🏳️‍🌈✝️ HIV Testing Doesn’t Have to Suck

Going to the doctor can create a lot of anxiety for most people, let alone going in to get tested for HIV. 

By Zachary Zane

 

April 17 2017

 

 

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I get tested for HIV and other sexually transmitted infections every three months, if not more often. I’ve been pretty diligent about this ever since I became sexually active. But it hasn’t always been easy. In fact, it used to suck. 

Going to the doctor sucked. Going to the doctor as a gay or bisexual man sucked even more.

 

Going to the doctor as a queer man who’s sexually active — and wants to get tested for HIV and other STIs — sucked the worst. 

 

Going to my college’s healthcare center was absolutely terrible. I was shamed mercilessly by the doctors there. They thought I was reckless. I was 19, getting drunk, and having sex. (I know — shocker. Who would have thought I would be getting drunk and having sex at college?) Still, I can understand why they thought I should take more precautions. What I don’t understand is why they thought yelling at me — or diagnosing me with an STI that I didn’t have — was the way to get through to me.

I didn’t stop having sex, but I did start going off campus to get tested. I went to a community clinic in a rundown area in Poughkeepsie, N.Y. The clinic was visibly dirty, and home to sex workers, drug addicts — and me. The nurses there were burnt out. You could hear it in their lethargic voices and see it in the bags underneath their eyes. They were exhausted from years of positive diagnoses, and could no longer care about their patients. Being invested was too painful. I kept going — for three years — because that’s what you do. I needed to feel safe. I needed to feel in control. Still, I never got over the dread I felt going there to get tested.

After college, I started working at Massachusetts General Hospital in Boston. They had a free infectious diseases clinic that I went to during walk-in hours. That’s where I met Julie, a nurse practitioner who had been working with queer men since the early ’80s. She’s knowledgeable, direct, and doesn’t judge. When she first asked me how many people I’d slept with in the past three months, I said, “It’s tacky to count.” 

This has become an ongoing joke of ours. It’s something I say every time I come in. We always laugh together. She follows up, “Greater than 10?” I nod. She laughs when I tell her raunchy stories, and she remembers my partners, giving them ridiculous nicknames. 

“You still sleeping with Herpes Girl?” She asked me once upon entering the exam room. I was. 

There’s something about Julie’s direct and arguably crass language that makes me feel comfortable. Rather than dreading our appointments, I’m excited about coming in to see her. 

She’s the medical professional who calmed me down after I slept with an HIV-positive man without a condom. (He hadn’t been truthful about his status.) I had recently started PrEP, but it was one of the first times I had slipped up and not used a condom with a man in so, so long. The research was still out, and I wasn’t sure the HIV prevention pill really worked. 

Julie was the one who assured me that Truvada worked. She was the one who told me the facts and statistics about PrEP. She was the one who said, “Come in 14 days from when you were exposed. When you come in, tell the receptionist you’re here to see me, and I’ll come out and see you right away. It doesn’t matter how many people are in front of you.” She was the one who called me directly to tell me my results were negative, instead of having me call into a hotline. 

Julie is, hands down, the best ID health provider I’ve ever had. There are so many clueless doctors and nurses out there. Medical professionals who have no idea how the needs of gay and bi men differ from that of straight men. Medical professionals who don’t know what PrEP is or are hesitant about prescribing it. Medical professionals who shame you for sleeping with numerous partners, even when you’re having consensual, protected sex — and are asking your partner about their status.  

Unfortunately, the impetus is on us, as gay and bi men, to find a good doctor.  I specifically go to an infectious disease clinic to get tested, because I not only find them more knowledge about STIs, but also because they’re accustomed to seeing queer men. It’s not only important when it comes to getting tested, but for all other physical and mental health issues. I see a gay therapist who specializes in LGBTQ issues and my primary care physician was referred to me by a lesbian friend who promised she worked well with LGBTQ clients.

Going to the doctor doesn’t have to be a pain in the ass. Getting tested doesn’t need to be a horrifying or frustrating experience. It’s time we took charge of our health, and didn’t settle for anything less than we deserve.

