eye protection when you may be splashed with blood or other body fluids
Universal precautions should be used by all workers including housekeepers, laundry workers, diet workers and janitors.
If there are splashes of blood or body fluids on the floor or on your clothes, common cleaning materials such as bleach and water, and ammonia, destroy and dissolve the AIDS virus within 30 seconds.
The union can help its members in at least three ways:
The union can protect workers from HIV infection by improving health and safety at work
The union can protect workers with HIV infection or AIDS
The union can provide support for workers and their families who have HIV infection or AIDS and may become too sick to work
As workers, you will be concerned about avoiding infection with HIV and about fair treatment for workers living with HIV. You will be concerned about safe working conditions, protection from discrimination and protection of benefits. Shopstewards have a very important role to play in dealing with these concerns. As a shopsteward in a workplace, it is your duty to do the following:
- establish an HIV / AIDS committee in your workplace or use the existing health and safety committee
- help to ensure fairness and equal treatment for all your co-workers, including those infected with HIV / AIDS
- help to establish a supportive atmosphere for workers living with HIV / AIDS
- educate and inform co-workers about HIV / AIDS and how to prevent it
- be able to demonstrate how to use a condom
- help your union to develop a policy and programme on HIV / AIDS
- ensure that there is a policy and programme on HIV / AIDS in your workplace
- participate in the development of the policy and programme and ensure consultation takes place throughout the workplace
- encourage workers to be involved in the programme
- show commitment to the programme from the unions
The most important thing the union can do to support a member with HIV infection is to help the worker remain at work. Staying at work means that workers keep their pride, dignity and health-care benefits. Workers with HIV infection or AIDS should be assisted to do their job as long as they are able. The union must help them by protecting their benefits and protecting them from discrimination.
Discrimination is when:
- An employer tries to fire a person with AIDS
- An employer denies medical benefits or sick leave to a worker with AIDS
- Co-workers refuse to work with a person who has AIDS
- Unfair restrictions are placed on a worker, like having to eat lunch alone or take breaks away from other workers
- A qualified worker is not promoted because he/she has AIDS
- A worker's personal health information is discussed without his or her permission
An HIV / AIDS policy states how your organisation views its workers with HIV / AIDS and what it will do to support them, as well as the strategy it will use to prevent the spread of HIV / AIDS. The policy must be developed through consultation with all levels of workers. The policy demonstrates the commitment of your organisation to respond to the HIV / AIDS epidemic.
An HIV / AIDS policy should cover:
- Access to jobs for applicants with HIV / AIDS
- Job security for workers with HIV / AIDS
- Whether workers and applicants should be tested for HIV / AIDS
- Whether workers HIV status will remain confidential
- The right of the worker to disclose his or her status
- Protection against discrimination
- Workers benefits
- Access to training, promotion and benefits
- Performance management
- Grievance procedures
- Reduction of risk in the workplace
- First aid and precautions against infection
- Education and awareness programmes
- Other prevention programmes
- Wellness management
A commitment in the form of policy must be taken further in the form of a programme.
There should be regular evaluation, monitoring and review of the policy and programme
(There is a draft workplace policy included at the end of this booklet that you can use to help you.)
The most important thing to know about AIDS and the law is that people with HIV / AIDS may not be discriminated against in the workplace.
The constitution gives all workers the right to "fair labour practices" and states that everyone is entitled to equality and freedom from unfair discrimination.
The LRA also outlaws discrimination and protects workers from being dismissed simply because they are HIV-positive. It also protects them from being discriminated against with regard to benefits, staff training and other opportunities at work.
The Occupational Health and Safety Act requires employers to create a safe working environment. This means that proper equipment should be provided to protect workers against infection and that workers should be trained in the use of precautions.
The Employment Equity Act prevents employers from testing for HIV / AIDS before employment (pre-employment testing).
The Compensation for Occupational Injuries and Diseases Act provides compensation for workers who are injured in the "course and scope" of their employment. Therefore, if there is a possibility that a worker has been exposed to HIV during an occupational accident:
- an accident report should be completed and forwarded to the Workmen's Compensation Commissioner
- the worker should be tested for HIV to determine their status before the accident
- any other person who was involved in the accident should be tested with their informed consent
- if he or she tests negative, the worker should be tested again at 3 and 6 months after the accident
- if they sero-convert (test positive) during this period, an application for compensation may be made
The Medical Schemes Act prevents medical schemes from discriminating against people with HIV / AIDS
The right to confidentiality means that a worker does not have to inform his or her employer if he or she is HIV positive. Also, doctors and healthcare workers are not permitted to give any information to employers about any worker's' HIV status.
