Presently there are over 2,500 people diagnosed with HIV and over 200 people with AIDS living in the Czech Republic. Battling the symptoms and coming to terms with the prognosis can be hard enough but people with AIDS and HIV are also up against the stigma and prejudice associated with the disease. I spoke to Jakub Tomšej, a lawyer who provides counselling at the Czech AIDS Help Society, about some of the problems that his clients face.
“Unfortunately I have to say that we have seen a number of cases where HIV positive people have been subjected to discrimination and the situation where we see the biggest problem is when the HIV positive person requires some kind of health care, for instance they need to see a dentist, and it happens quite often that they are refused and that they really have a problem getting the medical care that they need.”
Surely this is against medical ethics?
“It is against medical ethics and also against the law because according to the Czech law there are certain reasons on the grounds of which a patient can be refused, but obviously HIV status or a different problem relating to the health of the patient is not a reason for refusal. So it is not correct and we have some cases where HIV positive people have been claiming either an apology or some kind of compensation for this. We are also in negotiations with public authorities and are somehow trying to raise their awareness about this problem so that potentially doctors get some more education and support in this respect. But at the moment the situation is not really great.”
Why do doctors refuse them? Is there not enough awareness, is it because of other patients – do you know why they get refused?
“Well, normally it could be somehow understandable that a doctor wants to protect him or herself and his or her patients but in the Czech Republic there are no mandatory HIV tests so theoretically everyone who comes to a doctor’s office can be HIV positive and people who have not yet been tested and who are not subject to any health care can usually represent an even bigger danger because the level of HIV in their body is higher. So from the medical point of view there is no reason why a patient who declares him or herself to be HIV positive should be refused. Some people may subjectively perceive it as a problem to come into contact with an HIV positive person and this subjective stand may apply to doctors as well, but we believe that this behavior is not right because there are very clear measures which every doctor should take to protect him or herself from transmission of HIV and if these are observed then there should be no risk.”
“We have seen situations where fellow employees practically launched a campaign against the given person, informing other employees about the risk, telling them they should avoid touching this person or sharing things with them.”
And how would the doctor know? Do patients volunteer the information?
“Actually under Czech law people have an obligation to inform a doctor prior to medical treatment about their HIV status, so HIV positive patients are informed that every time they go to see a doctor they have to inform him or her about their HIV status. In practice I have seen cases where people have withheld this information because they were afraid of being refused, but this is in breach of the law and the person may be fined for it. As a rule this information must be provided to the doctor.”
What is the situation on the labour market for people with HIV?
“On the labour market there is no mandatory information duty so if someone is HIV positive they do not have to notify their employer. Notwithstanding that, it happens now and then that an employer learns that an employee is HIV positive and many employers treat this information with respect because they know that in the normal work process there should be no risk. However there have also been some cases where people have been dismissed because they are HIV positive despite the fact that the HIV status did not present any obstacle to the job that they performed.”
Do you have any specific cases in mind?
“Yes, there is one case now in court where a police officer was dismissed due to his HIV status and he is claiming discrimination and wants some kind of financial compensation from the state. The case is now being tried by a court of the first instance so it is too soon to say what the outcome will be. The situation is slightly complicated by the fact that legislation pertaining to the police force says that in some circumstances an HIV positive officer may be dismissed if, in his work, he carries out certain activities where there is a risk of transmission but the officer suing the state claims that this was not the case.”
When you say that some employers dismiss HIV positive employees – why is it? Is it at their own initiative or under pressure from other employees?
“It can be both. We have seen situations where fellow employees practically launched a campaign against the given person, informing other employees about the risk, telling them they should avoid touching this person or sharing things with them. And the employer then reacted by dismissing the person. I would say that under Czech law the person breaching the labour code is not the one with HIV but the person who is trying to get them dismissed. The fact that other employees are not happy with having an HIV positive colleague should not be a valid reason for their dismissal, however in practice even such situations occur.”
Do you have any idea how much of this goes on and how many HIV positive people who meet with discrimination defend their rights in court?
“Well, in the Czech Republic there are approximately 2,500 HIV positive people registered so far and I would assume that most of them have good jobs and careers simply because their employers and colleague do not know about their HIV status. Where the information is revealed I would say there is an increased risk of bullying at the workplace or even termination of their contract. Presently I am aware of only one court case where an employee has sued their employer, however I have been involved in many more cases where employees have been dismissed because of their HIV status but have decided not to go to court. One concern is money – the financial consequences should they lose the court case – but also, and much more importantly, the fact that they are afraid their identity will be revealed if they sue their employer. That’s the reason why most of my clients in the end decide that they do not want to pursue any further action.”
Are they adequately legally protected if they did decide to go to court?
“We do not have any specific legislation which would protect people with HIV. However we have anti-discrimination laws and they clearly state that people must not be discriminated against on the grounds of health capacity. And HIV is also covered by this, so there are laws which should give HIV positive clients sufficient protection. Having said that, in practice these laws are not always observed and it is not always the case that the client decides to go to court and exercise their rights because for various reasons they do not want to take it further.”
“Often employees who have been dismissed because of their HIV status decide not to go to court.”
Do you feel there is a lack of awareness in this country about HIV –is that what causes the prejudice?
“Yes, I would say that on the one hand it is a lack of awareness and on the other hand a lack of practical experience with being in tough with HIV positive people. Most of us have heard and read about HIV and the means of transmission but not many of us know an HIV positive person and have had the opportunity to gain some direct experience. And what I see in practice is that if, all of a sudden, we meet someone like that then the theory that we have from books or what we heard on the radio may not be sufficient and may not protect us from incorrect judgements and decisions.”
Has the situation changed for the better in the past ten or twenty years?
“To be honest I am not really sure. What I definitely see is an increase of HIV positive people and therefore an increase in cases where they need some legal support. I would tend to say that the situation has not improved much and that awareness in society needs to improve.”
Do they have a good support network?
“Well here in the Czech Republic there are more non-profit organizations which provide various types of support to this group of people. Our organization – the Czech AIDS Help Society – provides not only legal counselling but also shelters for people in socially difficult situations, labour market counselling, various other forms of assistance and consultations, psychological help, a “buddy” program where an HIV positive person can apply for informal support from a more experienced HIV “buddy” so to say and other programs. So, as far as non-profit organizations are concerned, I believe that we are trying to do what we can.”
What in your opinion would help most at this point – is it money, greater awareness or something else?
“Well, I would say that two things would significantly help. Of course, it would be great if non-profit organizations had more money to run campaigns against both HIV transmission and prejudice and discrimination against HIV positive people. The other thing that would help (it would not cost much but may be harder to achieve) would be for people to have more examples of HIV positive people around them ; if everyone had more opportunities to get some kind of personal experience with them. In this respect I have found it interesting that it was recently revealed that a famous US actor is HIV positive and although some of his life paths may not be inspiring for the public I think it is good that people hear that for instance Charlie Sheen is HIV positive and that there are more examples of HIV positive people around them –that this is not a problem concerning a select group of people but that it can affect anyone.”
And there are not many of these examples in the Czech Republic?
“That’s right. Of course we do not know if there are any celebrities or well-known people who have HIV but at this stage it is very difficult for anyone to come out with the information that they are HIV positive. If we compare it to the situation within the LGBT community a couple of years ago it was very difficult for anyone to admit that they are lesbian, or gay or whatever because there were not so many other examples, while now times are changing slowly and people are getting used to having LGBT people around them. It would be great to see a similar development with HIV positive people but I do not think this will be so easy. ”
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