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Section 6
HIV Discrimination

Question 6 | Test | Table of Contents

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In the last section, we emotional healing.  The techniques provided in this section focus on healing emotions and encouraging growth as an additional way HIV positive clients can improve their immune systems.     

In this section, we will discuss understanding discrimination.  Have you, like I, treated clients who not only needed help dealing with having HIV, but also needed help dealing with those who refuse to accept an HIV positive person?  Because discrimination against clients who are HIV positive is sometimes prevalent in society, let’s examine four related topics.  These will include  the Louis Holiday case, five criteria for discrimination, reasonable accommodation, and assumed and direct threats

♦ #1  The Louis Holiday Case
First, let’s take a look at the Louis Holiday case.  Louis Holiday wanted to become a police officer for the city of Chattanooga, Tennessee.  Holiday submitted to a hiring process in which he passed the criteria.  After passing a written and physical agility test, Holiday received a conditional offer of employment from the Chattanooga Police Department.  Holiday’s employment offer was contingent on passing a psychological and physical exam. 

During the physical exam, Holiday informed the doctor that he was HIV positive.  Now, the Chattanooga Police Department does not have a policy that requires applicants to test negative for HIV.  However, Holiday was informed that the city’s conditional offer of employment had been withdrawn because he had not passed the physical exam.  When Louis Holiday asked why, the city claimed that it didn’t want to "put other employees and the public at risk by hiring" Holiday. 

The city used possible blood to blood contact during police work as the basis for their argument.  Later, however, the city withdrew these claims because there was no evidence that this was a reasonable assumption.  Instead, the city began to claim that Holiday’s HIV positive status had nothing to do with the withdrawal of his employment offer. 

Holiday decided to take the matter to court, where a judge ruled in his favor, stating that Holiday "was entitled to be evaluated based on his actual abilities and relevant medical evidence, and to be protected from discrimination founded on fear, ignorance, and misconceptions."

The ACLU used Holiday’s case to make it clear that employers cannot discriminate against employees or job applicants because they have HIV.

♦ #2  Five Criteria for Discrimination
If you have an HIV positive client like Louis who feels as though he or she is being discriminated against, perhaps you could review the five Criteria for discrimination with him or her or play this section in your next session. 
--1. The first criterion is action or inaction.  As you know, discrimination requires someone doing something or not doing something that causes harm or injury.
--2. The second criterion is harm or injury.  As I explain to my clients, "If something bad happens to you on a physical level, or if you are denied something good, then that comprises harm or injury."
--3, 4, 5. In addition to action or inaction and harm or injury, the third criterion for discrimination the fourth and fifth criteria for discrimination are disparate or unequal impact and separate treatment. 

Think of your HIV positive client.  How could an understanding of discrimination benefit him or her?  Perhaps your client may find that just sharing an understanding of the law with the right people at the right time can solve or prevent problems.

♦ #3  Reasonable Accommodation
In addition to Holiday’s case and the five criteria for discrimination, let’s examine reasonable accommodation.  As you know, reasonable accommodation is any modification or adjustment to a job, application process, or work environment that will enable a qualified person with a disability to perform job functions, apply, or enjoy the benefits or privileges of employment. 

For example, Steven was an HIV positive client of mine.  Steven worked as a computer programmer.  Steven suffered from occasional severe bouts of nausea caused by his medication.  His employer provided Steven with equipment that he could use to work from home on those days.  Do you have a client like Steven who could benefit from knowing his or her rights regarding reasonable accommodation?

♦ #4  Assumed and Direct Threats
If your HIV positive client is concerned regarding possible discrimination, you may also find it helpful to discuss with him or her the differences between assumed and direct threats.  For example, Garret, age 33, was an airline pilot.  Garrett felt that he had been discriminated against when he was fired due to his HIV positive status.  Garrett was very upset and stated, "I’m going to take those motherless bastards to court!" 

I discussed with Garrett that he was correct in his belief that HIV can only be spread through exposure to bodily fluids which carry the virus.  But I asked Garrett, "Did the airline tell you that you were being fired because you may transmit the virus to a customer or co-worker?"  Garrett understood that if the airline had fired him to prevent infection, they would be operating under assumed threat. 

However, Garrett stated, "No.  They said I am a direct threat.  It is the airline’s policy not to employ HIV positive pilots because possible bouts of dementia can be a danger to the safety of passengers."  How does your client’s concern regarding discrimination relate to assumed and direct threats?

Do you have a client like Louis Holiday, Steven, or Garrett?  Could your client benefit from listening to this section?

In this section, we discussed understanding discrimination.  Because discrimination against clients who are HIV positive is sometimes prevalent in society, we examined four related topics.  These included the Louis Holiday case, five criteria for discrimination, reasonable accommodation, and assumed and direct threats. 

In the next section, we will discuss taking control of life.  Three ways you can help your client begin taking control of his or her life include dividing and conquering, positive denial, and maintaining equilibrium. 
Reviewed 2023

Peer-Reviewed Journal Article References:
Bogart, L. M., Wagner, G. J., Galvan, F. H., Landrine, H., Klein, D. J., & Sticklor, L. A. (2011). Perceived discrimination and mental health symptoms among Black men with HIV. Cultural Diversity and Ethnic Minority Psychology, 17(3), 295–302.

Breslow, A. S., & Brewster, M. E. (2020). HIV is not a crime: Exploring dual roles of criminalization and discrimination in HIV/AIDS minority stress. Stigma and Health, 5(1), 83–93.

Frye, V., Paige, M. Q., Gordon, S., Matthews, D., Musgrave, G., Greene, E., Kornegay, M., Farhat, D., Smith, P. H., Usher, D., Phelan, J. C., Koblin, B. A., & Taylor-Akutagawa, V. (2019). Impact of a community-level intervention on HIV stigma, homophobia and HIV testing in New York City: Results from project CHHANGE. Stigma and Health, 4(1), 72–81.

James, T. G., Gebru, N. M., Ryan, S. J., & Cheong, J. (2021). Measuring dimensions of HIV-related stigma among college students. Stigma and Health, 6(3), 296–303.

Stock, M. L., Gibbons, F. X., Peterson, L. M., & Gerrard, M. (2013). The effects of racial discrimination on the HIV-risk cognitions and behaviors of Black adolescents and young adults. Health Psychology, 32(5), 543–550.

What are five criteria for discrimination? To select and enter your answer go to Test.

Section 7
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