HIV and AIDS AND THE LAW


Contents

Introduction

What are HIV and AIDS?

The different stages of HIV

How is HIV passed on?
How can you treat HIV and AIDS?
Why do people living with HIV and AIDS suffer prejudice and discrimination?
How does poverty help spread HIV?

HIV and AIDS and the Bill of Rights

The Equality Clause

Does the equality clause protect people with HIV or AIDS?

Protecting rights

CHART: What the rights mean for people living with HIV or AIDS

Health and Medical rights

Confidentiality

Some rules about confidentiality
HIV or AIDS as a notifiable disease
Confidentiality and openness
What can you do if a health care worker abuses your right to confidentiality?

HIV testing and informed consent

Some rules about HIV testing and consent
Exceptions to the rule of informed consent
Who can give consent?
What can you do if an HIV test was done without your consent?

The right to health care and medical treatment

Rights at work

Laws that give people rights at work
Some rules about HIV or AIDS and rights at work
Code of Good Practice on HIV and AIDS and employment
What happens if you become too ill to work?
What can you do to protect your rights at work?

CHART: Summary of rights of employees with HIV or AIDS

Women and HIV and AIDS

The right to equality
Rape

HIV infection because of rape
Marital rape (rape in a marriage)

Abortion

CHART: Some points about abortion

Sterilisation
Domestic violence
Sexual harassment
Commercial sex work
Customary law and women's rights

Virginity testing

Mother to child transmission

Rights of lesbians and gay men

Rights of children and youth

How does HIV and AIDS affect children?

What are the consequences for children?
How are children protected by the law?

Access to education

Right to sexuality education

Children's health and medical rights and HIV and AIDS
Adoption and fostering

Some rules about HIV or AIDS and adoption or fostering

Rights of prisoners

Some rules about prisoners and HIV or AIDS
The rights of accused people

Can an accused person be forced to have an HIV test?
Bail and sentence for rape accused with HIV and AIDS

Social support: Living with HIV and AIDS

Can a person with AIDS get a disability grant?

How to apply for a disability grant

Grants-in-aid
Other forms of relief

Medical costs
Child support

Department of Health plan for HIV and AIDS

The goals of the plan

Key objectives
Priority areas
Guiding principles

Resources
Problems

Problem 1: Keeping medical information confidential
Problem 2: Entry to school refused
Problem 3: Dismissing a worker who is HIV positive
Problem 4: Refusing to employ an HIV-positive person
Problem 5: Making a complaint about being refused medical care
Problem 6: Applying for a disability grant

Guidelines

Running an HIV and AIDS campaign

Workshop

Community education workshop on HIV and AIDS


INTRODUCTION

NOTE !
This chapter was written and published in May 2002. So any changes to the laws  after this date will not be reflected in the text. We note areas where there may be changes to the law, for example, where parliament is still debating a bill.  We will also do an update to the laws and information in this chapter every year. 

Everybody has heard about AIDS. It is one of the most widely talked about illnesses in history. HIV and AIDS is a big problem in Africa and South Africa. But very few people understand the real causes of HIV and what can be done to prevent it.

There are many untrue stories about AIDS. People who are living with HIV or AIDS are discriminated against in all kinds of ways in our society. For example, some people are refused employment or proper health care. This is mostly because very few people understand what HIV and AIDS mean. It is important that people understand what HIV and AIDS are, what causes the illness and what the law says about peoples rights.

What are HIV and AIDS?

HIV stands for the Human Immune Deficiency Virus. This virus attacks the immune system which is the body's defence against disease. HIV can live in our bodies for years without us looking or feeling sick in any way. Most people with HIV feel healthy and are able to work and live healthy lives for many years. It is only when a person develops an AIDS-related illness that he or she becomes very ill.

AIDS is caused by HIV. AIDS stands for Acquired Immune Deficiency Syndrome. It is the name given to a group of serious illnesses that are caused by your body being unable to fight infections. People with HIV or AIDS are more likely to get some diseases and infections because their immune system cannot fight them off.

The different stages of HIV

There are 5 stages of the HIV disease:

Primary HIV infection

After an early feeling of sore throat, swollen glands, headache, muscle aches or similar flu-like symptoms, you will return to feeling completely well.

The asymptomatic or "silent" stage

If you have the primary HIV illness you can feel very well for many years. But the virus slowly destroys your immune system during this stage. You can also easily infect other people through unprotected sex.

Early HIV symptomatic disease

After many years, some people will begin to show mild symptoms of HIV disease, for example:

Medium-stage HIV symptomatic disease

This is the stage when people with HIV can become quite ill without developing the 'Aids-defining illnesses', for example:

Late-stage HIV disease (AIDS)

If there has been no treatment to build up the immune system, the damage done to the immune system by HIV causes opportunistic infections, cancer and HIV-related damage to other organs such as the brain. This stage is usually called 'AIDS'. People with AIDS often have many illnesses at the same time, for example:

How is HIV passed on?

HIV is mostly passed from one person to another in these ways:

Besides these ways, HIV is very difficult to pass on. You cannot get AIDS from someone who is HIV positive through kissing on the lips, hugging, sharing food and drink or using the same bath or toilet.

WARNING !
Deep kissing or 'french' kissing can pass on HIV if you have sores in your mouth.

Anyone can get  AIDS, but some people are more vulnerable because they do not have the power to say no to unprotected sex or because of their risky lifestyles. The groups who are most vulnerable and have the highest infection rates are:

Young women are the most vulnerable because they are the most common victims of rape and sexual abuse and are often powerless to say no to unprotected sex. Young girls are also at risk because of the myth that having sex with a virgin will cure you of AIDS. This is completely untrue.

NOTE!
Having sex with a virgin cannot cure you of AIDS

Other vulnerable groups are :

How can you treat HIV and AIDS?

There is no cure for HIV, but there are many ways to help people living with HIV to improve the quality of their lives, for example :

Anti-retroviral drugs cannot cure a person living with HIV but they can strengthen the immune system and slow down the effects of the virus. Anti-retroviral drugs should only be taken under the supervision of a doctor.

Why do people living with HIV and AIDS suffer prejudice and discrimination?

Fear leads to discrimination and victimisation against people living with HIV or AIDS. People have been taught to believe that only gays, prostitutes, people who sleep around and drug users get infected with HIV. They think if you are not one of 'these', you are safe. This makes it easy for some people to discriminate against others and blame them for the disease, while not protecting themselves. And because people fear the discrimination they will face if others know that they are HIV positive, they are afraid to go for an HIV test or to be open about their HIV status.

HIV and AIDS affects every one of us, whether we are gay, lesbian or heterosexual.

The biggest problem in fighting HIV and AIDS is breaking the silence that surrounds the epidemic. Although thousands of people are ill or dying, we are still afraid to speak about it. Families often hide the fact that a relative had died of an AIDS-related illness. People who are infected are afraid of being stigmatised (rejected by their families and communities), so they hide their illness.

NOTE !
The case of Gugu Dlamini is a terrible example of the prejudice in communities towards HIV positive people. Gugu Dlamini was murdered by people in her community because she announced that she was HIV positive.

Most discrimination against people living with HIV or AIDS is based on ignorance and fear.

HIV and AIDS is also linked to power in society. Usually it is the least powerful people who are most at risk, for example:

To act against the ignorance, fear and power linked to HIV and AIDS, there is a need to teach people how to avoid HIV. But it is also important to encourage them not to turn against those who are HIV positive.