It is important to get yourself tested for HIV if you think it is possible you have been exposed to the virus. It is important to know whether you have the virus because you can remain healthy by eating healthy food, sleeping properly and cutting down on alcohol. Also, you may be able to begin treatment immediately.
However, it is your choice as to whether you wish to be tested. Nobody may test your blood without your consent. If you agree to be tested in your workplace, your results must remain confidential and counselling must be provided before and after testing.
Employers are legally prevented from testing for HIV before hiring workers. The LRA also protects applicants from unfair or discriminatory hiring practices
Testing for HIV before you are admitted to a medical aid scheme is also illegal.
The Medical Schemes Act prevents medical aid and medical insurance schemes from discriminating against people infected with HIV.
There are other benefits that workers may be entitled to , such as retirement and ill-health benefits, group life or disability cover and funeral benefits.
Workers should be made aware of how much cover their benefit schemes offer for HIV / AIDS. Any changes to benefit schemes should be made in consultation with employee organisations, workplace forums and bargaining councils. The negotiations on benefit packages must take place transparently so that all workers understand the changes.
There is no cure for AIDS. There are medicines available which boost the immune system and reduce the amounts of the virus in the body. These are called anti-retroviral drugs and protease inhibitors. Most of them are produced by multinational pharmaceutical companies and are very expensive. It has been found that if you take three of these drugs together, it boosts your immune system effectively. However, South Africa would not be able to afford to provide this treatment to all of its 4 million HIV-positive citizens. It would cost about R200 billion to do so.
Two common examples of these drugs are AZT and nevirapine. AZT is particularly effective in reducing the possibility of a mother infecting her baby during childbirth. Because it costs the government a lot of money to treat babies who are born with HIV infection, it is more cost-effective for it to provide this drug to pregnant women who are HIV positive.
Apart from these anti-retroviral drugs, there are medications which treat the infections that invade your body when you have AIDS. These medications help people live longer and better. Again, most of the drugs are sold by American or multinational pharmaceutical companies, and are too expensive for workers. Some of the drugs are produced much more cheaply in other countries, such as India or Thailand, but South Africa is under pressure not to produce or import cheaper versions of the drugs.
The government has drafted a Bill - the Medicines and Related Substances Bill - which would allow South Africa to import the cheaper medicines into South Africa, and provide a wide range of treatments for AIDS infections. The Pharmaceutical Manufacturers Association, which represents many of the multinational drug companies, have taken the South African Government to court because they believe the Bill will affect their profits.
COSATU supports the government's struggle to access cheaper drugs for the benefit of all of our people. An important part of COSATU's HIV / AIDS campaign will be against the multinational companies involved in this action.
Phase 1: September 1999 - December 1999
- Develop a pledge on HIV / AIDS
- Affiliates negotiate a day off for shopstewards training on 22/23 November 1999
- Prepare training material on HIV / AIDS awareness, treatment and legislation
- Workshop for health and safety coordinators, gender coordinators and COSATU regional gender coordinators and educators
- 23 - 30 November 1999 - discussions at all workplaces where shopstewards will educate workers on AIDS awareness and treatment
- 1 December - "World AIDS DAY" - distribute COSATU HIV / AIDS material, and each workplace to have an extended lunch-time meeting
Phase 2: February 2000 - June 2000
- Begin training of core HIV / AIDS activists in COSATU who will attend structural meetings, continue educating workers and report on awareness and developments on treatment
- Affiliates to negotiate HIV / AIDS policies for workplaces to be included in the collective agreements eg: paid time off for training shopstewards, no discrimination against affected workers, supportive working environment and funded training by SETA's
- 2000 begin preparations for the HIV / AIDS conference taking place in South Africa
Shopstewards will lead this campaign. They need to be able to answer questions workers might have, and to create a supportive environment so that workers feel comfortable talking about and understanding AIDS. COSATU calls on all workers to be responsible, sympathetic and pro-active in the fight against this disease. We need to join forces and take on the battle against HIV / AIDS as a strong united working class! Every shopsteward should negotiate for extended lunch-time meetings at their workplaces for 1 December.
