An enormous change has occurred among those infected with the virus, if not yet among the organizations that serve them. PLWHAs today are just as likely to seek help with return to work issues as they are for drug regimens. The drug therapies that have reduced infections and prolonged life for HIV positive individuals have similarly expanded their options. For an ever-growing segment of the PLWHA population, one of those options is employment. While men and women living with the virus primarily and properly list health maintenance as their number-one goal, more and more of them are doing something they never thought possible -- looking for a job.
While this is a relatively new aspect of the AIDS crisis, it is a familiar one to MTS (Multitasking Systems). For twelve years this New York-based social service agency has been helping people with HIV/AIDS find employment. The agency provides some form of job training, employment assistance or career guidance to more than 2000 HIV-positive men and women every year. Their experience may be instructive to PLWHAs and organizations serving them.
Factors affecting PLWHAs interested in returning to work are significantly more complex than those affecting persons with other disabilities. Negative perceptions about AIDS and persons with the disease, while not as prevalent as they once were, are still present to some extent in the working world. PLWHAs seeking employment face other challenges as well. Most long-term survivors have employment gaps of months, or even years. In many situations, the long period away from work left them with obsolete or irrelevant expertise. For some PLWHAs, starting up again in a former high-stress or unhealthful career just isn't a viable alternative. Many PLWHAs receive public or private benefits that may be lost and will certainly be reduced once they start working, and there is the lingering fear that benefits once lost may never be regained. In communities of color, longstanding patterns of discrimination compound the problem of finding meaningful employment.
Add to this the inescapable fact that PLWHAs, like other job seekers, must write resumes, answer ads, network and undergo the normal frustration and rejection associated with a job search campaign. The whole process can be overwhelming and, while not life threatening, is stressful and not always conducive to good health. But regardless of the difficulties, the trend is clear. The future for growing numbers of PLWHAs will include employment.
The decision to seek employment, particularly after a sustained and lengthy period of unemployment, requires careful thought and reflection. While any individual's efforts to change his or her life should be supported, prudence is called for as well. What appears doable to someone who has not been on a fixed schedule may be less attractive in actual practice. The demands of a job are somewhat consistent from day to day and may not allow for a great deal of flexibility.
It's only natural to want to take advantage of improved health and the mental outlook that goes with it, but while starting a full-time job in a high-stress field might be appropriate for some people, most PLWHAs will achieve success by taking a more moderate course. Part-time or temporary employment (part-time or full-time) is a good option for anyone who hasn't worked for a while. It offers the opportunity to develop a working rhythm and test one's stamina. Volunteering is another route back into the mainstream. It not only helps build credibility; it may lead to a job offer.
For large numbers of PLWHAs, benefits considerations play a critical role in the decision-making process. The loss of benefits or the fear of losing them may keep some people from seeking employment who might otherwise jump at a job opportunity. While the impact varies depending on the specific benefit, the simple fact is that most people will be better off financially by working. True, they will lose some benefits, but for public benefits at least, their work incentives are sufficiently attractive to encourage employment. Private benefits are a different story. The continuation of some private benefits is contingent upon the inability to work. A private benefit recipient who works could lose those benefits, and the hope of ever regaining them.
A decision to return to work is rarely considered without reference to a specific job or career field. For some PLWHAs, old careers may be inappropriate, not least because they are unhealthful. A firefighter, a cook, or a commodities trader may have an obviously stressful or physically demanding job, but a job as a retail clerk or a clerk typist can be as stressful and more physically debilitating for a PLWHA with neuropathy. It also doesn't make much sense for a PLWHA to return to a job or career field that was unappealing or unfulfilling the first time. An impaired immune system is a good reason to stay away from things, jobs included, that are unpleasant. The best advice for PLWHAs is the same advice we'd offer anyone looking for work -- find something you like to do.
In one way, PLWHAs reentering the job market are fortunate. If they have been unemployed for long periods and have adapted financially and professionally to long-term unemployment, they can frequently make informed choices about jobs based on personal interest and not on financial need. Few mid-career professionals ever have that opportunity. This has led many PLWHAs to pursue jobs in not-for-profits, go back to school, or in a few cases, pursue long-dormant entrepreneurial goals.
Whatever the choice of career field, it should reflect market realities as well as characteristics of the job seeker. That is, consider the availability of specific types of assignments in a given geographic area while realistically assessing professional strengths and weaknesses. It's easy and usually a mistake to opt for current "hot" careers or to make choices on vague, ill-defined interests such as "working in the health care field" or "getting into public relations." A good criteria checklist can be used to assess both the potential for achieving one's objective, and to determine what those objectives should be. Anyone looking for a job should use such a criteria checklist, one that addresses the mundane (how long a commute is acceptable) and the significant (what is a minimum acceptable income). By establishing some criteria at the outset of the job search process, potential jobs or specific job offers can be easily measured. Adjustments can be made or standards changed as appropriate. For example, a higher income or a more flexible work schedule might compensate for a longer commute time. In any event, the development of objective and measurable criteria helps keep the job search effort in focus. It also increases the likelihood of finding the right job.