There is also a need to make it easier for people to be open, to go for tests, and to get proper health care. HIV must be treated as an illness and not a shame that must be kept hidden and secret. Communities need to become more caring towards people with HIV and orphans of people who have died from AIDs-related illnesses. They also need to take more responsibility for preventing the spread of the disease.

How does poverty help spread HIV?

Where people don't have a basic education or access to radio or TV, it is hard to teach them about HIV and how to avoid passing on the virus. It is also difficult to change the sexual behaviour of people who live in desperate poverty in order to prevent HIV infection.

In addition, very poor people cannot afford the basic requirements for a healthy lifestyle - such as healthy food, a clean environment and  clean water. They also cannot afford the costs of basic health care - transport to clinics/hospitals, medicines, anti-retroviral drugs, etc - unless the government makes these accessible to them.

So, it is clear that poverty cannot cause HIV or AIDS, but poor people are more at risk of HIV infection and of developing the disease more quickly.

HIV is mostly passed from one person to another in these ways:

Besides these ways, HIV is very difficult to pass on. It is impossible to pass on HIV through kissing, sharing knives, forks and cups, toilet seats, swimming pools, and so on. The virus has to pass from one person's blood to another person's blood.

This chapter explains the legal and human rights of all people who are living with HIV or AIDS. Each section in this chapter says what steps people can take to protect their rights in different situations

At the end of the chapter there are typical problems people have to face about HIV and AIDS. We discuss what steps people can take to deal with each problem, and refer you to the relevant information in the manual.



HIV and AIDS and the Bill of Rights

Our Constitution has a Bill of Rights. These rights apply to all people living in South Africa and they must be respected by the courts, parliament, private organisations and individual persons.

The Bill of Rights includes civil rights such as the right to vote, the right to freedom of speech, and socio-economic rights like the right to access to food and health care services.

Socio-economic rights are important because they can help to improve the living conditions of people living with HIV or Aids. They say what rights people have to basic health care, education, social services, shelter, and so on. The government has a duty to make it possible for people to use their socio-eonomic rights. But it must do this within its available resources. In other words, the government must provide what it can afford. But, if it cannot afford to provide for these rights immediately, it must show that it has a plan to do so in the future.

NOTE !
Children living with HIV and AIDS cannot be discriminated against at school.

Any person or organisation has the right to go to court to claim or defend all these rights, either for themselves or for other people.

The Equality Clause

One of the most important rights in the Bill of Rights is the right to equality. This is called the 'Equality Clause'.

Under the Constitution, equality means that everybody shares the rights and freedoms that are listed in the Bill of Rights.

THESE REASONS CANNOT BE USED FOR DISCRIMINATION

The Equality Clause lists 17 reasons that people are not allowed to use to discriminate against another person. These are: Race, Gender, Sex, Pregnancy, Marital Status, Ethnic Origin, Social Origin, Colour, Sexual Orientation, Age, Disability, Religion, Conscience, Belief, Culture, Language and Birth

The government has passed a law that will enforce equality. This law is called the Promotion of Equality and Prevention of Unfair Discrimination Act (No 4 of 2000). The Act spells out what types of discrimination is against the law and how people can be compensated if they have been discriminated against.

The Equality Act does not list HIV and AIDS status separately as a ground for non-discrimination on the basis of disability. But the Act does recognise that HIV and AIDS status leads to discrimination. It says the courts must decide in each case whether HIV and AIDS should be regarded as a dis-ability or as discrimination as a separate ground.

Does the equality clause protect people Living with HIV or AIDs?

The Equality Clause says that people with disabilities should not be discriminated against. The question is : is living with HIV or AIDS a disability? Disability is not the same as incapacity which means that a person cannot do a job properly

Some people say HIV and AIDS should be protected on grounds of disability under the equality clause and Equality Act  because:

People with disabilities are generally discriminated against in our society. But people living with HIV or AIDS are disabled by a condition or illness that makes them suffer the same kinds of handicaps or discrimination which other people with disabilities experience. Attitudes from people in society and restrictions in employment are two examples of this. . So, people living with HIV or AIDS need to be protected from discrimination in the same way as other people who are disabled.

Some people also believe that HIV should be treated as a separate listed ground for non-discrimination under the Equality Act because:

Protecting rights

Protecting and enforcing your rights means using and claiming your rights to protect yourself. People can do this by going to court, or to other bodies such as the Public Protector, the Equality Court and the South African Human Rights Commission.

WHAT THE RIGHTS MEAN FOR PEOPLE LIVING WITH HIV OR AIDS

Section in the
Bill of Rights
RIGHTWHAT IT MEANS FOR YOU IF YOU ARE LIVING WITH HIV OR AIDS
10Human dignity
Everyone has inherent dignity and the right to have their dignity respected and protected
A person or institution, such as hospital or company, may not insult or take away your self-respect, by their words or actions.
12Freedom and security of person
Includes the right to:
  • make decisions about reproduction
  • security and control over your body
  • not be subjected to medical or scientific experiments without your informed consent
You have the right to take your own decisions about medical treatment and pregnancy e.g. you cannot be forced to have an HIV test. You may not be treated in a cruel or degrading way by any person or institution.
14Privacy
Everyone has the right to privacy.
You have the right to keep the fact that you have HIV or AIDS to yourself. An employer or hospital cannot force you to tell them, or force you to have an HIV test.
16Freedom of expression
Everyone has the right to freedom of expression, which includes freedom to receive or impart information or ideas.
Proper information can be made available in schools or prisons about how to prevent HIV.
18Freedom of association
Everyone has the right to freedom of association.
You can join any organisation you choose. You cannot be forcefully separated from other people.
21Freedom of movement and residence
Everyone has the right to:
  • move about freely
  • enter, remain in or leave the country
  • reside anywhere in the country
You are free to move around the country. You cannot be forced to live in a separate place, away from the rest of society.
22Freedom of trade, occupation and profession
Every citizen has the right to choose their work freely.
You can choose what kind of work you want to do e.g. you may not be told that you cannot be a teacher or a health care worker.
23Labour relations
Everyone has the right to fair labour practices.
You may not be unfairly discriminated against at work.
24Environment
Everyone has the right to an environment that is not harmful to their health or well-being.
This right may be important for people living in a state institution such as a prison or psychiatric hospital.
26Housing
Everyone has the right to have access to adequate housing. No-one may be evicted from their home, or have their home demolished without a court order.
You may not be refused a subsidy or loan to buy a house because you have HIV or AIDS. It is unlawful to evict you from your home because of your health.
27Health care, food, water and social security
No-one may be refused emergency medical treatment.
Everyone has the right of access to:
  • health care services, including reproductive care
  • social security, including appropriate social assistance if they are unable to support themselves and their dependants
Hospitals or medical people cannot refuse to treat you.
You have the right to a disability grant if you are too ill to support yourself or your family.
29Education
Everyone has the right to a basic education, including adult basic education.
You have the same right as anyone else to education. A school cannot refuse to educate you or your child because you have HIV or AIDS.
32Access to information
Everyone has the right to see any information held by another person that they need in order to exercise or protect their rights.
If for example you feel your rights are being violated because of a company policy, you can demand to see the policy and may then  challenge it in court. You have the same right with private institutions or the state , for example an organisation, or your medical records at a state hospital.
33Just administrative action
Everyone whose rights have been negatively affected by administrative action, has the right to be given written reasons. This includes reasons for very long delays.
If you believe that you are being refused a social service (e.g. a house or education) for unjust reasons, you can demand to get the reasons in writing. You may then decide to challenge the decision.
35Arrested, detained and accused people
Everyone who is detained, including every sentenced prisoner, has the right to conditions of detention that are consistent with dignity.
Prisoners cannot be discriminated against or treated in an undignified way just because they have HIV or AIDS.