Read more articles from PLUS, here.
 

🏳️‍🌈✝️More Than 40 Percent of Americans Have HPV

One quarter of men and one fifth of women have high-risk strains of human papillomavirus (HPV) that can cause various cancers.

April 18, 2017

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Genital human papillomavirus (HPV), which causes genital warts, infects 42.5 percent of U.S. residents, including 45.2 percent of men and 39.9 percent of women, The New York Times reports. 

Higher-risk strains of HPV are associated with various cancers, including those in the mouth and pharynx in the case of oral infections, and the cervix, vagina, penis, anus and throat in the case of genital infections.

HPV, the highest-risk strains of which are preventable with vaccines, causes an estimated 31,000 cases of cancer per year in the United States.

Publishing their findings in a data brief, the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics produced national estimates of oral HPV prevalence among those 18 to 69 years old by analyzing data from the 2011 to 2014 National Health and Nutrition Examination Survey (NHANES) results, as well as the prevalence of genital HPV among those 18 to 59 years old based on data from the 2013 to 2014 NHANES results. They considered 37 strains of HPV, including 14 high-risk strains.

An estimated 25.1 percent of men and 20.4 percent of women 18 to 59 years old had high-risk strains of genital HPV. Broken down by race, the high-risk strain prevalence was highest among Blacks (33.7 percent), followed by Latinos (21.7 percent), whites (21.6 percent), and Asians (11.9 percent).

An estimated 7.3 percent of those 18 to 69 years old had oral HPV, including 4 percent who had the high-risk strains.

To read the New York Times article, click here.

To read the CDC report, click here.

Read more articles from POZ, here.
 

🏳️‍🌈✝️ Why Is HIV Testing Vital to Trans Health?

Today is National Transgender HIV Testing Day. Get in the know with why getting tested and knowing your status is important to trans folks everywhere.

By Cole Hayes

 

April 18 2017

 

 

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I got lucky. I got lucky in the sense that Seattle is a very proud city, especially when it comes to its LGBT community. There are organizations, doctors and mentors around every corner. When I got tested for HIV/AIDS for the first time, I was nervous, but I knew I was in good hands.

Capitol Hill Medical is an LGBT clinic and strives in helping Seattle's queer people when it comes to their health. April 18th is National Transgender HIV Testing Day and on this day it's important to spread the word. Routine tests are vital when it comes to maintaining our health, and having the resources available for trans-specific people makes testing a lot less stressful and scary. 

 

It's about reaching out to as many people as possible and showing that trans people are included in that call. Overall, we want to feel safe and heard when it comes to our bodies and our identities. 
Having spaces available for trans people to go for their medical check ups is the goal! 

Websites like Transhealth provide heaps of information on where to go and how to get tested, knowing that who you are is not only valued but validated. What makes this so special to me is it shows that as a trans person, my health care needs are a little different, and there are people who want to ensure I'm taken care of appropriately.

The fact is that trans people want to be seen for who we are, but ignorance is very much alive.
This ignorance in the medical field often keeps trans people from seeing a doctor, which can lead to a variety of complications and issues. Having a day that hones in on trans needs is amazing and hopefully will encourage more trans people to get tested for HIV, knowing there really are places and people who care, understand, and want to help.

A few weeks after I slept with my boyfriend for the first time, I was sitting in the doctors office having a routine blood draw to check my hormone levels. Once the needle was out and I was all patched up, my doctor turned to me and asked if I wanted them to check my status for HIV/AIDS. 
I almost said no but she explained it was a free test. Even if it hadn't been, I knew it was important, so I agreed. 

I was nervous, and while I waited I texted the boy I had previously slept with. As my doctor came back into the room with the results, he responded telling me he had been tested months prior. 

Then, my doctor announced I was HIV-negative. 

I was happy I had decided to do it because I knew I was doing my body a service.

Spreading awareness and sharing the news to your fellow trans folk could help so many. We shouldn't have to shy away from clinics and hospitals, we shouldn't have to worry about being misgendered or mistreated because of who we are. Our care is specific and we deserve to work with doctors who understand that. 

