"Charges of Human Immunodeficiency Virus Discrimination in the
Workplace: The Americans with Disabilities Act in Action"
American Journal of Epidemiology (08.02.02) Vol. 156, P. 219-
229:David M. Studdert
     The Americans with Disabilities Act (ADA) is arguably the
most important piece of civil rights legislation enacted in the
United States in the past 25 years. The objective of safeguarding
persons with HIV from discrimination figured prominently in the
genesis of ADA and its enactment in 1990. Although drafters of
the ADA apparently intended the legislation would protect persons
with HIV and AIDS, courts in the mid-1990s began to cast doubt on
whether asymptomatic HIV continued to meet the definition of a
disability under the Act. In 1998, the United States Supreme
Court resolved this question in the affirmative.
     The workplace presents special risks for individuals with
HIV/AIDS. The hierarchical structures, imbalances in power, and
close personal interactions common to most employment situations
offer abundant opportunities for discrimination. Title I of the
ADA targets the workplace.
     Little empirical information exists about how the ADA has
actually been used by its intended beneficiaries to redress
discrimination. The current study describes the epidemiology of
ADA charges alleging employment-related discrimination due to HIV
since the inception of ADA in 1991. Using a national database of
all HIV discrimination charges filed since 1991, the study treats
respondent employers, issues of dispute and outcomes of charges.
It then uses multivariate regression analyses to compare the
socio-demographic characteristics of charge filers with those of
a nationally representative baseline sample of workers with HIV.
     Persons who believe they have been discriminated against in
their employment begin by filing an administrative charge at an
Equal Employment Opportunity Commission (EEOC) or Fair Employment
Practices Agencies (FEPA). An ensuing investigation determines
whether there is reasonable cause to believe that discrimination
has occurred. If there is reasonable cause, the charge is
classified as having merit and the agency attempts to begin
voluntary resolution between the employee and the employer.         
     Using the HIV Cost and Services Utilization Study (HCSUS),
the authors developed a national probability sampling of persons
eligible for sampling. Interviewees who reported having jobs at
baseline or at a follow-up interview were classified as workers.
These persons comprised the General Base Population (GBP).
     Of the 3,520 HIV employment discrimination charges filed
through 1999 in this study, 18 percent had merit and 14.1 percent
received monetary compensation. HIV charges account for 2.8
percent of ADA enforcement caseloads and 8 percent of all
monetary benefits awarded under Title I. Seven states accounted
for 55 percent of all charges and three states - California (11.5
percent), Texas (11.3 percent), and New York (9.6 percent) -
accounted for one-third. About one-third of charges in
Pennsylvania and one-quarter of charges in New York were deemed
of merit. Nearly 60 percent of all charges alleged discriminatory
discharge from employment. The next most common allegations were
conditions of employment, harassment and failure to provide
reasonable accommodation.
     Compared with the GBP, women were underrepresented among
charging parties, as were black workers and those aged less than
25 years. Workers aged less than 25 years were approximately one-
third as likely as those ages 35-44 to file charges, and those
ages 25-34 were three-fourths as likely. Neither the racial nor
the income differences observed in unadjusted comparisons with
the GBP were statistically significant.
     According to the authors, "There are two competing
explanations for these discrepancies; each has quite different
implications. On the one hand, they may simply reflect lower
rates of discrimination (perceived or actual) among workers with
HIV who exhibit these particular characteristics.... On the other
hand, the discrepancies may signal a lower propensity to seek
relief when discrimination occurs."
     In summary, the study illustrated the significant extent to
which epidemiology can be used to document discrepancies in
charges placed and in the under representation of groups covered
by this civil rights legislation. "As improved treatments
continue to erode the barrier HIV poses to a person's capacity to
work, the number of Americans who stand to benefit from effective
safeguards against discrimination grows larger." With this study,
the authors hope to aid in targeting dissemination, guidance, and
support services around anti-discrimination laws towards the
groups of workers who need them the most.