By Amy Joyce
Washington Post Staff Writer
Sunday, December 10, 2006
Two weeks after she started to work at Catholic Relief Services in 2004, Jennifer Munthali decided to tell her boss that she was HIV positive.
"I barely knew my supervisor," said Munthali, who was the program manager for AIDS relief in Zambia. "It was indeed a scary time. Even though I was at a higher management level, I was afraid I was going to lose my job."
Her manager handled the news well. But neither he nor Munthali was sure what CRS's policy was on HIV treatment. She didn't know if her insurance at the Baltimore organization would cover her. And she didn't know what policy -- if any -- CRS had on HIV and AIDS treatment and support.
Munthali and her managers were in a situation they share with many other employers and employees. The approaches and attitudes toward HIV and AIDS, particularly in the workplace, are still complex. Many managers don't know what, if any, accommodations are available to HIV-positive employees. Others might simply handle the news poorly because there is still a stigma attached to AIDS.
"Earlier there was lot of hysteria, ignorance and panicked reactions, and sometimes that still happens today," said Peter J. Petesch, managing partner with law firm Ford & Harrison in the District and a board member for the Business Responds to AIDS program of the U.S. Centers for Disease Control and Prevention. "Even with companies that have sort of attached policies where AIDS and HIV are mainstreamed with other chronic and catastrophic illnesses, there is still a lot of wisdom in providing employer and manager education."
CRS is a relief and development agency that works in 99 countries. As part of its mission, it helps people who are HIV positive. But CRS had only a thin, outdated policy from 2001 in place for its employees.
A lot has changed since then in the approach to the HIV/AIDS, Munthali said. "We were at the point where the church was. I think the Catholic church has done a great job in taking care of the sick and showing compassion for the poorest of the poor. But in doing that, the programs were for caring for people while they were sick, but not helping people get tested and get treatment to stay alive."
Munthali's revelation of her HIV status led other CRS employees to share theirs. And her experience, challenges and concerns were used in writing the organization's new policy, which she and others worked on for a year.
CRS's program has been in place for 10 months. It includes training for all employees about HIV and AIDS, information for managers and employees about what CRS can do for its employees who are HIV positive, and 100 percent coverage of all treatment and testing for the virus. In many cases, CRS's insurance hadn't helped workers in foreign countries. Not all countries take insurance. And overseas, the rate of HIV-infection is much higher, so insurance companies might not include all treatment in their policies, Munthali said.
The new program also created mandatory HIV training for all employees at least once a year, in addition to complete coverage for testing and treatment for all of its employees. CRS hopes the coverage will encourage its 5,000 employees to get tested and get treatment. Its home state, Maryland, is in the top 10 for HIV prevalence.
"We started to recognize as an agency that the same stigma and access to treatment issues are actually affecting our own staff," said Munthali, 36. "Here we were saving people in the community but losing our own staff to HIV."
Munthali was infected in 2000 when she was working for another nongovernmental organization in Zimbabwe. She didn't know of her HIV status until she moved to Malawi to start working on an HIV program. Her flu-like symptoms went undiagnosed until she requested an HIV test. "I definitely think my own experience helps me to do my job. I understand what people are feeling, and I'm able to share my experience with them," she said.
Munthali moved to Baltimore this year to start the HIV workplace program at the headquarters and help make its way to the countries in which CRS works.
Other organizations are asking Munthali how CRS created its policy and what challenges the organization has faced. Many groups are worried that if they also offer complete coverage of treatment, it will be too expensive to sustain. But the coverage has cost less than 20 percent of CRS's overall HIV workplace budget, Munthali said.
"That helps other agencies learn this is something affordable and the cost benefit is a healthier staff that is well informed and able to contribute to the work," she said.
Petesch spends a lot of his time on the same issue.
He first took action on HIV/AIDS in the workplace when his best friend, who worked for a supposedly progressive lobbying firm, died in 1987 of complications from AIDS. Petesch soon found out that his friend's boss's response was to drain her pool because his friend had been in it during a company party a few months earlier.
Although people have progressed in their understanding of AIDS, there is still a stigma surrounding it, he said. Policies such as CRS's will help eradicate that.
Over the years more companies have "mainstreamed" HIV/AIDS policies, he said, to educate employees and managers.
"People are living longer and working longer, and that just puts more of a spotlight on some of the workplace challenges that need to be addressed in these policies," Petesch said. When he advises companies to write the policies, they usually include a nondiscrimination portion and a part that urges people with HIV/AIDS to come forward and reminds them of what they need to do to get an accommodation -- such as a flexible schedule or telecommuting options -- if they need it. It also usually includes an education portion to reinforce that people with HIV and AIDS are "perfectly able and safe to work."
As Munthali has proven: She works full time and is getting her master's degree in public health from the London School of Hygiene and Tropical Medicine. "Treatment has saved my life," she said.