I can't tell you how many times I've heard nurses and doctors tell trans people they couldn't help them, simply because they are trans. Having resources that provide ongoing counseling, treatment, repeat HIV testing, information on where to go, who to see and support (specifically for transgender individuals) can make a difference. 

There are people who care, and they want you to know that they do. Facing stigma and having negative past experiences is something almost every trans person can relate to. I'm proud to speak out on this day, knowing that the barriers keeping trans people from the health care they need is finally starting to dissipate. 

COLE HAYES is a 25-year-old trans writer who lives in Seattle, Washington. Follow him on Twitter @itscolehayes. Photo by Kyler St John.
 

Read more articles from PLUS, here.

🏳️‍🌈✝️ Scientists Discovered a Way to Create HIV-Resistant Cells

It might sound too good to be true, but a new generation of cells are now able to block HIV altogether. 

By David Artavia

 

April 17 2017

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It sounds like something out of a science fiction movie, but the best discoveries always do don't they? Researchers at The Scripps Research Institute in San Diego found a way to make cells resistant to HIV. 

The team of scientists were able to tether HIV-fighting antibodies to immune cells, which created an entire cell population resistant to the virus. These new and improved cells are able to replace HIV-infected cells.

The TSRI team plans to collaborate with investigators at City Hope’s Center for Gene Therapy to further test the therapy under federal regulations. Once they get approval, they hope to start human trials. 

So, how did they do it? Obviously it sounds like the kind of news we've been waiting for. Perhaps this is the key to curing HIV altogether — one can hope.  

First, you have to look at what happens to cells once they’ve been attacked by HIV. When a cell is diseased, they eventually die off. But these new "protected" cells end up spreading the protective gene to other cells, and they end up copying themselves over and over again, thus making a population that are resistant to the virus. 

The team first tested their theory against rhinovirus, a virus found in many cases of the common cold.

Using a vector called lentivirus, they delivered a whole new kind of gene to human cells. From there, they had the cells synthesize antibodies that bind with the kind of receptors rhinovirus needs in order to corrupt them. And while the antibodies were monopolizing, they discovered that it prohibited the virus from entering the cell. 

Meanwhile, the cells without the antibody protection were dying off, leaving only the protected cells to multiply and pass along the improved gene to a new population of cells. 

Now, HIV is obviously different from rhinovirus. In order for it to have the same results, all strains of HIV need to bind with a cell surface receptor called CD4. 

After the team introduced cells to the virus, they were pleased to see a new population of HIV-resistant cells. Turns out, the antibodies recognized the CD4 binding site, which ended up allowing them to block HIV from corrupting the receptor. 

But why does it work so well? While today's therapies allow antibodies to float freely in the bloodstream at low level concentrations, this new strategy, which has been dubbed the “neighbor effect” by senior staff scientist at TSRI Dr. Jia Xie, allows antibodies to stick nearby. 

Xie and their team confirm that the tethered antibodies blocked HIV more effectively than free-floating soluble antibodies. The long-term goal is to be able to control the virus in HIV-positive people without needing them to take a cocktail of additional medicines.

The next step is to engineer antibodies to protect a different receptor on the cell surface, but other scientists seem to think this kind of research is too good to be true. 

“HIV is notorious for generating large variations and what will happen is that some population of the virus will not bind to the antibody so you'll kill off sensitive cells but the virus will continue to grow,” Dr. Carl Dieffenback of the National Institute of Allergy and Infectious Disease questioned to Daily Mail. “With antiretroviral drugs, we have to use a three drug cocktail because of the virus's many variations so you would have to use a similar cocktail of antibodies. We have amazing therapy and really effective therapies, very good tools. But we're not at the point yet where we can make better tools, like a cure or a vaccine.”

Read more articles from PLUS, here.

🏳️‍🌈✝️ Can I Get an Infection From Receiving Oral Sex?

Whether it's the common cold, the flu, or an STI, how possible is it to catch an infectious disease while being a "receiver" during oral sex? 

