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Page 1

Vulnerability assessment of
people living with

HIV (PLHIV) in Lithuania
FINAL Report

Page 2

Vulnerability assessment of people living with HIV (PLHIV) in Lithuania 2

The views expressed in this publication
are those of the authors and do not
necessarily represent the views of

Copyright ' 2009 United Nations
Development Programme
All rights reserved.

Vilnius, September, 2009

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Vulnerability assessment of people living with HIV (PLHIV) in Lithuania 69

the needs of HIV-positive employees. Employers are a cell of society, a part of so-
ciety which lacks information and knowledge, which is why they are influenced by
common negative attitudes and stereotypes concerning PLHIV. Thus, education is
the primary activity that would create the founding preconditions for employers
to distance themselves from traditional negative stereotypes.

Experiences of PLHIV in the labour market.

Employment possibilities of PLHIV in the Lithuanian labour market. The most
frequent decision of an employed HIV-positive person is to not inform their em-
ployer and their work environment about his or her HIV diagnosis because it would
result in the loss of their job and social exclusion, and financial sources are important
resources to receive treatment, eat nutritious food, and to fulfil financial obligations
for one’s family. When PLHIV are employed, they are not inclined to disclose their
diagnosis to their employer because if there is an alternative to choose between
two employees, the “healthy” one will be chosen, despite his or her other habits,
even if they are harmful. One of the illegal and, one could say, immoral solutions as
viewed by PLHIV is to acquire a health certificate stating that they are healthy. The
latter statement was mentioned by PLHIV only as a consideration of the possibility,
even though none of the research participants had such an experience. The major
obstacle in the labour market is the non-awareness and ignorance of the need for
knowledge about HIV/AIDS of employers themselves, which leads to a stereotypi-
cal approach and negative attitudes concerning PLHIV: they see the HIV diagnosis
rather than a person’s professional qualifications, competence, and capacities based
on work experience. Therefore, equal competition for a job with other persons who
are not infected with HIV but may have different habits and other diseases which
can cause problems in the work environment is practically impossible for PLHIV.
Thus, subjectivity supersedes objectivity concerning PLHIV in the labour market.
For this reason, PLHIV consciously do not inform their employer of their health
status, realising their moral and social responsibility for such a decision, and giving
themselves the power to protect their own health and the health of others.

Needs of PLHIV to adapt in the labour market. In the labour market, it is not a
special status but equality, i.e. human dignity in the labour market context, which
is important for HIV-positive people. Specific laws creating preconditions for HIV-
positive people to exercise their rights and guarantees and that are also encou-
raging employers to hire PLHIV are necessary. Employers must have training on
HIV which would enable the development of their tolerance and understanding
as a means of preventing social exclusion in the context of the labour market. The
concealment of an HIV diagnosis only poses problems to an HIV-positive person
relatively (“as long as they do not know, there are no problems�); however, this is an
artificial situation, the social consequences of which may be revealed at any time
– the HIV-positive person’s decision not to inform their environment is a defensive
position determined by societal stereotypes and attitudes, which are also held by
employers, while the non-awareness of HIV among employers and ignoring of the
need for this information in all work environments is irrational because ignorance
in the health statuses of employed persons is a precondition for an unsafe work
environment, and knowing is power and the ability to ensure safety by general
humane, social and morally acceptable solutions, while ignoring the stereotypes
that have already become standardised concerning PLHIV and maintaining the
dignity of an HIV-positive person and that organisation.

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Vulnerability assessment of people living with HIV (PLHIV) in Lithuania 70

Table 8. Health Disorders of PLHIV

Category Subcategory Interview statement

consequences for
physical health

Excessive sweating
at night

<...> the main thing is that I sweat a lot, all the time I get up wet at night.
I sweat constantly. <...>


And weakness <...>
<...> constant weakness..
Weakness. The organism has to work twice as much. It must fight against HIV, against
the virus, and it must fight against any external factors. Sometimes even three times
as much. So, you can imagine how this constant work of the cells exhausts the
organism. And therefore the organism gets tired. Not because you are lazy but this
process becomes much faster in the organism. You need more protein because you
are practically feeding your HIV <...>. It destroys proteins, which means, you must
produce protein for it so that there would be enough protein, etc.

Fatigue <...> fatigue.
Quick exhaustion You become exhausted very quickly.

Lack of appetite

There is no appetite, I don’t have one anymore, maybe when I found out ... since
that time I have never eaten normally, no matter what kind of food it is, I don’t
eat. God, a little bit. And it happens that I don’t eat anything for several days. <...>
Of course, sometimes I eat normally but what concerns food, I look at it as at some duty.

Vesicular skin
rashes Herpes, maybe that’s why I have more rashes.

Constant feeling
of heat <...> I am hot <...>

Morning weakness

It’s not good, no strength. A person gets up in the morning full of energy, there’s
something somewhere… I am not like this, I get up and think – here we go, I
need to “live through” one more day somehow, to suffer one more day, well, so,
I’m awake...

Leg pain

And now I have problems with my leg, before I had problems with my spine. The
surgeon who performed the operation on my back said that you have a very weak
immune system. But he said this in hints but he did not say anything directly and
did not make any tests, they don’t make tests. <...> now my leg has some kind of


<...> such depression, it’s not going away, it’s lasted for six months...

Frequent colds
Most often, there are all kinds of cold infections. Well, you go somewhere by bus,
somebody sneezes – you catch a virus. You use antiretroviral medicines but still
this infection gets into the organism.

Digestive system

There are problems with the digestive system...
Liver disorders <...>

Seborrhoea Diseases... seborrhoea. First, I thought that those are problems with my skin but later I found out that this can be related to a weak immune system.
Excretion system
problems <...> kidney disorders...

lymphatic nodes Enlarged lymphatic nodes.

Good health status
at the beginning of
HIV infection and
treatment against it

Absence of health
caused by HIV

<...> at the moment, what is caused by HIV, I couldn’t say.

Low morbidity

But my own morbidity is low.
What is weird is that I even forgot when I had to go to a physician last time.
I don’t have any diseases, so I really don’t go there. I even cannot remember when
I was running temperature, to tell you the truth.

Rare morbidity
One time per year practically.
I wasn’t sick even once during the year, even with the so-called winter infections,
I did not have any respiratory diseases or flu this year.

Complexity of
between their HIV-
related condition
and their general

Failure to
the symptoms
characteristic of HIV

It is hard to say now in the recovery stage, all those signals sent from the inside,
they are mixed with the general condition that it is impossible to say what is
associated with that virus and what is associated with the recovery.

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Procedure for Checking the Health of these Persons� � (Valstyb�s �inios, 2002,
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