Reduction of HIV/AIDS Related Employment Discrimination in Viet Nam

Executive Summary:

"This UN [United Nations] discussion paper is based on a joint ILO [International Labour Organisation] and UNDP [United Nations Development Programme] project and consolidated research on Reducing HIV/AIDS Related Employment Discrimination in Viet Nam, which was executed in 2003 by the ILO with funding and input from UNDP. The project aimed at contributing to the protection of the rights of people living with HIV/AIDS [PLWHA], and addressing HIV/AIDS through workplace prevention policies and the reduction of the epidemic's adverse consequences on social, labour and economic development.

This paper contends that discrimination and stigmatisation of PLWHA is widespread in Viet Nam and could affect the fundamental right of PLWHA to work. Forms of work place discrimination include job dismissal of infected workers, and mandatory screening for HIV of job applicants in a number of enterprises. The study has found that discrimination against PLWHA is partly due to lack of proper knowledge and understanding of how HIV is transmitted and partly due to the perceived linkages of HIV/AIDS to socially disapproved behaviour such as injecting drug use and sex work.

The paper reviews the concepts of stigma and discrimination, particularly in relation to HIV/AIDS. It also looks at the ILO Code of Practice on HIV/AIDS and international experiences in how anti-discrimination policies have been integrated into laws and practices in countries of South East Asia. The paper highlights several policy and institutional gaps in the Vietnamese legal framework concerning HIV/AIDS prevention and anti-discrimination measures as well as gaps in activities undertaken by key players in the world of work.

A set of recommendations is made in the paper on how to address the current challenges to overcome stigma and discrimination of PLWHA in the work place. These include:

• Strengthen information and data about the impact of stigma and discrimination
  against PLWHA
• Revise the legal framework to incorporate stipulations for reduction of
  stigmatisation and discrimination, taking into account the ILO Code of Practice
  on HIV/AIDS and the World of Work
• Translate policies into concrete instructive documents for legal implementation and enforcement with guidelines covering reduction of stigma and discrimination, confidentiality, social dialogue, prevention of transmission, gender equality, care and support
• Increase allocation of government and non-government funds for programmes aiming at addressing HIV/AIDS in the work place
• Engage the VGCL [Viet Nam General Confederation Labour] and VCCI [Viet Nam Chamber of Commerce and Industry] more in policy implementation and the collective effort to prevent and control HIV/AIDS
• Greater attention should be paid to information, education and communication to strategically change negative perceptions of the Vietnamese population on HIV/AIDS and PLWHA

Together these policy changes are considered key measures to eliminate stigma and discrimination in the workplace and to protect the rights of people living with HIV/AIDS including their constitutionally protected right to work."

Excerpts from the Recommendations follow:

Information
"So far, there is a serious lack of information on the current situation of stigma and discrimination against PLWHA in general, and those at the workplace in particular, especially the impact of stigma and discrimination is unknown. Thus, a nationwide study that looks at stigmatisation and discrimination should be undertaken to provide baseline data for an evidence-based policy formulation and intervention design and implementation.

National policy framework
The legal framework of HIV/AIDS prevention and control should be revised and amended to incorporate stipulations for reduction of stigmatisation and discrimination, taking into account the ILO Code of Practice on HIV/AIDS and the World of Work. Presently, regulatory changes can be enacted immediately for the National HIV/AIDS Strategy and the HIV/AIDS Ordinance, so that responsibilities and duties of both employers and employees regarding non-discrimination can be clarified, and mechanisms for their realization institutionalised in these two documents. More specifically, both documents need to include the following statements:

• HIV infection or AIDS is not considered to be a justifiable basis for termination
  of employment;
• HIV screening, whether direct (HIV testing), indirect (assessment of risk behaviours) or asking questions about tests already taken, should not be required;
• Confidentiality regarding ALL medical information, including HIV/AIDS status, must be maintained;
• There should be no obligation on the part of the employee to inform the employer regarding his/her HIV status;
• Female employees should have access to voluntary confidential counselling and testing (VCCT), including pre and post-test counselling, when pregnant.

Policy implementation

• Policies should be translated into concrete instructive documents for legal implementation and enforcement. There is an urgent need for guidelines covering reduction of stigma and discrimination in non-discriminatory conduct, employment, working environment, confidentiality, social dialogue, prevention of transmission, gender equality, care and support, etc.
• The National strategy, five-year plans, and annual plans on HIV/AIDS must incorporate activities to address HIV/AIDS in the workplace, including reduction of stigma and discrimination, as separate interventions (although being integrated holistically into the overall programme) to emphasize their particular significance. There should also be detailed instructions for effective implementation.

Budget
Budget for programmes aiming at addressing HIV/AIDS in the workplace must increase significantly...

Institutional framework
The roles of VGCL and VCCI should be better clarified and institutionalised, with more authority in participation in policy making, M&E programmes and implementation. Their capacity should therefore be upgraded accordingly. It is also important to have the involvement of more stakeholders, including PLWHA, in the collective efforts to prevent and control HIV/AIDS.

Sector intervention

• Activities to reduce stigma and discrimination should be undertaken in enterprises in both state and private sectors, particularly those of the latter as it is here that the rights of workers are more likely to be violated, the link with national programmes seems to be weak, and IEC [information, education, and communication] seems to be neglected. There should be clear statements in legal documents to enforce and encourage their full application in collective efforts, as well institutional arrangements for their realization.
• The concept of 'workplace' should also cover prisons and rehabilitation camps where infected inmates are also required to work, and where there are PLWHA.

Labour rights
It should be stipulated that the rights of employees are to be protected in case of HIV infection, and that these are stated clearly in their labour contracts signed with enterprises. In addition, legal education and information on S&D [stigma and discrimination] should be provided to all employees, employers, and health care workers, and at all enterprises, both state and private, including (where appropriate) their clients.

Information, Education, and Communication
IEC activities undertaken in enterprises and beyond including media participation must be refined, excluding erroneous and stigmatising messages, to strategically change negative perceptions of the Vietnamese population on HIV/AIDS and PLWHA....[T]hese activities should aim at: (i) providing accurate knowledge about HIV/AIDS (stages of disease development, modes of transmission with special attention to demystifying the likelihood of being infected through casual contacts, etc.) to reduce misconceptions about the epidemic; (ii) de-linking stereotyping perceptions about 'social evils' and HIV/AIDS; (iii) real risk of HIV infection; (iv) changing perceptions of PLWHA, especially their rights, human capacity, need for support and care; and (v) legal education related to HIV/AIDS. The IEC activities should also address not only workers but also employers and health staff of enterprises, and clients, and should encourage the participation of the PLWHA themselves."

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