By David Artavia

 

April 18 2017

 

 

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The last thing anyone wants is for their partner’s penis or vagina to catch a cold (that would be bad). It’s natural for us to worry about getting them sick when we’ve come down with the flu or any other type of infection, like strep throat or an STI. So, how possible is it for us to pass an infection to our partner by giving them oral sex? 

First, let’s take a step back. 

The last thing you want is to worry yourself or your partner. Whether it’s fish or beef on the menus, transmitting any kind of infection is a two-way street. Just as you can get an infection from going down on them (if they have contracted a virus), they can also get an infection from you (if you have contracted a virus). 

So rather than playing the blame game of “who gave me what,” it’s best to understand that sex health practices go both ways. All we have to do is have an open line of communication. Trust me, these pesky viruses don’t discriminate. 

Now, in the case of minor sore throats caused by the common cold or flu, chances are you don’t need to rid yourself with guilt. Most germs that cause the common cold or flu enter one’s body through the nose or mouth. If your partner catches your cold, it’s probably not because you went down on their penis or vagina. Chances are, it was passed by kissing, touching or holding them close to you during sexual activity. 

But what about STIs like gonorrhea, Chlamydia, herpes, syphilis, HIV, and hepatitis A or B or C? Great question!

Chlamydia — Being the most common STI in the U.S. (nearly 1.5 million cases reported each year), most people do not experience symptoms so it’s hard to know when you have it unless you’re getting tested regularly. Like all other STIs, Chlamydia is passed from an infected person to a partner through sexual activities, but it is way less likely to be transmitted through oral sex. 

Chlamydia is passed when the mucous membrane (that soft little piece of skin covering all openings) comes into contact with secretions of semen or vaginal fluids. Because the bacteria that causes Chlamydia prefers to target genital areas rather than our throats, it is less likely to pass it on during oral sex, much less have it be transmitted from a “giver.” 

Transmission is not known to occur from mouth-to-vagina or mouth-to-anus, however it is still possible to transfer from penis-to-mouth or vagina-to-mouth (though unlikely). 

Gonorrhea — This STI can be passed through oral sex, whether you’re the “receiver” or the “giver.” And whenever it does pass from someone who is giving oral sex, it’s usually because the vagina, cervix, anus, penis or mouth come into contact with an infected person’s secretions. And unfortunately, gonorrhea is known to live in the throat and eyelids from time to time. 

The bacteria causing gonorrhea often sets up shop in the throat and the lining of the eyelid, which can lead to eye infection and discharge from the eye itself (hand-to-eye contact during sex is also another way for it to pass). It also lives on the surfaces of the urethra, vagina, cervix, endometrium, fallopian tubes, anus, and rectum. 

Hepatitis A, B, C — Transmission of hep A, B, or C through oral sex is wishy washy, whether you’re receiving or giving, however if the “giver” has bloody gums or fresh mouth piercings, the risk is magnified due to the possible transfer of blood from the mouth-to-genitals during the session. All forms of hepatitis are transmitted through direct contact with blood, semen, or vaginal secretions. 

In the case of hep B, there are rare cases for the virus to be transferred by saliva through biting — not by kissing. 

In the case of hep A, the virus is transmitted mainly through oral contact with feces. Oral-to-fecal contact, i.e. rimming or tossing a salad, is one of the biggest culprits. Because feces is a major carrier, it can also be transferred through contaminated food or water, and is also spread in daycares. 

So to look at the bigger picture, it is possible for fecal matter to transfer from a “giver” if, say, they kiss you after they’ve had contact with bits of someone’s hep A-contaminated fecal matter. By the way, an estimated 125,000 to 200,000 people are infected with hep A each year in the United States, according to the Centers for Disease Control and Prevention. 

As for hep C, it is mainly transmitted by direct contact with blood by sharing needles, which is the most common risk factor to date. While hep C can be spread by vagina or anal sex, it doesn’t happen very often. So needless to say, catching it from your partner who’s giving you oral sex is also rare, unless (like I said above) they have fresh piercings or bloody gums. 

Herpes & genital warts — This is by far the most easily transmitted STIs because your partner doesn’t necessarily need to have an outbreak for them to pass it onto you. Research suggests that 80 percent of people carry the herpes virus (cold sores), and 50 percent of sexually active people have genital warts cause by the human papilloma virus. 