Acknowledgements, HIV and AIDS & The LAW: A Resource Manual, 2nd edition.
The Aids Law Project & The Aids Legal Network



Health and Medical Rights

Many people living with HIV or AIDS complain that they are treated badly at hospitals and clinics. Sometimes medical staff even refuse to treat patients who have HIV or AIDS. People also complain that information about their illness is not kept confidential.

Health care workers also have rights, including the right to a safe working environment, while patients have rights to:

Confidentiality

Confidentiality means that doctors, nurses, psychologists, dentists and other health care workers have a moral and legal duty to keep all information about patients confidential. Any information about the patient's illness or treatment cannot be given to another person unless:

EXAMPLE

In the well-known McGeary case, the Supreme Court of Appeal said that a doctor cannot tell other doctors about the HIV status of a patient without the patient's consent.

Mr McGeary applied for a life assurance policy. The insurance company told him to have an HIV test before they could approve his application. The doctor got the results of the test told McGeary that he was HIV positive.

The next day the doctor played golf with another doctor and a dentist. During the game they discussed AIDS and McGeary's doctor told the other two that McGeary was HIV positive.

The news of McGeary's condition spread around the small community. McGeary began a civil claim to get compensation from his doctor for breaking his rights to confidentiality. The Court said the doctor had to pay McGeary compensation for breaking his right to confidentiality.

SOME RULES ABOUT CONFIDENTIALITY

Telling other health care workers

A health care worker must get a patient's permission before giving any of that patient's medical information to another health care worker or to another health care centre.

Telling a patient's sexual partner

A health care worker may not tell the patient's sexual partner that the patient has HIV, unless the partner appears to be at risk because the patient refuses to practise safer sex. The health care worker must counsel the patient on the need to tell their sexual partner and to practise safer sex. The health care worker must then warn the patient that if he or she does not tell their sexual partner or practise safer sex, then the health care worker will have to tell the partner about the person's HIV status.

Telling a court

A court can order a health care worker to give them confidential information.

HIV and AIDS AS NOTIFIABLE DISEASE

A notifiable disease means that health care workers have to keep statistics about the number of cases they see, and inform the health authorities. Because AIDS is not a notifiable disease, a health care worker does not have to report it to the health authorities when a person is diagnosed with AIDS or when someone dies of AIDS The Department of Health sent out draft regulations in April 1999 to make Aids a notifiable disease but these have not been passed as law.

CONFIDENTIALITY AND OPENNESS

HIV and AIDS is often not an open issue, mainly because people living with the disease fear the negative label society gives to it and the discrimination that they may suffer. This makes it very difficult for them to come forward and tell others about their illness. People should be encouraged to be open about their HIV status, so that society becomes less prejudiced and more aware of the epidemic.

Being open about your HIV or AIDS status means that you choose to tell certain people, but you do not lose your right to confidentiality with a doctor, nurse, health care worker or employer, for example. Your personal right to privacy and confidentiality must still be respected. It is your choice to tell others, and to choose who tell.

NOTE !
Being open about your HIV or AIDS status does not mean that you lose your right to confidentiality with a doctor, nurse, health care worker, or employer, for example. Your personal right to privacy and confidentiality must still be respected.

What can you do if a health care worker abuses your right to confidentiality?

You can complain to the Health Professions Council of South Africa (HPCSA). You can also make a civil claim for damages (compensation) against the health care worker, hospital or clinic, or any member of the public who has abused your rights.

The HPCSA has published ethical guidelines on the treatment and management of patients with HIV. You can contact them for information on these guidelines.

HIV testing and informed consent

Every person has the right to privacy, dignity, respect, to make their own decisions and to protect themselves from harm done by others.

This means that each one of us has the right to have our own decisions about our body treated with respect. In other words, no patient can be given medical treatment without their consent.

Consenting to medical treatment has two parts to it: information (understanding) and permission (agreeing) This means you:

With an HIV test, you must know what the test is, why it is being done and what the result will mean for you before you agree to the blood sample being taken. This is called pre-test counselling. After the HIV test results have been received you must be counselled again to help you understand and accept the effect that a negative or a positive result will have on your life. This is called post-test counselling.

EXAMPLE

Thami is a care-giver in a children's home. The matron informs him that all staff in the hospital must have a Hepatitis B test.

Thami agrees to this. But, the hospital does an HIV test too, saying it saves time and money to do both tests at the same time. The matron tells Thami he is HIV positive. Thami is furious because he only gave permission for the Hepatitis B test.

The matron did not have a right to do the test. She should have discussed it with Thami first and obtained his consent.

The Department of Health's National policy on Testing for HIV (2000) says the patient should:

Some rules about HIV testing and consent

Here are some rules to remember :

Exceptions to the rule of informed consent

These are the only exceptions to the rule that a person must give their consent to treatment or an operation:

Who can give consent?

Adults who are of sound and sober mind can give consent to medical treatment. Children over 14 can also give their own consent to medical treatment.

What can you do if an HIV test was done without your consent?

If an HIV test was done without consent, your rights have been abused.

You can complain to the Health Professions Council of South Africa (HPSCSA). You can also bring a civil claim for invasion of privacy, and a criminal charge of assault against the health care worker or the person they were acting on behalf of.

CASE STUDY

In the case of 'A' v South African Airways (SAA), in the Johannesburg Labour Court, 'A' had applied for a job with SAA as a cabin attendant. He was asked to sign a consent form for an HIV test, but the test was not explained to him.

'A' was therefore tested without informed consent and without any pre- or post-test counselling.

SAA admitted that they had not followed the rules regarding testing and informed consent. The court ordered them to pay compensation to 'A'

The right to health care and medical treatment

The Constitution gives every person the right of access to health care services and medical treatment. This includes having access to affordable medicines and proper medical care.

For many people the new Medicines and related Substances Control Amendment Act of 1997 (Medicine's Act) will help towards making medicines more affordable for people.

The government is obliged to improve access to health care services, including essential medicines. The Treatment Action Campaign (TAC) has been lobbying and taking legal action to have cheaper HIV and AIDS drugs imported into South Africa.

Government has a responsibility to promote the nation's health. It must provide fully-staffed hospitals and clinics, as well as medicines, to give health care services to everyone.

The right to access to health care services includes the right to proper care from a health care worker. It is against the law for a health care worker to :

The Department of Health has developed policy guidelines for managing and treating patients with HIV and AIDS. Every patient living with HIV/-AIDS has a right to these treatments.

If a hospital or clinic refuses to treat someone living with HIV/ AIDS, they can be reported to the Department of Health or the Public Protector. The case can also be taken to the High Court, which can review and cancel the hospital's decision to refuse to treatment.



Rights at work

Laws that give people rights at work

Workers living with HIV and AIDS are often discriminated against by their employers, supervisors or colleagues (other employees). The following are some of the different laws that give people rights at work.