The good news for anyone who hasn't looked for work in a long time is that job hunting hasn't changed that much. That's also the bad news. Job hunting is not easy and probably never will be. The Internet has expanded the range of employment related resources, but the rules of the game are still the same. A good resume is essential, though today's resumes are just as likely to be scanned electronically as read by a human. Well-written cover letters are important and the key to job hunting success is, as it always has been, . . . network, network, and network. There is however, at least one issue of special importance to PLWHAs returning to work, and that is how to handle long-term employment gaps.
The glib, though entirely appropriate response to long-term employment gaps is "don't worry about it." No one is hired for his or her deficiencies or liabilities, whatever they are. An employment gap is no more or less detrimental than not having a degree or the absence of a specific qualification. Employers are not universally disposed to reject applicants with employment gaps or without degrees. The important point is to keep the focus on the positive. On a practical level, gaps in employment can sometimes be filled with references to volunteer work or entrepreneurial activity and a well-written resume can frequently hide or downplay the problem. As to how to handle interview questions about gaps, while that can be difficult, be sure your answers are truthful.
Individuals who exhibit enthusiasm and interest during an interview and who possess the requisite skill and experience frequently find that employment gaps are not a major problem. That is not to say that the subject is never raised -- it frequently is -- but rather that it is rarely an insurmountable concern. For some PLWHAs without any recent job assignments or volunteer activity to fill a gap, a simple, non-defensive response along the lines of "I've been ill, but my health is strong and I'm excited about getting back to work" works well.
Actually, employment gaps are of less concern to employers than are drastic career changes. Overcoming employer concerns in this matter requires an unambiguous statement of job and career objectives from the job seeker. Career changers are also advised to emphasize that they sought advice and counsel and made such a major decision only after long and careful reflection on personal goals, skills and market needs.
Landing a job may turn out to be the easy part. Adapting to the demands of a new job or career is a challenge for anyone. For a PLWHA, the challenge is often compounded by concerns relating to health, HIV disclosure and reasonable accommodation. It is inevitable, too, that the job duties will differ, if only slightly, from the description proffered in interviews. That line in all job descriptions "and perform other duties as assigned" can be particularly distressing to PLWHAs. Employers are not always forthcoming about the job or the company and not necessarily because they are devious. Job seekers too are sometimes capable of playing the rising expectations game, often innocently. It is easy enough to respond to simple employer inquires with answers designed to please the interviewer, only to discover later the difficulties involved. A positive response to "can you work overtime occasionally?" may be deeply regretted when "occasionally" turns out to be five days a week.
Other factors may have an equally harmful effect on the level of job satisfaction. An environment that seemed friendly and supportive during the interview process could prove unpleasant and discriminatory. Supervisors that were accommodating and helpful in an initial meeting, may turn out to be demanding, unresponsive and arbitrary. What then does one do when the job is the wrong one? Our advice is the same as it is for anyone in a similar situation, with one major caveat. Don't quit one job until you have another. The caveat of course is that health concerns should take precedence.
Ultimately, the rewards of working can outweigh the negatives. Even for persons living with AIDS, the opportunity to become a productive and contributing wage earner is empowering and contributes to good health. The self-esteem and personal gratification that come with employment are similarly "health enhancing."
Return-to-work issues for persons who are HIV positive cannot be discussed without reference to what has been called "the changing face of AIDS." Today's PLWHA is frequently poor, African American or Hispanic and frequently without a high school diploma or a GED. And more and more PLWHAs are women, often with children, and some have a secondary disability such as traumatic brain injury, a history of substance abuse or mental illness. For many of these individuals, HIV/AIDS is only one of several issues affecting their employment prospects.
Another unique characteristic of PLWHAs who are seeking to return to work is that, without coercion or force, they are voluntarily trying to change their lives. They come to MTS because they want to work. And therein is a lesson for the thousands of organizations that advocate for, work with and otherwise support America's growing population of PLWHAs. We have come to accept the fact that AIDS is no longer a "death sentence." We now need to recognize that employment or re-employment is a viable option for people living with HIV/AIDS. PLWHAs as much as anyone deserve the opportunity to achieve financial self-sufficiency and to experience the professional satisfaction that comes with a job.
Charles T. Kelly is director of marketing and placement for MTS, which provides employment, training and career-related assistance to PLWHAs and operates a temporary employment service exclusively for PLWHAs. MTS can be reached at (212) 962-7090.