|AIDS HELPLINE||0800 012 322|
|National Progressive Primary Health Care Network (NPPHCN)||(011) 403 firstname.lastname@example.org|
|Planned Parenthood Association of South Africa (PPASA)||(011) 482 email@example.com|
|National HIV / AIDS and STD Programme, Department of Health||
|AIDS Law Project||(011) 403 firstname.lastname@example.org|
|East London AIDS Training, Information and Counselling Centre||(043) 705 2621|
|Port Elizabeth AIDS Training, Information and Couselling Centre||(041) 506 1249|
|Queenstown AIDS Training, Information and Counselling Centre||(0458) 38 2233 ext 2282|
|Umtata AIDS Training, Information and Counselling Centre||(047) 531 2763|
|Bloemfontein AIDS Training, Information and Counselling Centre||(051) 405|
|Leratong AIDS Centre||(057) 353 3029|
|Tshwaranang AIDS Centre||(051) 723 0197|
|The Community AIDS Information and Support Centre||(011) 725 6710 / 6721|
|AIDS Consortium, University of the Witwatersrand||(011) 403 email@example.com|
|Klerksdorp AIDS Training, Information and Counselling Centre||(018) 462 215|
|Mamelodi AIDS Training, Information and Counselling Centre||(012) 308 5570|
|Pretoria AIDS Training, Information and Counselling Centre||(012) 308 8743 / 8|
|Hope Worldwide, Soweto||(011) 984 firstname.lastname@example.org|
|Vaal AIDS Training, Information and Counselling Centre, Vanderbijlpark||(016) 950 5337 / 8|
|KwaZulu - Natal|
|Durban AIDS Training, Information and Counselling Centre||(031) 300 email@example.com|
|Pietermaritzburg AIDS Training, Information and Counselling Centre||(0333) 95 1612 / 3|
|Nelspruit AIDS Training, Information and Counselling Centre||(013) 759 2167|
|Witbank AIDS Training, Information and Counselling Centre||(013) 690 6204|
|Pietersburg AIDS Training, Information and Counselling Centre||(015) 290 firstname.lastname@example.org|
|Western Province AIDS Training, Information and Counselling Centre||(021) 400 email@example.com|
HIV and AIDS in South Africa are a major health problem, with employment, human rights and economic implications. This policy is intended to cover all employees and employers in the Republic of South Africa.
The policy is necessary for the workplace because:
HIV infection takes place mostly among the economically active age group;
Women are additionally at risk of HIV infection.
The policy recognizes that workplace based programmes that promote HIV / AIDS awareness, prevention and care are an important part of a national HIV / AIDS strategy.
The main objective of this policy is to reduce the number of new infections among employees and their families and to ensure that the rights of employees with HIV are fully respected. This policy conforms to the Southern African Development Community Code on HIV in Employment, which was endorsed at the SADC summit in September 1997. It is also in compliance with the protections against arbitrary discrimination that are embodied in existing labour legislation.
Employees with HIV / AIDS should be treated the same as all other employees.
Employees with HIV-related illnesses, including AIDS, should be treated in the same way as any other employee with a life-threatening illness.
An employee with HIV / AIDS should not face unfair discrimination in access to employment, training, promotion, or employee benefits.
Employees infected with HIV should be protected from stigmatisation and discrimination by co-workers. Where there has been adequate information, education and provisions for safe work, then disciplinary procedures should apply to people who victimise other employees with HIV.
CONFIDENTIALITY AND TESTING
It is the law that HIV testing should only take place after appropriate counselling and with informed consent.
There should be no direct or indirect pm-employment testing for HIV. There should also be no HIV testing for training or promotion purposes.
The HIV status of an individual employee is of no relevance to an employer. People with HIV have equal rights to privacy and confidentiality. If an employee discloses his or her HIV status to colleagues and management this information should be treated as confidential.
MANAGING ILLNESS AND JOB SECURITY
No employee should be dismissed merely on the basis of HIV status; nor shall HIV status influence retrenchment procedures.
When due to medical reasons an employee can no longer continue with his or her normal employment duties, efforts should be made to offer alternative employment (reasonable accommodation). When the employee becomes too ill to perform his or her job, standard procedure for termination of employment due to incapacity should apply without discrimination.
EDUCATION, COUNSELLING AND TRAINING
A fund should be established at the industry level, jointly managed by the union and employers, for the purpose of HIV / AIDS education and training in the industry.
