Discrimination in Public and Private Benefits

Pages75-77

Page 75

The Issue

Due to the persistent stigma that often accompanies HIV and AIDS, PLHIV may face discrimination in various contexts. Public and private benefits are no exception. Without adequate legal protection, PLHIV often experience difficulty in obtaining health or life insurance, social security benefits, and credit or other financial services. Also, access to public facilities such as public buildings, parks, hotels, restaurants, buses and trains, and other facilities or areas that are typically open to the general public, should not be denied to PLHIV.

Legal and Policy Considerations

National laws and policies may address discrimination related to benefits, financial services, and access to public accommodations through general anti-discrimination laws. In countries that adopt this approach, the general laws may directly designate antidiscrimination protections for benefits, insurance coverage, or accommodations, guaranteeing that those making decisions in these areas are not discriminating against PLHIV. Legislation and regulations applicable to specific industries, such as insurance or financial services, may also include separate protections against discrimination. For example, in countries where health insurance, life insurance, and other benefits are provided through employers, labor and employment laws may prevent HIV-negative status from being used as a prerequisite for eligibility for insurance or benefits, and may forbid employers and others from sharing information about a person's HIV status with insurers without consent.

A central consideration for policymakers is to find the fair equilibrium between preventing discrimination and allowing the insurance and financial markets to work. Since health directly impacts the insurance scheme, insurance companies need certain private information from the people they insure. Insurers may try to refuse to cover HIV-positive persons or charge an excessively high premium for their coverage. Many countries have found a balance by prohibiting insurance companies from requiring an HIV test or a declaration of HIV status prior to approving insurance coverage, yet still allowing them to make reasonable actuarial decisions. The UNAIDS/OHCHR International Guidelines on HIV/AIDS and Human Rights recommend fair and equal treatment of HIV status in insurance: "exemptions for superannuation and...

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