Should you hire or retain a maid who tests HIV positive?

Should you in the first place have a maid tested for HIV? With or without her knowledge and consent? Should it matter whether she turns out positive or not? Two women who have knowingly kept on maids who tested HIV positive share their reasons for their choices, the fears and their experiences.

I have employed two maids with HIV
Winfred Luutu, a counsellor with Mildmay Uganda, married with three children, the eldest now at the university.

“When I employ someone, I always tell them who I am and where I work. I tell them that I am a counsellor. I encourage everybody to know their HIV status.

First HIV positive maid
The nature of my home is such that I do not employ young househelp. My home is big; I even have farm yard animals so a young maid would not manage. I employed the first of two HIV positive maids in 2009.

She was from Busiika in eastern Uganda. She was sent to me by one of my relatives. This maid was almost 40 years old. When she came to work for me, I told her that I worked with Mildmay Uganda and that was an eye opener for her. One day, she told me there was something she needed to tell me and then she disclosed that she had been getting care and treatment for HIV from Mulago hospital.

“When they were caring for us at Mulago, they told us that we should not keep quiet. They told us that when we go to work, we must disclose our HIV status,” she said.

I was happy that she had told me her status because in my line of work, we get so many househelp testing for HIV and we encourage them to disclose the results to their employers.

When she told me she had tested HIV positive, I asked about her hospital visits and told her that I would give her time off to go for care.

Our eldest child was about 15 then. I also had to disclose to my husband what kind of maid we had otherwise he would have wondered about her frequent absences. However, once I had chosen to keep the househelp, he respected my decision.

The house help stayed two years after which she left the employment to return to the village on family business.

Second maid was also HIV positive
In the second case, when the house help came, I told her that I was a counsellor. It took her more than three months to come forward about her status. Then she reminded me that I had told her I could do an HIV test at home. She had lost a partner to HIV and she was in a fearful state. She told me, “I feel I need to be tested.”

I also asked her to encourage Ssalongo the Shamba boy to do the HIV test but he refused. I brought the test kits, tested her, only to find out that she was HIV positive. I counselled her and advised her to seek treatment and care. I contacted a colleague at Mukono hospital and referred her there.

She joined care. She also appreciated the fact that I had taken the news of her status positively. I knew she had three children and after we talked, I encouraged her to test her youngest child for HIV. The boy also tested positive and they opened up a file in her home village where the child stays with his grandparents.

These people managed to be in our home when they were HIV positive and there was no harm. If someone discloses their HIV status, it becomes easier for you to accept them as they are.”

My maid tested HIV positive after I’d had her for over a year
Dora Barungi: Mother of three

I had been with my 36-year-old maid for over a year when she started to fall sick regularly in 2010. I could have taken her to a clinic and had basic medication prescribed for her, or simply given her money to go find medication but I did not. I felt an urge to have her thoroughly checked out, so, I made time and took her to hospital. There, we asked the doctor to do a comprehensive medical checkup. Among the tests done was the HIV test, which returned positive.

I was shocked, but not really surprised. She had been so sickly at the time, it had crossed my mind that she could be sick. Still, the confirmation was disturbing. When I told her, she was subdued but did not seem surprised. It was like she’d had her suspicions too.

There were so many things going through my mind as we walked out of the clinic. I had read about how one should not lose their job because they were HIV positive. I was, however, also thinking about my two boys at the time who were at her disposal throughout the day. Wondering about all those things you hear maids do to children under their care like breast feeding them or deliberately infecting family members.

But this maid had been, for the year she had been with us, super. She was hardworking and really loved my boys. And I’d had my share of bad maids so I knew a good one, and this was one. I decided to talk about it and see how she could keep on as my employee, even with her recently discovered status.

In the car on our way back home, I asked her if she still wanted to work, she said yes. I told her we would need to discuss new terms of her employment as she would now have to be more careful especially around the children. Fortunately, I had another maid whose main chore was the children. We agreed that she would not use the bathroom and toilet or their utensils.

She would be careful with items she used like toothbrushes and razor blades, ensuring that the children do not re-use them. It was a candid talk where we basically agreed that she would keep on but be more careful. She would, in fact, concentrate on the chores that were not to do with the children. And so she kept on, and we were both happy.

I also had to let my husband know about her status, and all the other adults who came home like my siblings. This way, they would all understand when she fell sick or needed to go get her medication. She started on ARVs and the bouts of sickness stopped.

I was happy to continue with her but it did not mean that I did not have any worries. I would sometimes worry about children sustaining wounds in situations where she was the only one available to attend to them. What if we made her angry and she decided to revenge? Those fears never went away, but a better part of me trusted the maid because she had been good the previous year.

In 2012, she decided to move on to get married and venture into business and I regretfully saw her off.

We had had a good run though and I have never regretted my decision to keep her on. She also expressed her gratitude for letting her stay on saying she had been sure she was going to be sent packing”

If you decide to keep her:
• Firstly, I would advise everyone to be in the know of their domestic servants’ status. It is more risky if you do not, especially since they also do not know.

• Firing a maid who tests positive should not be the default. it is unfair. But I understand the fears and it is ultimately one’s choice on whether to keep them or not.

• If you are not comfortable with a maid who tests positive, it is better to let her go than keep her on as you may offend her, and make her a risk in your home.

• If you keep them, ensure that you have a good open relationship where you can express your fears and concerns without offending her.

• Be careful and mindful of their health, ensuring they have no open sores and all infections are treated immediately. Be considerate, and let them rest when they are ill and take their medication.

General health precautions for domestic servants (By Dr Stephen Watiti)
Dr Stephen Watiti, Senior Medical Officer at Mildmay Uganda advises that when you get a new domestic employee:
• Talk to them about general health and hygiene; I would emphasise good health and hygiene practices such as don’t kiss a baby on the mouth or to wash a glass after drinking from it. Even if you don’t have HIV, you should not be breastfeeding someone else’s baby.

• Encourage the house help to test for communicable diseases such as Tuberculosis and Typhoid.

• You can also encourage them to test for HIV but this should be voluntary since compulsory testing for HIV is a violation of one’s rights.

When the help is HIV positive
• The risk of catching HIV from someone casually is almost zero. The main way that we should emphasise is sexual transmission of HIV. The sexual risk is the highest. The man of the house (husband) and the big boys could have sex with the house help. They also have feelings.

• Talk to the big boys (males of age) around the home about the risk of having sexual relations with the house help. You also need to talk to the house help.

• If people are put on ARVs, the risk of transmission is further reduced.

• There are many people living with HIV amongst us. It is not just the house help but probably also our colleagues in the workplace. If you stigmatise people, they become angry. If people living with HIV are treated humanely, then they will not become angry.

• Of course there are some exceptions. There are those people with criminal minds but even if they spit in your food, you will not get HIV, unless it involves blood. You would need to swallow six litres of saliva to get infected.

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