HIV / AIDS education and counselling should take place in every workplace during working hours.
The objectives of education, counselling and training should be:
To create awareness of the HIV / AIDS epidemic;
To remove the stigma against those infected;
To promote safe sex through condom distribution;
To equip union leadership with counselling skills;
To provide care and support for people with HIV / AIDS.
To ensure effective education, the industry should build partnerships with local, provincial and national government as well as with NGOs, CBOs and organisations of people living with HIV / AIDS.
Strategies should be devised to monitor the impact of training on an ongoing basis.
HEALTH AND SAFETY
All workplaces must ensure that they are equipped with proper universal precautions (infection control equipment and procedures) that can be used in cases where there are accidents that lead to blood spills.
Workplace health and safety committees should receive special training on HIV and AIDS and on how to take universal precautions.
HEALTH CARE FUNDS
Efforts should be made to standardise health care services throughout the industry, and primary health care protocols for the care and management of HIV should urgently be developed.
No health care fund should be allowed to discriminate by refusing cost-effective treatment and / or reasonable benefits for the treatment of Sexually Transmitted Diseases (STDs) including HIV.
Additional funds should be made available in order for the health care funds to offer quality services for HIV / AIDS infection.
PROVIDENT FUND & OTHER BENEFITS
Whilst it is recognised that HIV / AIDS may make it necessary to restructure or revisit employee benefits, this should be done in a way that allows the funds to remain economic, but does not exclude or limit benefits to employees with HIV / AIDS.
The employers and unions should commission research into the impact of HIV / AIDS on the existing employee benefits.
The union should establish necessary structures at all levels, including joint union and management teams, for the successful implementation of this policy.
REVIEW, MONITORING AND EVALUATION
A baseline study to establish the present impact of HIV in the workplace, including knowledge of HIV by workers and employers, should be conducted as soon as possible.
Pilot programmes to test AIDS prevention strategies should be devised and run jointly by the union and employers. In addition, there should be ongoing evaluation and monitoring of activities that are required by this policy.
The policy should be reviewed periodically in the light of changes in medicine and science concerning the HIV / AIDS epidemic.
Notes: If we are against discrimination against PLAs, then the word unfair discrimination should be avoided and discrimination should assume its rightful place. In other words, we should talk of discrimination instead of unfair discrimination.
We, the representatives of organized labour in South Africa, comprising the Congress of South African Trade Unions (COSATU), the Federation of Unions of South Africa (FEDUSA), the National Council of Trade Unions (NACTU), as well as independent trade unions, acknowledge:
The HIV / AIDS epidemic affects the economically active people in our country, South Africa
The proportions to which the disease is spreading and the serious challenges it poses to the country's development and future.
Poor living conditions and low wages are factors that make it difficult for many people to change behaviour that puts them at risk of HIV infection
Our response, therefore, must to he to campaign for HIV prevention and care with the same determination and energy with which we fight many other working class struggles. We say AIDS must he made a priority issue for every trade union member. Campaigns to stop AIDS must be discussed at every trade union meeting.
It is now clear that awareness-raising and condom distribution, though important, are not enough. This requires a new approach and strategy. Therefore, labour will confront the HIV / AIDS epidemic with the same tools of the struggle: tenacity, vigour and militancy.
We therefore pledge to:
Campaign for adoption and implementation at every workplace the union-developed HIV / AIDS POLICY by October 2000;
Campaign for every workplace to have an HIV / AIDS prevention programme by October 2000;
Step up HIV / AIDS training within trade union structures;
Promote non-discriminatory employment practices, especially in access to employment;
Create a supportive work environment for workers with HIV / AIDS;
Campaign for access to facilities, materials, information, funding;
Continue to support efforts in search of a cure for HIV / AIDS;
Push for favourable policy and legislation, specifically:
Uphold and enforce Employment Equity Act;
Press for adoption of a legally enforceable Code of Good Practice on AIDS and Employment;
Join and support campaigns for accessible and affordable treatment for people With HIV / AIDS.
With a resolute determination to achieve the above, we recommit ourselves to a partnership with our government and other organs of civil society to ensure that the spread of HIV/AIDS is stopped: that the impact of AIDS on infected and affected people is minimised: and that the dignity of all South Africans living with HIV / AIDS is respected.
AIDS Helpline 0800 012 322