Question: I am going to start work next month and have arranged for a domestic worker to do the housework and look after my children aged 2 and 4. I want her to have a blood test before she starts work because I am worried that she might have HIV and my children could get infected. How do I go about making sure she gets tested?

Answer: Even if a person tests HIV negative before they start work, it is possible that they might become infected sometime in the future. In South Africa it is illegal to insist that someone have an HIV test before offering them a job. It is also illegal to dismiss anyone just because they are HIV positive.

Even if a person who is employed decides to have an HIV test, they are not legally bound to inform their employer of the result. Should they do so, the employer is obliged to keep this information confidential.

Anyone who decides to be tested must receive counselling both before and after the test is done. The person must also sign an informed consent form before blood can be taken for the test. In practical terms this means that, before the test is done, the person will receive education about HIV/AIDS, discuss the risk of testing positive and explore how they think they might cope with either a positive or negative result. The counsellor will determine why the person needs to be tested and inform him/her of their legal rights. Should the person test HIV positive, the counsellor will explore how they can prevent transmission or the virus to others.

Human rights abuses have happened when employees were taken for blood tests, by their employers and without informed consent having been obtained. This constitutes an assault. Further, any health care worker who informs an employer of the employee's HIV status, without that person's consent, would be guilty of the serious offence of breaching confidentiality.

Many people are concerned about becoming infected with HIV themselves, or about possible risks to their children. However, it is important to remember that HIV is not spread through casual contact. If this were the case almost all of us would be positive by now as we are constantly in contact with infected people. HIV is spread in three ways:

• unprotected sex with an infected person
• an HIV positive mother might infect her child during pregnancy, labour or breastfeeding
• exposure to blood infected with HIV.

South Africa has one of the safest blood transfusion services in the world. Further, we seldom come into contact with other people's blood. For a person to become infected this way, they would have to have a cut through which the infected blood could get into their bloodstream. Most people who are asked to recall when they last came into contact with anyone else's blood, in this way, find that they can't answer that question. The best way of preventing the spread of this disease is to arm yourself with knowledge and act accordingly.

Some domestic workers who have tested HIV positive have been in the fortunate position of being able to confide in their employers and receive support. These employers recognise that people with HIV are also breadwinners and that it is the quality of their work, rather than their HIV status that is important.