I can't let this be the defining factor of my life, yet it is.
All I plan for, all I do, I do with my diagnosis [HIV] in mind.
It defines me.
The impact of being diagnosed with a life threatening illness is significant and far-reaching. People with a positive diagnosis of HIV must integrate their diagnosis into their self-concept and career goals while they also continue investing in their relationships, their careers, and their overall well-being. Moreover, many people who are HIV positive encounter discriminatory treatment at work, leading them to seek new career opportunities or to withdraw from work altogether. For most people, however, completely separating from work is not financially feasible. In addition, many people find a sense of meaning, purpose, and dignity in their work that enables them to live effectively. Thus, people who are HIV infected must retain their interest in working while living lives that have been altered significantly as a result of their diagnosis.
Maintaining active involvement in work is even more important due to recent medical advances in treating HIV, including new drug combinations, earlier intervention, and improved treatment regimens. For example, highly active antiretroviral therapy (HAART) allows many people living with HIV disease to live longer, have a better quality of life, and experience fewer illnesses related to their HIV status (Bettinger, 1997; Centers for Disease Control and Prevention, 1998, 2001; Jones et al., 1999; Kohlenberg, 1997; Martin, 1999). As a result, there are people living with HIV/ AIDS who are either able to maintain employment because of these treatment regimens or become employed again as their health situation improves. Clearly, the continuous development of medical treatments to fight the complications related to HIV/AIDS increases the need to understand the career concerns confronting people living with this disease.
As with any chronic illness, people living with HIV disease must incorporate the disease into their career identities and career goals (Hoffman, 1997). Career development issues for people living with HIV/AIDS are many and varied. For example, on receiving an HIV-positive diagnosis, some people may despair that they do not have time to attain their goals (Morin, Charles, & Maylon, 1984). These feelings may lead them to minimize their accomplishments, label their lives as unimportant, and resist identifying long-term goals. Other people may "respond with a deep desire to make a long-lasting contribution to society and leave some legacy of their lives" (Hoffman, 199l, p. 508).
People who are HIV infected, but asymptomatic, may need help with career exploration and long-term career planning issues. Some people may be terminated from their employment as a result of prejudice; some may make a voluntary career change to find more meaningful work; and others may remain in the same situation whether they are employed, underemployed, or unemployed. Even those workers who are able to remain in their jobs, however, may have concerns about their future work situations, including vocational and financial independence. As the disease progresses, there may be a need for job analyses, modifications, and reasonable accommodations if people are to maintain employment.
In her review of the literature related to employment and HIV, Hoffman (1997) found that as their disease progressed from HIV infection to AIDS, many people lost their full-time employment. Hoffman reported that people who were symptomatic were more likely to have changes in their employment status. She also noted that people with jobs requiring more mental work than physical activity were more likely to remain employed and to stay employed longer after a diagnosis of AIDS. One limitation she found in the research literature was that only a small proportion of participants were still employed (either part-time or full-time) when these studies were conducted. …