San Francisco Chronicle - The Voice of the West, 901 Mission Street, San Francisco, CA 94119 - Monday, March 10, 1997 - Page E1
Ilana DeBare, Chronicle Staff Writer

Today Westaway is in fact back at work -- popping 24 anti-AIDS pills a day, working part-time from his home, wooing clients and carrying out sales presentations for a fast-paced Silicon Valley telecommunications firm.

Westaway is unusual among people with AIDS in the speed and intensity with which he plunged back into his career.

But he is part of a new and growing trend in the AIDS world -- one of thousands of people who barely a year ago were preparing to die, and now, buoyed by new drug treatments, are suddenly confronting the possibility of re-entering the world of work.

The prospect of returning to work raises both hopes and fears among people with AIDS. They wonder: Will their improved health survive the rigors of a full-time job? How long will the benefits of the new drugs last? What happens if they get a job, lose their disability insurance, and then become sick again? And -- not least of all -- how will potential employers respond to a mysterious several-year gap in their resumes?

It also raises questions for employers, who are legally barred from discriminating against people with AIDS but still must decide how welcoming a workplace they will create.

"You can't ask what an applicant's medical condition is or what treatments they're getting," said Raymond Wheeler, a labor law expert with Morrison & Foerster. "But employers still want to know things like: Am I hiring someone who's dependable or sick all the time? Am I hiring someone who will send my medical insurance costs through the roof? Am I hiring someone who is going to be out of here in a year?"

Both for job-seekers with AIDS and for their potential employers, this is all completely uncharted territory.

"In the early stages of the epidemic we were dealing with people getting sick and leaving work -- now we're looking at the reverse," said Timothy Rodrigues, spokesman for the San Francisco AIDS Foundation.

"There's a real need for the business community to become engaged in this," said Mark Misrok, director of Positive Resource, a San Francisco job counseling agency for people with AIDS or the HIV virus that causes it. "There's an awful lot of incredibly talented people out there that the business world could use. We need to develop a way to bring these people back in."

Two years ago, no one would have predicted that returning to work would become one of the hottest topics of discussion within the AIDS world.

But then, in early 1996, federal officials approved the use of a new class of anti-AIDS drugs called protease inhibitors. Last July, AIDS researchers said that the new drugs had managed to eradicate all trace of HIV from the blood of some patients. And just last month, government scientists announced the first drop in nationwide AIDS deaths since the epidemic began -- a drop they attributed in part to the new drugs.

The protease inhibitors don't work for everyone. Researchers have estimated that 10 percent or more of people with AIDS won't see any long-term benefit from the drugs.

But those who do use the drugs successfully have found themselves with an unexpected new lease on life.

Instead of a slow decline toward death, they suddenly started to imagine five, 10 or even 40 years of life. The shift changed their perspective on everything from finances to friendships -- including work.

Some people started thinking about work when they realized they would outlive the savings accounts they had marshalled for their last year or two of life.

Others began thinking about work as a way to regain much- missed feelings of independence, achievement and social connection.

Eric Ciasullo, who quit his job as director of a San Francisco housing program for homeless youth in 1992 due to AIDS, began taking the protease drugs last August. His T-cell count -- one key indicator of health among people with AIDS -- rose from less than 50 to nearly 200. His stamina also increased: He no longer needs a daily nap, he is able to clean his house, and he can walk his dog around the block without getting winded.

"I feel a moral imperative to work, to contribute to society," said Ciasullo, 34, a board member of the San Francisco AIDS Foundation. "And we live in a culture where people really identify with the work they do. It would be nice to have the structure of a full-time job again, with goals I am trying to achieve both personally and professionally."

But Ciasullo also worries about the potential costs -- both financial and medical -- of returning to work.

He worries about losing his current disability insurance if he takes a new job, and what would happen if he falls ill while waiting to be eligible for new coverage.

He also wonders what the strain of work would do to his still- tenuous health. "These days, if a company hires someone for a 40- hour week, they really expect 50 or 60 hours," he said. "Employees with HIV are going to have a hard time handling that."

On top of all that, Ciasullo is confused about what kind of work to do -- certainly not the intense, emotionally draining work with troubled teenagers that he did before he got sick.

"There are issues of stress in the workplace that everyone faces, but which can be life-threatening to people with AIDS," he said. "I'm now five years older than I was. There's an edge I've lost, a patience I've lost. I can't imagine myself as a counselor for homeless youth anymore."

Ciasullo is far from alone in contemplating a major career change due to his experience with AIDS.

Michael Nelson, 37, used to own a booming real estate business with his lover, who died of AIDS. He spent most of the past five years spending down his savings and getting ready to die. Today, he's putting together a resume -- seeking work in the nonprofit world, not real estate.