According to the CDC, one out of every six people between 14 and 49 years old have genital herpes. It can be spread during vaginal or anal sex, by sharing sex toys, and yes, oral sex. Now, because it’s spread through skin contact, it can also be spread through kissing. Basically your only defense is a good offense. Make sure you wrap up with some strong latex before placing your skin on someone else’s, and always remember to get tested and know your status. 

HIV — The short answer is that it’s highly unlikely, but not impossible. Believe it or not, HIV is not the easiest virus to get. It’s passed through blood, semen, pre-seminal fluid (or pre-cum), rectal/vaginal fluids, and breast milk. In order for it to transmit to another person it needs to be fed into their bloodstream. The main ways it does that is through mucous membranes, needles, or blood transfusions.

Nonetheless there are plenty of things you can do to help lower the risk if you're still nervous. For example: 

When giving oral sex, always spit or swallow ejaculate. Do not let it sit in your mouth for long periods of time, as it might make its way through open sores or damaged tissue in the mouth. 
Swallowing is perfectly safe, according to San Francisco AIDS Foundation. Once semen makes its way past the mouth, stomach acid and enzymes in the esophagus kill any HIV in it, so swallowing is actually one of the safest things to do after a blow job.

When receiving oral sex, it can benefit both of you not to jab with such force that it tears delicate tissue around a penis, vagina, or inside your partner’s mouth, thus creating a wider opportunity for fluids to seep through. Be sure to double check your penis (around the head especially) or vagina to be sure there aren’t any tears.

Read more about HIV and oral sex HERE. 

Syphilis — A curable bacterial infection, this kind of bacteria enters the body through mucous membranes or abraded (torn/cut) skin. Once inside, syphilis enters the blood stream and latches onto the cells, which damages the organs over time if left untreated. 

Now, because you can contract syphilis when your mouth, genitals, or another part of your body touches a syphilis sore on a person who has the disease, it is very possible to get it through receiving oral sex. According to the CDC, syphilis sores can be in the mouth as well as on the genitals. Whether you’re giving or receiving, exposure is always possible even if you can’t see a sore. 

Read more articles from PLUS, here.

 

🏳️‍🌈✝️ You’re Not Fat, It’s Just Your HIV Meds

New report offers a consensus statement on obesity and HIV-related fatty deposits.

By Jacob Anderson-Minshall

 

April 18 2017 

 

 

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Researchers from 12 universities from across the U.S. and Europe (as well as Canada) have released a consensus statement about obesity and lipohypertrophy among people living with HIV. 
 

Lipohypertrophy is a side effect of a handful of antiretroviral drugs, and it causes fatty deposits to form in specific places on the body. It can lead to a “buffalo hump” on the back, but it can also cause localized fat accumulation in the abdomen, neck, and other areas. Published in The Journal of Infectious Diseases seeks to help develop a standard for the diagnosis and treatment of excess fatty tissue among those living with HIV. 

 

The authors set out the current knowledge about lipohypertrophy, its association with HIV medications, diagnosis guidelines, treatment options and how it both differs from and shares “clinical consequences” with obesity.

Up until now, there has not been a set of standardized symptoms for doctors to turn to when diagnosing HIV-related fat accumulation, or distinguishing it from general obesity (which is also an over accumulation of fatty tissue). As the authors write, “Both generalized obesity and lipohypertrophy are prevalent” among those on ART (although rates of the latter may be going down with new antiretroviral medications). Both conditions have potential long-term impacts, including on cardiovascular and metabolic health, so should be prevented from developing or treated early.

There are not a lot of treatment options for either obesity or lipohypertrophy. The authors point to “structured exercise with or without dietary intervention” as being the most successful treatment for “abdominal obesity in most studies of HIV-[positive] persons.”  Of course, there are also multiple weight loss drugs, but the authors acknowledge, “No agent has emerged as first line therapy,” and some require “caution” when prescribed to HIV-positive people, due to their potential interactions with antiretroviral medication.