The Constitution

The Constitution gives all employees the right to be treated fairly at work. The Bill of Rights says:

The Labour Relations Act (LRA)

The LRA gives employees the right to be treated equally. It is an unfair labour practice to discriminate against an employee on any grounds, including, race, gender, sex, colour, sexual orientation, age, disability, religion, conscience, sexual orientation, belief, political opinion, culture, language, marital status or family responsibility.

Discrimination is 'automatically unfair' if it breaks any of the basic rights of employees. If a person is discriminated against because of their disability for example, this is automatically unfair and the case will go to the Labour Court. (See case-study overleaf Hoffman v South African Airways, 2000.)

The Employment Equity Act (EEA)

The Employment Equity Act of 1998 aims to create equality in the workplace by prohibiting unfair discrimination on the same grounds listed in the Constitution and the Labour Relations Act (LRA). Both the Constitution and the LRA protect people living with HIV and AIDS from being treated unfairly in at work, because both laws say it is against the law to unfairly discriminate against a person with a disability.

The EEA is more specific about the rights of people living with HIV or AIDS. The EEA explicitly prohibits unfair discrimination against people at work on grounds of their HIV status.

The EEA prohibits testing for HIV in the workplace unless this is authorised by the Labour Court. If any employer (state or private) wants to test a person for HIV before employing her/him, they will have to get permission from the Labour Court to do this.

CASE STUDY

Hoffman v South African Airways (2000)

Mr Hoffman applied for a job as a cabin attendant with South African Airways (SAA) and was asked by SAA to go for an HIV test. The test showed that he was HIV positive. SAA refused to give Mr Hoffman the job because, they said, part of his job involved travelling to different countries and he would need to have a yellow fever vaccination. It is not advisable for someone with HIV to have these vaccinations. SAA said that this was an inherent requirement of the job (essential for the job) in the airline and therefore they couldn't employ him.

The case was referred to the Constitutional Court. The court was asked to decide if SAA had gone against Hoffman's rights to equality, dignity and fair labour practices.

The court decided:

  • that SAA had discriminated against Hoffman
  • the discrimination was unfair and infringed his dignity
  • being HIV negative was not an inherent requirement of the job of being a cabin attendant; they should have taken greater steps to investigate how Hoffman's immune system could have dealt with travelling and the possibility of getting a strange disease.

The EEA doesn't cover members of the South African National Defence Force, the Secret Service or the National Intelligence Agency. But members of these organisations can still take their cases to the Constitutional Court.

The Occupational Health and Safety Act and Mine Health and Safety Act

Sometimes an accident at work can cause a bleeding injury. If the injured person is HIV-positive and someone who tries to help him or her also has an open wound, there is a small chance of the helper becoming infected if his or her wound comes into contact with the injured person's blood. The employer has a responsibility to make sure that the workplace is safe and that employees are not at risk of HIV infection at work.

There are new regulations issued by the Department of Labour which say:

Compensation for Occupational Injuries and Diseases Act (No 130 of 1993) (COIDA)

COIDA gives employees the right to compensation if they are injured or become ill at work. If you get infected with HIV because of a workplace accident, you can claim for compensation.

The Medical Schemes Act No 131 of 1998 and Regulations: Government Gazette 20556, 20 October 1999

Medical aid as a form of insurance is an important employee benefit in the workplace. In the past, the majority of medical schemes refused to cover illnesses that were linked to HIV infection.

The Medical Schemes Amendment Act of 1998 prohibits discrimi-nation on the grounds of 'state of health'. This covers a person living with HIV or AIDS. It means that the medical scheme cannot refuse to cover reasonable care that could prolong the health and lives of people living with HIV or AIDS

The Medical Schemes Act came into operation on 1 January 2001. The Act stops medical schemes from discriminating against people living with HIV or AIDs by saying:

Some rules about HIV and AIDS and rights at work

The Employment Equity Act prohibits testing for HIV in the workplace unless this is authorised by the Labour Court. An employer cannot :

Other rules that apply are :

Code of Good Practice on HIV and AIDS and employment

The Department of Labour has published a 'Code of good practice on key aspects of HIV and employment under the Employment Equity Acts. This Code gives employers and trade unions guidelines to ensure that people who are HIV-positive are not unfairly discriminated against in the workplace. This includes provisions dealing with:

The Code also provide guidelines for employers, employees and trade unions on how to manage HIV and AIDS in the workplace. This is based on the fact that the HIV and AIDS epidemic can affect the workplace and people working there on a number of different levels. These guidelines look at the problem as a whole. It requires people to take all factors into account when managing HIV in the workplace, for example:

For a copy of the Code, see website: www.labour.gov.za/docs/aids/index.htm

What happens if you become too ill to work?

NOTE !
Eventually, many people with HIV start to become ill and their capacity to work is affected. In other words, because of their illness they are not able to do the job properly. So, the employer can dismiss them (including a person with AIDS) on grounds of incapacity.

All employees have a right to sick leave and an employer has no right to discriminate against or dismiss an employee who uses these rights. The Basic Conditions of Employment Act says an employee can have 6 weeks paid sick leave over any 3-year cycle.

But, an employer is allowed to dismiss an employee on grounds of incapacity and poor work performance, even if the employee has not used all their sick leave. This means, if an employee is unable to do their job properly because of their illness then the employer will eventually be able to dismiss them.

There are very clear guidelines for employers to follow when they want to dismiss an employee for incapacity. For example, the employer must see whether the incapacity is going to be permanent and must also investigate alternative employment. for the employee.

What can you do to protect your rights at work?

Employees can take disputes about dismissals or discrimination to a Bargaining Council or the Commission for Conciliation, Mediation and Arbitration (CCMA). The Bargaining Council or CCMA will try to settle the dispute by conciliation, mediation or arbitration.

Cases about unfair discrimination and automatically unfair dismissal will be referred to the Labour Court. Employees can appeal against decisions of the Labour Court by going to the Labour Appeal Court.

SUMMARY OF RIGHTS OF EMPLOYEES WITH HIV OR AIDS

RIGHT

Right to fair labour practices

LAW

The Constitution
The Labour Relations Act (LRA)

Right not to be unfairly dismissed because you have HIVThe Labour Relations Act (LRA)
Right not to be unfairly discriminated against on the basis of your HIV statusEmployment Equity Act (EEA)
Right not to be tested for HIV unless your employer has applied to the Labour Court for authorisationEmployment Equity Act (EEA)
Right to a safe working environmentOccupational Health & Safety Act, and Mine Health & Safety Act
Right to compensation if infected with HIV at workCompensation for Occupational Injuries and Diseases Act (COIDA)
Right to certain basic standards of employment, including 6 weeks of paid sick leave over a 3-year periodBasic Conditions of Employment Act (BCEA)
Right to no unfair discrimination in giving employee benefitsMedical Schemes Act
Right to privacy about your HIV status at workCommon law right

Acknowledgements to HIV and AIDS and the Law: A Resource Manual, 2nd Edition. Published by AIDS Law Project & The AIDS Legal Network



Women and HIV and AIDS

Women are seriously affected by HIV and AIDS. Gender discrimination causes women to be treated differently from men in many spheres of life. Women are also at great risk of being infected by HIV because:

The right to equality

The Bill of Rights has an equality clause which says it is against the law to discriminate against a person on certain grounds, for example gender, sex, sexual orientation and pregnancy.

