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Employment-Related Concerns of HIV-Positive People in the Netherlands: Input for a Multidisciplinary Guideline


Purpose Finding and keeping employment is difficult for people with HIV. To improve supportive care for people with HIV and employment-related problems, a multidisciplinary guideline was developed in the Netherlands in 2010/2011. To identify the employment-related concerns of people with HIV and to formulate the key questions for the guideline, we conducted a qualitative study. The results of this study are described in this article. Methods This study was performed in three HIV-treatment centers in the Netherlands. In total 18 participants participated in three focus-group interviews and nine participants were interviewed individually. The data were transcribed ad verbatim and were analyzed according to the principle of constant comparison. Results Our findings indicate that people with HIV in the Netherlands face many work-related concerns. The themes which emerged from this study were disclosure, stigma and discrimination, knowledge about HIV, physical and psychological factors, working conditions, absenteeism, reintegration, and dismissal and counselling. Conclusions This study provides insight into employment-related concerns for people with HIV living in a Western country. It formed the basis for the key questions which were addressed in a multidisciplinary, evidence-based guideline “HIV and work”. Finally, it gives leads for further scientific research and opportunities for improving the vocational guidance of people with HIV.

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    Relevant Dutch Social Security Laws and insurance:

    Equal Treatment Act: This law states that unfair treatment on the grounds of a handicap or chronic illness, including HIV, in the work environment or at a private practise is prohibited.

    Medical Examinations Act: the employee is under no obligation to reveal his or her HIV-status during the course of a job interview. The employee retains the right of privacy.

    The Eligibility for Permanent Incapacity Benefit (Restrictions) Act: The objective of this law is to improve the chances of reintegration and/or the return to the labour market, by giving the employer and employee more responsibility for this process. In case of illness the employer is required by law to continue paying wages for 2 years.

    Capacity for Work Act (WIA): After 2 years of illness the employee can apply for a WIA allowance. This amount to 75 % of the employee’s most recent salary.

    Dutch Unemployment Benefit: In case of unemployment people can apply for a Dutch unemployment benefit.

    Health Care Insurance: all citizens are obliged to take out Dutch Health Care insurance.


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We would like to thank the patients for their participation. We would also like to thank the HIV-treatment centers for their participation: Slotervaart Hospital Amsterdam, Leiden University Medical Center, and Erasmus MC Rotterdam.

Author information



Corresponding author

Correspondence to M. N. Wagener.

Appendix: Information About the Guideline “HIV and Work”

Appendix: Information About the Guideline “HIV and Work”

The multidisciplinary, evidence-based guideline was developed by a multidisciplinary core group in which all involved professional associations were represented. The guideline was developed according to “evidence-based guideline development (EBRO)” methods (CBO, 2004). The guideline is authorized by all involved professional associations and the Dutch HIV Association. The guideline and a summary for daily practice are available in Dutch. An English summary for daily practice will be digitally published in 2014.

Organization and development

Rotterdam University of Applied Sciences, Research Centre Innovations in Care, P.O. Box 25035, 3001 HA Rotterdam, The Netherlands

T. (010) 794 54 54 |

The guideline is available on

the websites of the professional associations

the website of the Dutch HIV Association (

The guideline has been authorized by

Dutch HIV Association (HVN)

Dutch Association of HIV-treating physicians (NVHB)

The Netherlands Society of Occupational Medicine (NVAB)

Professional Association of HIV/AIDS Nurses) collectively affiliated with Dutch Nurses’ Association (V&VN VCHA)

Occupational Social Workers Professional Association), part of the Dutch Association of Social Workers (NVMW)

Dutch Association of Insurance Physicians (NVVG)

Association of Occupational Health Nurses (BAV)

Dutch Institute of Psychologists (NIP)

Dutch Association of Labor Experts (NVvA)

This guideline has been compiled with the aid of

The Dutch College of General Practitioners (NHG)

Occupational Therapy Netherlands.


This guideline was developed with the financial support of ZonMw (The Netherlands Organisation for Health Research and Development) within the framework of the Kennisbeleid Kwaliteit Curatieve Zorg (KKCZ) program (Qualitative Curative Care).

Publication date

29 March 2012.

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Wagener, M.N., van Opstal, S.E.M., Miedema, H.S. et al. Employment-Related Concerns of HIV-Positive People in the Netherlands: Input for a Multidisciplinary Guideline. J Occup Rehabil 24, 790–797 (2014).

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  • HIV
  • Employment
  • Qualitative research
  • Vocational guidance