While surgical interventions like bariatric surgery have been successful in treating obesity, liposuction as a treatment of lipohypertrophy often fails to have a lasting impact. “Fat accumulation may recur,” the researchers explain, “requiring repeat procedures. Large studies are lacking, with case studies reporting recurrence rates from 0-50 percent. Data on the metabolic effects of surgical fat removal are also lacking.”

Tesamorelin (Theratechnologies’ Egrifta), is a growth-hormone releasing factor analog, that is the only Federal Drug Administration approved drug to reduce excess abdominal fat in those with HIV who are on ART. The drug, which is administered via injection, must be taken consistently; if stopped the fat can reappear within six months.

In conclusion, the authors note, “Prevention and treatment of these disease states are critical to the present and future health of HIV-[positive] persons. Although promising treatment strategies exist, further research is needed to better understand the pathophysiology and optimal treatment of obesity and lipohypertrophy in the modern ART era.”

Read more articles from PLUS,here.
 

🏳️‍🌈✝️ Understanding Your Rights and Responsibilities as an HIV-Positive Person in the Workplace in the U.S.

From The Well Project

 

July 4, 2016

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Table of Contents

• Frequent Workplace Questions
• Rights in the Workplace: Know the Law
• Taking Care of Yourself at Work 

You can do a lot to prevent HIV discrimination at work by learning about your rights and responsibilities in the workplace. Here are answers to some of the questions most frequently asked by people living with HIV (HIV+) in relation to their work.

Frequent Workplace Questions

How do I request a reasonable accommodation?

If side effects or symptoms interfere with work, you might ask for changes in your working conditions that would allow you to continue doing a good job. Suppose your HIV drugs make you nauseated in the morning. Suppose your job could be done just as well if you came in an hour later and stayed an hour later. A change like that is called a "reasonable accommodation." If you feel you need a reasonable accommodation, it is your responsibility to ask your employer for one. There are several bits of information you will need to gather and provide:

• Name the specific functional limitation you want your employer to accommodate (i.e., fatigue, tiredness)

• Be specific about the change you need to address the limitation (e.g., rest breaks every 90 minutes)

• Back up your request with a health care provider's note that supports the functional limitation -- but does not state the diagnosis!

• Make it clear that you understand the purpose of the accommodation: you still have to be able to perform the whole job, even if you have to work longer or different hours

• Give the request to the person who arranges reasonable accommodation for all conditions (the disability program manager) -- this person is usually not your supervisor. This person may be the HR (human resources) representative or an officer of the company.

• If you cannot do the whole job even with the accommodation, it is important to consider taking a short-term leave or asking for a job with different requirements that you can meet

How can I get to work on time when I am facing serious diarrhea for two hours after I get up in the morning?

The diarrhea may be an adjustment to new HIV drugs. Other than getting up two hours earlier, you could:

• Ask for an accommodation (i.e., later arrival time) until you and your health care provider can resolve the diarrhea. Back up your request with a note from your provider.

• Offer to change your shift to start and end two hours later. Sometimes this is a benefit to an employer with customers who live in other time zones.

• Advise your supervisor that you have a new medication and will need frequent bathroom breaks while you adjust

If I have been discriminated against, to whom do I complain?

Start with your own supervisor, who is responsible for stopping discriminatory behavior. If that does not yield satisfactory results, or if the discrimination is coming from your supervisor, go to human resources or the person responsible for employee relations. If you still do not get satisfactory results, explain the situation to a company officer in writing. If you are still experiencing discrimination with no company action to resolve the issue, go to the US Equal Employment Opportunity Commission. It is important to document and keep track of all your conversations, writings, and efforts.


What should I tell people if I am injured and bleeding and someone is trying to help me?

Hopefully, by now everyone is using universal precautions. Universal precautions are things people do to protect themselves from contact with other people's bodily fluids -- like wearing gloves. People administering first aid can respond to you safely if they use personal protective equipment (PPE, like gloves, goggles, or face shields) and assume that any worker might carry blood borne diseases. If you know your employer has not provided first aid training for a long time, try to encourage your employer to provide updated first aid training for the benefit of all workers.