A Commission on Gender Equality has been set up to monitor and investigate issues on gender equality and to stop discrimination against women. Complaints involving discrimination can also be sent to the South African Human Rights Commission.

Rape

The law defines rape as intentional, unlawful sexual intercourse with a woman without her consent. Rape is an act of violence against women.

HIV infection because of rape

If a woman has been raped she may want to be tested for HIV to find out if she is HIV negative at the time of the rape. She can ask the district surgeon to do an HIV test on her. Even if the result is negative, she should go for another test after 3 or 4 months. In this way she will be able to prove that she was infected by the rapist.

She should report this to the prosecutor in her case who will be able to raise it in court. If a rapist is found by the court to be HIV positive, and he knew of his HIV status before the rape, this could be used to give him a harsher sentence.

A rape survivor can also make a civil claim against a rapist. If she has been infected with HIV during the rape, and she can prove this, she can make a claim against the rapist for her medical expenses and for pain and suffering because of the rape.

Marital rape (rape in a marriage)

Any sex against the wishes of a woman is rape, including in a marriage. A woman can lay a criminal charge of rape against her husband under the 1993 Prevention of Family Violence Act.

Abortion

There are many reasons why some women are not able to, or do not want to, continue with a pregnancy. In these situations some women choose to end their pregnancies early by having an abortion. The Choice of Termination of Pregnancy Act says that woman can have an abortion. So, women living with HIV can apply for an abortion.

SOME POINTS ABOUT ABORTION
 A woman cannot be forced to have an abortion because she has HIV.
 Every person has the right to have a family, and a hospital must help a woman to understand what abortion is about before they go into the clinic or hospital. Therefore any woman who wants an abortion should get advice from a friend, family member, health care worker or a counsellor.
 A woman does not need her husband's consent before she has an abortion.
 A girl under 18 can have an abortion without the consent or knowledge of her parents. She must be advised by the doctor or midwife to consult her parents, but she is not forced to do this.
 A woman with HIV cannot be sterilised if she doesn't want this.

Sterilisation

A woman with HIV cannot be sterilised unless she agrees to this. All women, including women with HIV, have the right to have children. However, women who are HIV should think carefully about having children as it is possible that the children will also get HIV.

Domestic violence

Domestic violence includes physical and emotional abuse. Most victims of domestic violence are women and children. Women who suffer abuse are usually unable to take control of their relationships and unable to demand safer sex. This puts them at a greater risk of getting HIV.

The Domestic Violence Act protects women by giving them a quick way to apply for a protection order to stop their partner from abusing them again.

Sexual harassment

Sexual harassment is unwanted attention given to you in the workplace, for example, pinching your bottom, staring at your body in an offensive way, touching parts of your body, rude comments or signs, requests for sex, and so on. Sexual harassment is an unfair labour practice and should be reported to a supervisor.

Commercial sex work

Commercial sex workers are vulnerable to HIV because:

Customary law and women's rights

Some customary rules affect the rights of women by giving them less power than men in the community.

For example, a customary marriage gives the husband some wide powers over his wife. He also has control over the property. If they get divorced the husband and his family usually keep the property and he does not have to take care of his ex-wife. If the husband dies, his family, and not his wife, keeps the property .

Rules that make women unequal to men make women more at risk of HIV and AIDS, because they are unable to make their own decisions about their bodies, for example, where they can't demand that their husbands practise safer sex by using condoms.

Customary rules that go against the Bill of Rights can be tested in the Constitutional Court. The courts will have to balance the right to live by customary law with the other rights in the Bill of Rights, especially the right of women to equality.

Virginity testing

Virginity testing is a customary practice usually done on girls. Some people believe that this prevents the spread of HIV and AIDS as it encourages young girls not to have sex - if a young girl knows she is going to have her virginity tested she will be less likely to have sex. Other people say this isn't true and it may have the opposite effect because -

Mother-to-child transmission of HIV

Research has shown that giving an anti-retroviral drug called AZT to HIV-positive pregnant mothers before they give birth decreases the risk of passing HIV on to the baby (this is called mother-to-child transmission). Studies in South Africa have shown that a drug called Nevirapine, which is cheaper than AZT, can also be used to prevent transmission of the virus from a mother to her baby.

Certain provincial governments in South Africa have said they are going to supply Nevirapine to pregnant mothers in all their hospitals and clinics.

The Constitutional Court has said that the national government must make it possible for all pregnant mothers to have access to drugs that will prevent mother-to-child transmission of HIV.



Rights of lesbians & gay men

Gay and lesbian communities have been blamed for the spread of HIV and AIDS. This adds to the discrimination and prejudice against gay people. A gay person with HIV or AIDS might suffer a double burden of discrimination and negative attitudes towards them: because of having the disease and because of being gay.

The Constitution makes it unlawful to unfairly discriminate against someone because of their sexual orientation (who you choose to have sex with).

Lesbians and gay men have all the rights discussed in this chapter, under the Bill of Rights, medical rights, rights at work, the rights of youth, children and prisoners, and they have access to the kinds of social support available. Lesbians may be affected by some of the issues discussed under Women and HIV and AIDS.

EXAMPLE

Our common law and the Sexual Offences Act (No 23 of 1957) used to make sodomy (anal sex between consenting men) a crime.

In the case of National Coalition for Gay and Lesbian Equality (NGCLE) and The South African Human Rights Commission v The Minister of Justice (1999) the Constitutional Court said these laws discriminated against gay men because of their sexual orientation and they were therefore unconstitutional.

The Sexual Offences Act makes the age of consenting to sex different for lesbian and gay youth. For heterosexuals the age of consent is 16, but for same-sex relations the age of consent is 19.

Because of laws like these and general prejudice and discrimination against gay and lesbian people, important ways of educating people about HIV and AIDS are lost.. For example, sexuality education in schools ignores or avoids discussion about lesbian or gay relationships. Most of the HIV or AIDS prevention materials aimed at school students do not discuss same-sex relations.



Rights of children & youth

The Constitution and the Bill of Rights protects children (anyone under the age of 18) by giving them the right, among others to be cared for, to have food to eat, to be protected, given proper health care and education.

How does HIV affect children?

HIV can affect children in the following ways:

What are the consequences for children?

Children who have HIV or whose parents are ill because of HIV or AIDS are often discriminated against by people in the community. Many suffer from neglect or are abandoned as babies. Children are refused access to crèches, some are refused entry into schools and students are excluded from getting bursaries. Orphans of parents who have died from AIDS are particularly vulnerable. Many of them turn to crime, drugs, or to the streets in order to survive.

How are children protected by the law?

Children are protected by various international, regional and local human rights documents :

EXAMPLE

SOME RIGHTS OF CHILDREN IN INTERNATIONAL DOCUMENTS ON CHILDREN'S RIGHTS

Children have the following special rights spelt out in these human rights documents:

  • the right to family care or parental care
  • the right to appropriate care (if they are removed from their parents)
  • the right to basic health care services
  • the right to basic shelter
  • the right to basic social services
  • the right to be protected from abuse or bad treatment
  • the right to be protected from child labour
  • the right to a basic education

Access to education

The Constitution says everyone has the right to basic education. If a child is stopped from going to school because of his or her HIV status, this is unlawful and can be challenged in court.

HIV is never passed on through casual contact. It is very difficult for children of any age to get HIV from contact at school. Therefore the risks of infection of other children cannot be used as a reason to exclude children with HIV from a school.