"I faced the reaper several times, and once you've done that, you change," Nelson explained. "I'm willing to put up with a lot less compromise (in my ideals) than I would before. I don't want to save the world, but whatever I do, I want it to have a little meaning."

Nelson faces one immediate question -- what to say on his resume about those past five years of his life.

"I was told to couch it in terms of a hiatus," he said. "Then people told me to write that I'd been working free-lance. Finally someone said, `Do a technical resume that lists your skills, rather than a chronological one.' "

Nelson and other people with AIDS worry that employers will reject them out-of-hand if they learn about their medical history.

Labor law experts assure them that such discrimination is illegal under the Americans with Disabilities Act.

And some Bay Area firms say they see an applicant's struggle with AIDS as a potential asset, rather than a liability.

"At Netscape it would be admired, rather than a point against you," said Bob Sundstrom, a diversity specialist with the Mountain View high-tech firm. "If you truly feel you came that close to death, you've come out with a knowledge of what's important or not. That's a skill you can bring to the management team."

But such assurances don't do much to quell the anxiety.

"If they know I have HIV, it will start a screening process in their minds where they'll think of all the things that could prevent me from coming to work," said one 34- year-old man who asked to remain anonymous. "They will see HIV as a whole Pandora's box of problems."

Of all the return-to-work scenarios envisioned by people with AIDS, John Westaway's is perhaps one of the best.

Westaway had an extremely supportive boss and employer, Aspect Telecommunications. The company held a job open for him, agreed to let him work a part-time schedule of 24 hours a week, and set him up with a complete home office so he could minimize the grueling 90-minute commutes between his home in San Francisco and company headquarters in San Jose.

But even with all these accommodations, Westaway is stepping into uncharted and worrisome territory.

Like others on protease inhibitors, he must adhere to a strict time schedule for taking the drugs -- in his case, three times a day, at least one hour before a meal. When he's working at home, that's not hard. But when he has customer meetings or out-of-town travel, it can get crazy.

"You get in a meeting with customers and you don't want to break the flow of the meeting, or lose your concentration," Westaway said. "So sometimes I miss my midday times. I get into a meeting, or I'm working on a deadline, and then all of a sudden I'd realize, `I'm an hour late, Jiminy Christmas.' "

Westaway knows that even occasional lapses in his drug schedule could render the treatments ineffective -- threatening his life. He is also well aware that overwork and stress can send him back into a downward spiral.

So he has thrown himself back into work with great enthusiasm -- but also with some caution.

"I'm going to see how this goes, and not jump to any conclusions," he said. "The first priority in my life is my health. If that's not working out because of my job, I may have to make a change." ------------------------------------------------------------

HIRING PEOPLE WITH AIDS OR HIV

-- Most job applicants with AIDS or HIV are protected from discrimination under the Americans with Disabilities Act. That means you can't turn them down for a job simply because they have AIDS or HIV.

-- If an applicant has a several- year gap in their resume, you may ask them what they were doing during that period. You may also ask if their skills are up to date and if they are capable of carrying out specific job functions. But you may NOT ask for any details about their health.

-- Once you've made a job offer to someone, you can ask them to disclose health information or take a medical exam -- but only if you require such an exam of all new employees in that job category.

-- If an employee requests it, the ADA says you must make "reasonable accommodations" for his or her disability. However, the exact definition of a reasonable accommodation can vary enormously, depending on the employee's needs and the size and nature of your business. In cases where it would cause your business "undue hardship," you don't need to provide an accommodation at all.

Most disability accommodations cost less than $100. Some firms have met the needs of employees with AIDS by offering flexible work schedules, time off for medical appointments, or desks near a bathroom.

"The law doesn't require you to grant the exact accommodation requested by the employee, just a reasonable accommodation," said David Durham, managing shareholder with Littler, Mendelsohn, Fastiff, Tichy & Mathiason, a San Francisco law firm. "If you sit down and talk with them, you can usually figure something out that works for both of you."

-- Keep employees' medical information confidential, unless you need to disclose it to their supervisor in arranging an accommodation.

-- Don't make assumptions about what employees with AIDS or HIV can or can't handle. While one person may find business travel too grueling, another may be ready and raring to go.

-- Want to actively help people with AIDS get back to work? You can offer extra training to help returning workers update their skills, or you can volunteer to serve as a mentor or adviser to people re-entering your industry. You can also list your job openings with Positive Resource, a nonprofit job counseling agency for people with HIV at (415) 928-1448.

-- More questions? You can get free information on how to handle AIDS in the workplace from the San Francisco Human Rights Commission at (415) 252-2500 or the San Francisco Chamber of Commerce at (415) 392-4520. The national Centers for Disease Control and Prevention also offers educational materials on AIDS in the workplace at (800) 458-5231.
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