Rights in the Workplace: Know the Law

 

 

Several laws cover your rights as a person living with HIV at work:

• Americans with Disabilities Act (ADA) of 1990:
   
  • If you can do the whole job, you are a qualified individual with a disability
   
  • If HIV or a side effect of medication limits you somehow, you have a functional limitation and can request a reasonable accommodation
   
  • If you need a change in your job because of the limitation, tell your employer that you have a disability -- you do not have to disclose your HIV status. Talk about what you can and cannot do. Use functional limitation language and back it up with a note from your health care provider that suggests a solution but does not state the diagnosis.
   
• You pose no threat to other workers' health on the job; being fired because you are living with HIV is illegal in the US

• The ADA is a tool that deserves wise, careful use; learn more about it from the Job Accommodation Network

• Consolidation Omnibus Budget Reconciliation Act (COBRA) of 1986: 
   
  • COBRA provides certain workers (and their spouses and dependent children) a right to 18 months of health insurance coverage at group rates following certain events that cause people to lose their health insurance coverage
   
  • Events that qualify you for COBRA as an employee include: quitting your job, being fired from your job (as long as it was not because of misconduct), or getting a reduction in your hours such that you are no longer eligible for benefits (e.g., group health insurance). As a spouse or dependent child of an employee, you also qualify for COBRA in the event of divorce or legal separation from the covered employee, death of the covered employee, or the covered employee becoming eligible for Medicare.
   
  • To qualify for COBRA, you must have been enrolled in the employer's group insurance plan while the covered employee worked for the employer
   
  • To sign up for COBRA coverage, you need to tell the group health insurance plan administrator within 60 days of the qualifying event (e.g., loss of job). The employer is also supposed to tell the group health insurance plan administrator of the event, and you should receive a letter telling you that you can choose to sign up for COBRA coverage within a couple of weeks. You then have 60 days to decide whether or not you want COBRA coverage. You have 45 days from the date you sign up for COBRA coverage to pay the first premium.
   
  • It is important to realize that, when you are an active employee and covered by your employer's group plan, your employer usually pays part of the premium for health insurance. However, COBRA coverage is generally more expensive than coverage for active employees because COBRA participants have to pay all of the premium themselves.
   
• Health Insurance Portability and Affordability Act (HIPAA) of 1996:
   
  • HIPAA enables workers to continue and transfer their health insurance if they change or lose their jobs; this prevents insurance gaps when you go from one insured situation to another
   
  • HIPAA protects against the sharing of confidential health information (and carries stiff fines for disclosing someone's medical information at work or in a medical setting)
   
• Family and Medical Leave Act (FMLA) of 1993:  
   
  • FMLA provides for up to 12 weeks of unpaid leave in one 12-month period to deal with a family issue or medical problem, either for you or an immediate family member. 
   
  • This law only applies to private-sector employers with over 50 employees.
   
  • You can take FMLA leave a few hours at a time, if necessary
   
  • FMLA leave is separate from short-term disability and is not the same thing as sick days or personal time off (PTO)
   
  • FMLA leave has its own application form
   
  • The FMLA form asks you to identify the reason for the leave. The reason is one of six broad categories listed on the form. If you want to protect your confidentiality, you do not have to supply a diagnosis on the form. If you need help filling out the form, ask a social worker or nurse at your health care provider's office.

Taking Care of Yourself at Work

• Keep track of all of your performance reviews. They are a testament to your ability to perform the work required. You may need them if someone learns your HIV status and suddenly begins giving you poor reviews (note: this is discrimination, and it is illegal!).

• It is important that you think carefully before disclosing your HIV status at work. Try to have realistic expectations about the possible outcome.

• Set a respectful tone at work in regards to health privacy and refuse to discuss other employees' medical conditions

• Focus on doing a great job

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This article was provided by The Well Project. Visit The Well Project's Web site to learn more about their resources and initiatives for women living with HIV. The Well Project shares its content with TheBody.com to ensure all people have access to the highest quality treatment information available. The Well Project receives no advertising revenue from TheBody.com or the advertisers on this site. No advertiser on this site has any editorial input into The Well Project's content.


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