Parents do not have to tell the school authorities if their child has HIV, even if the school asks them to fill this in on the application form.

NOTE !
HIV is never passed on through casual contact. It is very difficult for children of any age to get HIV from contact at school. Parents do not have to tell the school authorities if their child has HIV.

Right to sexuality education

Sexuality education means teaching young people about the human body, the changes that their bodies go through when they are teenagers and how to respond to feelings for another person. Young people also learn about what sex is, the different kinds of sexual choices, how babies are made, and why and how to use condoms and other contraceptives. Sexuality education includes teaching about safer sexual practices to prevent HIV and other sexually transmitted diseases (STDs).

The Convention on the Rights of the Child, which South Africa has signed and agreed to follow, says that a child should be given information that will help the child to develop her or his physical and emotional well-being. Sexuality education and information about HIV and AIDS is part of this.

Children's health and medical rights & HIV and AIDS

Rules regarding testing and confidentiality for children include:

Adoption and fostering

The Child Care Act does not say that parents must have a medical examination before getting permission to adopt a child.

But Child Welfare will not allow someone to adopt a child before they have gone through a medical examination. Child Welfare says the following people must have an HIV test before adoption can happen:

Fostering is usually for a short period so children are not tested for HIV before they are fostered.

Some rules about HIV and AIDS and adoption or fostering

Remember the following points when dealing with cases of adoption or fostering :



Rights of prisoners

Prisoner's rights are also protected by the Constitution. Awaiting-trial prisoners or people who have been sentenced lose some of their rights, such as freedom of movement, but they keep other rights such as the right to dignity. The Bill of Rights gives prisoners certain specific rights. In many cases, prisoners with HIV or AIDS are discriminated against, for example having information about their condition disclosed.

Some rules about prisoners and HIV and AIDS

These are some rights that prisoners have :

EXAMPLE

In the case of Van Viljon and Others v Minister of Correctional Services (1997), the High Court ordered the Department of Correctional Services to provide combination anti-retroviral drugs to two prisoners because the doctor had prescribed these drugs for them. This case makes it clear that if a doctor has prescribed anti-retroviral drugs, the Department of Correctional Services must provide them.

The rights of accused people

Accused people are people who have been charged with crimes but who have not yet been found guilty or not guilty.

Can an accused person be forced to have an HIV test?

Based on the right to privacy and freedom and security of the body, an accused person cannot be forced to have an HIV test.

But the South African Law Commission has recommended that the victim of a sexual crime should be able to apply to a magistrate to have the accused tested for HIV and the result should be told to the victim if -

Bail and sentencing for rape accused with HIV and AIDS

All accused people have a right to apply for bail. However, where the crime is very serious, the law makes it more difficult to get bail. The Criminal Procedures Second Amendment Act (no 85 of 1997) says what the conditions are for granting bail if a serious criminal offence has been committed, for example, rape - particularly where the accused knew that he was HIV positive or had AIDS at the time of the rape. The Act says a person accused of rape cannot get bail, unless he can show very good reasons why it is in the interests of justice that he is given bail.

The Criminal Law Amendment Act (No 105 of 1997) sets down minimum sentences for people who would previously have received the death sentence. The minimum sentence for a person living with HIV or AIDS who is convicted of rape, is life imprisonment. This is much higher than the minimum sentence of 10 years imprisonment for a person convicted of rape who is not living with HIV or AIDS



Social support: living with HIV and AIDS

The Bill of Rights says everyone has the right to have access to social security. If people are unable to support themselves and their dependants they have the right to social assistance.

People living with HIV are able to work and support themselves during the first phases of their illness. However, eventually many people with HIV become sick and unable to look after themselves.

There are different kinds of assistance available to people who are unable to work. The state and welfare organisations provide small sums of money. Some non-governmental organisations (NGOs) give support like food, items of clothing or emergency housing. The Social Assistance Act (No 59 of 1992) is the law which says when and how people can qualify for government assistance. It aims to protect people who cannot work because of old age, illness or a physical or mental disability. When people living with HIV or AIDS become unable to support themselves and their families, the Act says that the government should provide some assistance to them.

There are different types of social grants available to people:

The government has said that people living with HIV or AIDS will qualify for social security and assistance such as nutrition, transport, rent, burial costs and school books, where necessary.

Can a person living with AIDS get a disability grant?

The Act says that you can apply for a disability grant if you:

You can only qualify for a disability grant if the disability stops you from working, a person who has HIV or an AIDS-related illness will only get a disability grant if they become too sick to work. If that person is unemployed but still fit for work, they will not get a grant. The Department of Social Development will look at the medical report to make sure that the disability will stop the person from working for more than 6 months. Usually, a person will lose their grant if they become healthy enough to work.

The grant is R700 a month (in July 2003).

NOTE !
You cannot get a grant if you are unemployed but still fit for work

How to apply for a disability grant

To apply for a disability grant, you must go to the nearest Department of Social Development or Pension office.

You must take these documents with you:

At the Welfare office you must fill in an application form in front of a government official. You and the official must sign the form together. You are given a copy of the form.

If you are too sick to apply for the grant yourself, you can ask another person to go to the office on your behalf. That person will need to fill in your details on the form.

Applications usually take three months to process. The Department of Social Development will decide whether you have a disability and whether this prevents you from supporting yourself.

See Page 858 ‘Fast-tracking grants

Grants-in-aid

A grant-in-aid is help in the form of nursing care. This grant is given to people who are too sick to take care of themselves at home. When a person applies for a grant-in-aid, they must bring the same forms to the Department of Social Development as they would for a disability grant.

Other forms of relief

Medical costs

Most public hospitals give medical care for people living with HIV on a sliding scale. This means each person pays according to what they can afford. Pregnant women and children below the age of 6 years can get free medical services.

Child support

Under the Social Assistance Act the following grants are available for the support of children, including children living with HIV, or whose parents are living with HIV or AIDS :



Department of Health plan for HIV and AIDS

The Department of Health has developed a strategic plan for the years 2000-2004. The plan focuses on speeding up quality health service delivery. The plan has a strong focus on HIV and AIDS.

The goals of the plan

The goals of the plan are to reduce the number of new HIV infections, particularly among youth, and to reduce the impact of HIV and AIDS on individuals, families and communities.

Key objectives

The department aims to achieve their goals in the following ways:

Priority areas

The strategic plan will focus on four priority areas:

Prevention

Ways to prevent the spread of the disease are to

Treatment, care and support

The aims of this focus area are to

Monitoring and evaluation

This focus area concentrates on research and monitoring and aims to

Human Rights

This area focuses on the protection and enforcement of people's rights. It aims to

Guiding principles

The strategic plan is guided by a set of principles which include:

For more on the 5-year strategic plan, see the website www.hst.org.za/doh/stratplan such as at workplaces

The government’s plan for comprehensive treatment and care for HIV and Aids in South Africa – the roll-out plan for anti-retroviral drugs for treating people with HIV

The government has approved a plan, which includes providing people with anti-retroviral treatment in government hospitals and clinics, as part of its broader plan to fight HIV and Aids. The Department of Health has been given instructions to start implementing the plan.

According to the Plan there must be, within a year, at least one service point in every health district across the country. These service points must give people access to ongoing care and treatment. Within five years there must be a service point in every local municipality. The care and treatment of people living with HIV includes providing them with traditional health treatments and also anti-retroviral treatment for people who need it. In order to qualify for anti-retroviral treatment a person’s physical condition must be certified by a state doctor.

