Reducing workplace stigma on HIV can boost job effectiveness

Research from a team including Esade professor Anna Carmella Ocampo has revealed that unaddressed workplace stigma surrounding human immunodeficiency virus (HIV) can negatively impact employees’ job effectiveness. 

The findings, published in the Journal of Applied Psychology, suggest that people with HIV rely on their individual strengths such as having high self-esteem and overall health vitality to prevent HIV stigma from further compromising their ability to work. Ocampo noted that building the individual strengths of the already vulnerable population requires a supportive and engaging workplace.  

The results, according to Ocampo and co-authors Yueyang Chen, Simon Lloyd D. Restubog, Lu Wang, and Anthony Decoste, have important implications for organizations developing diversity, equity, and inclusion policies. 

Tackling workplace stigma 

Stigma is a process that alienates people for possessing certain characteristics. Employees with HIV are often stigmatized because they are generally perceived as dirty, immoral, and irresponsible. 
 
The potential for stigmas against a wide range of employee characteristics increases given the growing diversity of the workforce. Ocampo further points that “societal stigma surrounding HIV contributes to negative stereotyping and structural exclusion of employees living with HIV — despite efforts to improve access to health care assistance and legal protection against workplace discrimination.” 

Workplace interventions can combat stigma and maintain active and meaningful employment

There are currently around 40 million people living with HIV worldwide, 70 percent of whom are working-age adults. The economic cost of HIV to employers in the United States amounts to approximately $618,000 of lost productivity over the lifetime of an affected employee. 

By conceptualizing HIV stigma as a workplace issue, the researchers aim to inform managers and policy experts to develop workplace interventions that can help combat stigma and maintain active and meaningful employment. 

How HIV stigma seeps into the workplace  

Using a sample of 225 employees with HIV, the research team examined whether, how, and when stigma can impede two key dimensions of job effectiveness: in-role performance and organizational citizenship behaviors (defined as employees’ willingness to offer help to their colleagues and workplace). 

Over three measurement periods, employees with HIV completed measures that assess their stigma experiences, fear, shame, and job effectiveness. Indeed, they found that heighted HIV stigma experienced increased fear and shame, which reduced their ability to work effectively. 

Fear and shame resulting from being HIV-positive elicit defeatist and avoidant behaviors

According to Ocampo, stigma undermines the job effectiveness of employees with HIV because they intensely and frequently experience fear (“Because of my health condition, I feel scared”) and shame (“Because of my health condition, I feel worthless”).  

Over time, fear and shame resulting from being HIV-positive elicit defeatist and avoidant behaviors at work. These may compromise employees’ capacity to perform their key job functions and to help their co-workers.  

Higher levels of shame experienced by participants resulted in a decline in performance and lower levels of organizational citizenship behaviors. The stigma associated with HIV in the workplace was found to increase shame and reduce job effectiveness as a result of debilitating self-criticism. 

Boosting the coping ability of stigmatized employees 

Based on the findings, stigmatized employees can still overcome the negative consequences associated with their HIV-positive status. The authors tested a physiological and a psychological employee characteristic that may potentially ameliorate their HIV stigma experience.  

Specifically, the moderating role of physiological factors on job effectiveness was obtained by measuring levels of CD4 cell count, the biological indicator of HIV severity. Lower levels of CD4 cell count indicate a more severe level of infection. They also measured employees’ psychological characteristics using core self-evaluation (CSE), which assesses the core opinions people hold about themselves.  

People who are severely immunocompromised due to low CD4 cell count experience declines in physical ability, which can restrict their capacity to fully engage in work practices. This inability to fully engage with tasks expected during the course of work, such as working long hours or performing physically taxing roles, compounds feelings of shame and further restricts job effectiveness.  

Workplace implications 

“Our findings demonstrate that people living with HIV who have low CD4 cell count are the most likely to suffer from performance loss arising from HIV stigma given their insufficient physical energy for continued work,” say the authors of the research.

The findings also confirmed the hypothesis that people with low levels of CSE are less able to cope with negative perceptions about their condition, exacerbating their levels of shame and further reducing their ability to participate effectively. 

Individuals with high CSE are generally found to be more confident, in control of their life, emotionally stable, and efficacious. Those with low CSE are more inclined to be timid and unsure of themselves. 

Employers should introduce flexible work plans so those affected can safely take time off to attend to health needs

“People living with HIV who have low CSE may feel they lack the efficacy to protect themselves against potential threats,” the authors explain. “By contrast, people with high CSE tend to form more positive appraisals of themselves, enabling them to feel confident and in control of the intimidations associated with being HIV positive.” 

The research notes that, while individuals with high CSE recognize the danger created by HIV stigma, they are more able to withstand and even overcome the fear arising from stigma-related threats. Those with low CSE found levels of chronic shame exacerbated by negative self-appraisal processes. 

Key workplace actions 

These findings substantiate previous research that personal conditions vary the extent to which stigma is experienced within the same stigmatized group. To help counteract the internal damage associated with negative self-appraisal, they have outlined key actions for workplaces to adopt. 

Diversity training initiatives should include sensitivity training in the workplace to help co-workers understand the issues faced by colleagues with HIV. At an individual level, mentoring and formalized sessions that help to boost CSE should be implemented. 

Diversity training initiatives should include sensitivity training to help co-workers understand the issues faced by colleagues with HIV

Employers should also introduce flexible work plans so those affected can safely take time off to attend to health needs, particularly during the most critical phases of treatment. 

“Measures such as this can help the person with HIV to feel protected from both internal and external threats, work towards reducing shame and combat the stigma of HIV,” conclude the authors.