To provide people with this kind of care, the Plan looks at employing thousands of health professionals and a large training programme to make sure that all health-care workers, doctors and counsellors have the knowledge and the skills to ensure safe and effective use of medicines.

A specific budget has been allocated to the programme. This consists of ‘new money’ which means the programme will not take away money from other programmes of health care and social services. Over half of the budget that will be spent over the next five years in implementing the programme will go toward upgrading health facilities and infrastructure. The focus will be as much on educating people about prevention and on promoting a healthy lifestyle as on providing appropriate medical treatment.



RESOURCES

Department of Health and HIV and AIDS Department

website  www.health.gov.za
website  www.aidsinfo.co.za

Treatment Action Campaign (TAC)

website  www.tac.org.za

Aids Law Project
Telephone  (011) 717 8600
Fax  (011) 403 2106
Postal Address  The Co-ordinator, Centre for Applied Legal Studies,
Private Bag 3, University of the Witwatersrand, South Africa
e-mail  alpadm@law.wits.ac.za
website  www.hri.ca/partners/alp/

AIDS Consortium

Telephone  (011) 403 0265
Fax  (011) 403 2016
website  www.aidsconsortium.org.za

AIDS Legal Network

Telephone  (021) 423-9254
Fax  (021) 423-0891
Postal Address  P.O Box 6358, Roggebaai 8012
e-mail  aln@kingsley.co.za

Aids Training and Information Centre (ATIC)

Cape Town
Telephone  (021) 797 3327
Fax  (021) 797 3356

Durban
Telephone  (031) 300 3104
Fax  (031) 306 9294

East London
Telephone  (043) 705-2620
Fax  (043) 705 2620

Mpumulanga
Telephone  (013) 759 2167
Fax  (013) 759 3770

Pietermaritzburg
Telephone  (033) 395 1612
Fax  (013) 342 3245

Port Elizabeth
Telephone  (041) 506 1415
Fax  (041) 506 1486

Health Professions Council of South Africa (HPCSA)

Telephone  (012) 338 9033
Fax  (012) 328 5120
Postal Address  The Registrar, Health Professions Council of South Africa,
P.O Box 205, Pretoria 0001

Department of Health

Life Line manages the AIDS helpline for the Department of Health. Contact your nearest provincial Life Line office to find out the number of the Life Line centre nearest to you.

Aids Helpline Toll-free (0800) 012-322

Life line regional offices telephone numbers

Alexander
Crisis
(011) 443 5026
Cape Town
Guguletu
Office
(021) 638-5125
Khayelitsha
Crisis
Office

(021) 361-9077
(021) 361-5855
Durban
Crisis
Office

(031) 312-2323
(031) 303-1344
East London
Crisis
Office

(043) 722-2000
(043) 743-7266
Free State
Crisis
Office

(057) 352-2212
(057) 357-2746
Johannesburg
Crisis
Office

(011) 728-1347
(011) 728-1331
Tshepo-Themba Soweto
Crisis
Office

(011) 988-0155 / 6
(011) 988-0155 / 6
Mafikeng
Crisis 
Office 

(018) 381-4264
(018) 381-0976
Pietermaritzburg
Crisis 
Zulu crisis line 
Office 

(0331) 944-444
(0331) 456 161
(0331) 424-447 or 425-929
Pretoria
Crisis 
Office 

(012) 342-2222
(012) 342-9000
Vaal Triangle
Crisis 
Office 

(016) 428-1640
(016) 428-1740
West Rand
Crisis 
Office 

(011) 953-4111
(011) 665-2281 or 665 2111
Zululand
Crisis 
Office 

(035) 753-3333
(035) 753-4307
Southern Africa
Office 

(011) 781-2337
e-mail  national@lifeline.org.za
Council for Medical Schemeswebsite  www.medicalschemes.com
Rape Crisiswebsite  www.rapecrisis.org.za
SANTA (South African National Tuberculosis Association)
Main Regional Centres
Cape Town
Telephone  (021) 712-7491
Fax  (021) 712-4435
Durban
Telephone  (031) 577-1215
Fax  (031) 577-1265
East London
Telephone  (043) 736-9850
Fax  (043) 736-9857
Grahamstown
Telephone  (046) 622-3524
Fax  (046) 636-1042
Pietermaritzburg
Telephone  (033) 398-1038
Fax  (033) 398-1050
Port Elizabeth
Telephone  (041) 372-1011
Fax  (041) 372-1987
Pretoria
Telephone  (012) 386-5189
Fax  (012) 386-2854
Soweto
Telephone  (011) 938-8070
Fax  (011) 933-1435

Acknowledgement

The contents of this chapter were originally based on relevant chapters in the publication HIV and AIDS and the Law, by the AIDS Law Project and Lawyers for Human Rights. It was first published in May 1997 and a 2nd edition came out in 2001. The book has detailed information on the sections in this chapter. The cost of the book is cheaper for non-profit organisations than for commercial organisations. For more information about the book, you can contact the AIDS Law Project -
Telephone  (011) 717 8600
Fax  (011) 403 2341
e-mail  alpadm@wits.ac.za



PROBLEM 1: Keeping medical information confidential

Dr Vincent is a doctor at Langa day hospital. He tells two other doctors about his patient, Themba's, HIV status. Themba, is very angry about this. He believes Dr Vincent should have kept his HIV status confidential. Themba wants to take action against the doctor.

What are his rights?

Doctors, nurses, health-care workers, and so on have a legal and moral duty to keep information about a patient absolutely confidential.

What can you do?



PROBLEM 2: Entry to school refused

The principal of the local high school, Mrs Shabangu, refuses to admit a student, Melanie, to the school because Melanie is HIV positive.

What are her rights?

It is an act of discrimination to keep a child out of a school because of their HIV status.

What can you do?

You can help Melanie and her parents write a letter of complaint to the South African Human Rights Commission about the school's actions. The SAHRC must investigate the complaint. The services of the SAHRC are free.



PROBLEM 3: Dismissing a worker who is HIV-positive

Susan is a machine-operator in a factory. She tells her employer that she is HIV-positive. The employer tells Susan that she will have to leave her job, because the other workers will complain if they find out and he doesn't want any trouble in his factory.

What are her rights?

Everyone has the right to be treated equally and fairly at work. There can be no discrimination against a person because they are HIV-positive. Both the Constitution and the Labour Relations Act protect people living with HIV or AIDS from being treated unfairly.

An employer cannot dismiss a person because he or she is HIV-positive, even if other employees refuse to work with this person.

What can you do?

You can help Susan fill in the correct form for her to refer her case to the Commission for Conciliation, Mediation and Arbitration (CCMA).



PROBLEM 4: Refusing to employ an HIV positive person

Brian applies for a job with the South African Police Services (SAPS). On the application form he fills in that he is HIV positive. The SAPS refuses to employ him and give him no reasons explaining their refusal.

What are his rights?

The SAPS must give Brian reasons why he didn't get the job. The Labour Relations Act says an employer cannot refuse to employ a person because they have HIV. This is discriminating against the person.

What can you do?

You can help Brian find out the reasons why he didn't get the job. If the SAPS refuses to give the reasons, Brian can complain to the Department of Safety and Security.

If the reasons do not seem valid, and Brian suspects that the real reason he didn't get the job is because he is HIV-positive, he can take up a case of an unfair labour practice involving arbitrary discrimination against the SAPS. You can help Brian fill in the correct form to refer his case to the Commission for Conciliation, Mediation and Arbitration (CCMA). The CCMA will investigate the allegation of discrimination.



PROBLEM 5: Making a complaint about being refused medical care

Tina had been in an accident and is a patient at the Lagunya Hospital. Tina agrees to an HIV test. The test is positive.

Tina's wounds need to be treated every day, but the nurse treating her finds out the results of the test and refuses to treat her again. She also tells all the other nurses. They too refuse to touch Tina, and she is left in pain, with bload-soaked bandages for many hours.

What are her rights?

Everyone has the right of access to health care services. It is against the law for a health care worker to refuse to treat a person because they have HIV, or to treat people with HIV differently to other patients.

What can you do?

You can refer Tina to a lawyer to make a civil claim against the health workers or the hospital on behalf of the patient.

You can help Tina draw up an affidavit explaining her complaint. Include the names the health workers involved. Send the affidavit to the relevant medical council which can discipline their members.

Send the affidavit to the South African Interim Nursing Council or the Health Professions Council of South Africa, which has the power to discipline nurses.

If any doctor refused to treat Tina, send the affidavit to the Health Professions Council of South Africa, which has the power to discipline doctors.

You can also help Tina send a letter of complaint to the South African Human Rights Commission (SAHRC).


PROBLEM 6: Applying for a disability grant

Nobantu and Sipho are married with three young children. Both partners are HIV-positive.

Sipho has lost his job because he became too ill to work. The doctor says that he could die within 6 months. Nobantu earns R400 per month doing part-time domestic work but she has also become increasingly ill and her employer has warned her on a number of occasions that she will have to find someone else to do the work.

What does the law say?

Both Sipho and Nobantu are able to apply for a disability grant. The Minister of Social Development has also notified the department that applications from HIV-positive people for disability grants should be 'fast-tracked'. This means that these applications should be given priority and processed faster than any other grant applications.

‘Fast-tracking grants
You should find out from the provincial district office responsible for processing disability grants what the policy is on ‘fast-tracking’ as policies might differ from province to province. However, these are some of the standard rules about fast-tracking.

Both disability grants and care-dependancy grants in respect of children, can be ‘fast-tracked’ for a person who is sick with AIDS. However, only if a person is in stage 4 of AIDS will they qualify to have the grant fast-tracked. If a grant is to be fast-tracked it means it should take no more than five (5) working days to be processed. The procedure for applying to have a grant fast-tracked is as follows:

There is a prescribed medical form that is issued AND stamped by the District Office of the provincial social services department. The person must take this form to a state doctor and not their own private doctor to have it completed. The person either has to take the medical form back to the social services department or the doctor sends it. The grant should then be available within 5 days.

A child dependency grant will only be paid if a child’s physical condition stops him or her from going to school. The child must be in the full-time care of a care-giver at home.

Note!
A person who has HIV goes through four stages during the cycle of the illness. If he/she lives a very healthy lifestyle and boosts the immune system by eating healthy foods and taking food supplements, he/she can remain in stage 1 or 2 of the illness for many years living a normal life. Gradually as the person’s immune system breaks down the CD4+ cell count of the person drops lower and lower. (The strength of a person’s immune system is calculated by their CD4+cell count). The person then goes into stage 3 and if the illness gets worse, stage 4 of the illness when they will be at risk of getting an AIDS-related illness.

When the CD 4+cell count gets to a certain level the person can take anti-retroviral (ARV) treatment to boost their immune system and fight the virus. ARV was previously only available through private doctors. Now the government has agreed that it will make anti-retroviral treatment available to all people who have reached a certain stage of the illness. However a person who wants to receive the treatment must be medically certified by a state doctor. The roll-out plan for making ARV’s available to everyone with HIV will begin this year.

When a person reaches stage 4 of the illness it means that they are very sick and are in the final stages of AIDS.

Reference: See page 848a: The government’s plan for comprehensive treatment and care for HIV and Aids in South Africa



GUIDELINES: Running an HIV and AIDS Campaign

These guidelines will help you to run an HIV and AIDS campaign in your community - when you are planning your campaign you must keep them in mind.

What is the aim of the Campaign?

The aim of the campaign says what you want to achieve at the end of the campaign. To think about your aim ask yourself this question:

What do I want to achieve with this campaign?

So, for example, your aim(s) for an HIV and AIDS campaign could be:

I want to:

How are you going to achieve your aims?

Setting objectives for the campaign

Objectives are more specific than aims; they help you to achieve your aims. You can ask yourself the question:

What must we do to achieve our aims?

Your objectives could be as follows:

To build openness and awareness around HIV and AIDS

We will do this in the following ways -

To educate people about preventing HIV infection

We will try to get people to change their sexual behaviour in the following ways -

To develop community care projects

We will try to help community members living with HIV and AIDS, their families and orphans in the following ways -

Who are we going to target?

The campaign should reach everyone in the community but we can also target specific sectors which are more vulnerable -

The education and prevention part of the campaign

The awareness and openness part of the campaign

These groups are most likely able to influence people's attitudes -

The support and community care part of the campaign

People who need information, care and/or support:

People who can help provide information, care and/or support -

What will our message be?

You need to give the campaign an identity and decide what the main messages will be. For example, the Treatment Action Campaign encourages people to wear T-shirts with the slogan 'HIV-positive' to help bring AIDS awareness to the public.



WORKSHOPS

Community education workshop on HIV and AIDS

Time: 2 hours

Breaking the silence around HIV and AIDS

1.Questions to audience(5 mins)
Ask: Do you know anyone who you think has died of AIDS?
Now ask: Was the fact that the person died from AIDS publicly announced at the funeral?
(Few will put up their hands - use this to lead to the next activity)
2.Buzz groups
Ask people to discuss the following question with two people next to them for five minutes -
Why do you think there is a silence around AIDS?
Do a go-around and ask groups to give their points.
Write these up. Add your own if some points have been left out.
(15 mins)
3.Input (20 mins) Questions
Facts about AIDS and local services -
Use information from the manual and from other sources, such as the HIV and AIDS and the Law resource manual to get information to give an input on AIDS. In your research you should also find out what support the local services are providing for people with HIV or AIDS and include this in your input.
Ask people whether they have any questions to ask.
(10 mins)
4.Group discussion - What can we do?
Break people into groups of 5 -10 and ask them to discuss the following two questions:
  • What can we do to protect ourselves against infection?
  • What can we do to help people living with AIDS and orphans in our community?

After 30 minutes let each group make a brief report. Add in some of the things that are being done locally and ask people to join any projects that exist.
Report-back and discussion

(30 mins)






(20 mins)
5.Individual task - Personal promises
Ask people to each think of a pledge (promise) they can make about what they will change in their attitudes or behaviour after this workshop. Give them a few minutes and then go around the room and let each person speak. If you are recruiting volunteers for a campaign, have forms ready for people to sign up.
(15 mins)
6.Close and thank people

OTHER WORKSHOP PLANS

This is only one example of a workshop plan to educate people about HIV and AIDS. The Aids Law Project has published a HIV and AIDS training manual containing workshop plans on all aspects of HIV and AIDS. You can use these workshop plans to guide you when you are planning a workshop in your community.

© This material may not be used for profit without permission from ETU