Beyond the diagnosis: HIV-positive workers face employment barriers

Letsema’s story

Ntaoleng Letsema, 39, wanders the streets of Johannesburg searching for domestic work. She is burdened by the stigma that forced her to leave past jobs.  

She was diagnosed with HIV in 2010 and started treatment in 2013. She was living positively until workplace discrimination turned her world upside down.  

"It was only in 2023 when my coworkers at a factory in Maputsoe started treating me unfairly," she recalls.  

"They spoke badly about my status in my presence while pretending to talk  about someone else. They laughed and compared me to a person who had not lived an honest life.”  

"This started soon after they realised that I was taking ART. Before that, everything was normal at work."  

The hostility from her co-workers took a toll on her, and by January 2024, she resigned.   

"I  cried every time I had to go to work. It became toxic and affected my health.”  

"I remember that shortly after my resignation, some of our seniors asked why I had left. When I told them the reason, they were shocked but they did not do anything about it," she says.  

Hoping for a fresh start, Letsema found domestic work in South Africa. Sadly, the discrimination continued.  

"When I started working  in Johannesburg, for transparency, I disclosed my status to my boss.  

"But that was the start of my problems. I had opened a can of worms," she recalls.  

Her employer began threatening her.  

"She told me if anything happened to her child, she would blame me. One time, I took her child to the games, and when we came back, she had a cold. Her mother was furious. She kept saying, 'This child has the virus.' Letsema says.  

From that moment, her life was placed under strict scrutiny.  

"I am well-educated about HIV. I go for trainings and support groups. I've learnt how to take care of myself and protect others from infection. But my boss’s words made me very uncomfortable around her child.” 

By October 2024, Letsema needed to return to Lesotho for her medical check-up. 

"My boss told me that I had to be tested for all infectious diseases when I came back. She said she could not have me infect her child.  

"I agreed, but when I arrived in Lesotho, I decided  not to go back. I made up my mind to look for another job and keep my status to myself to save myself from discrimination and stigma.  

"That kind of treatment is very painful. It affects your mental health. You feel depressed and  worthless," she says.  

While she endured stigma until she resigned, Letsema says others had it worse.  

"I know people who have been fired because of their status, especially domestic workers.

"Bosses are so abusive toward people living with HIV. But we cannot stop looking for domestic work because it is what we qualify for. We are not educated.” As a single parent, she has no choice but to keep searching.  

Letsema feels that communities and families have become more accepting of HIV. But discrimination at work is common - especially from people who don't know their own status. 

A shared struggle: Lisebo’s story 

Letsema’s experience mirrors *Lisebo's, (29), a HIV-positive worker.  

"Most employers still discriminate against people with HIV," Lisebo says. "They believe that a person with HIV can infect their children, which makes no sense "  

Like Letsema, Lisebo has learned to hide her status to secure work. She disguises her medication as migraine pills. She travels to Lesotho every six months to collect her medication.  

Her struggle began long before her HIV diagnosis. Orphaned in 2003, she spent years moving from one relative to another.   

 In 2017, after giving birth, she took on domestic work to provide for her child.  

However, tragedy struck when she was sexually assaulted by the older son of the family she worked for.  

"But the biggest shift in my life came a few months after the assault when I tested positive for HIV," she explains. "I reported the case, and the police did whatever they could to take it to court."  

However,  the court proceedings became unbearable.  

"Everything was just not okay about me," she says. She made the painful choice to disappear, escaping the court case and her attacker.  

Moving  to South Africa was more than a job hunt; it was a desperate escape. From trauma, fear, and from the shadow of a diagnosis that continues to shape her life in ways she never imagined. 

What the statistics say

A 2021 study by the International Labour Organisation (ILO) shows that misinformation leads to stigma and discrimination. Only one in four people understand how people get HIV. Eastern and Southern Africa have the most positive attitude on including people living with HIV in the workplace. People with higher education are more open to working directly with people living with HIV. 

“It is shocking that, 40 years into the HIV and AIDS epidemic, myths and misconceptions persist. A lack of basic facts about how HIV is transmitted is fuelling stigma and discrimination,” said Chidi King, Chief of the ILO’s Gender, Equality, Diversity and Inclusion Branch (GEDI).

“This survey is a wake-up call to strengthen  HIV prevention and education programmes.  Workplace stigma and discrimination  pushes people living with HIV into poverty and undermines the goal of decent work.”

For Letsema and Lisebo, HIV stigma  is more than just cruel words - it is a barrier to stability and dignity. They have been forced to choose between survival and acceptance.

Women make up 75% of migrant domestic workers. They face high risk of exposure to HIV infection. It is difficult for them to access health information and services. Migrant domestic workers are forced to take HIV, TB, or pregnancy tests. Positive results can lead to job loss or deportation. 

What Lesotho’s Government is doing to fight workplace stigma

The Ministry of Health’s HIV and AIDS Communications Officer, Khatala Liphoto, notes that the Ministry prioritises continuous HIV education.

"When people understand HIV/AIDS better, they are less likely to stigmatize or discriminate ," Liphoto said.

The Ministry has implemented workplace programs targeting factories and prisons. However, domestic workers have been excluded due to funding and structural challenges. “They work as individuals, without unions to advocate for them,” Liphoto explained. He stressed the need to work with the Ministry of Labour to address their concerns. 

Ramaema Ramaema, Strategist Information Manager at the National AIDS Commission (NAC), says that stigma and discrimination against people living with HIV remain a challenge in Lesotho, especially among key populations.  

"While the Lesotho Stigma Index 2021 showed some progress in reducing stigma, verbal discrimination and discrimination against family members persist," Ramaema said. "This makes it difficult to disclose one’s status and adhere to treatment."  

The government addresses this in the strategic recommendations from the Lesotho HIV Strategic Plan 2023-2028.

"There is still a need to raise awareness on the impact of stigma and discrimination," he noted. NAC is helping update the 2025 Stigma Index which measures stigma and discrimination against people living with HIV. 

Lisebo and Letsema hope for a future where no one has to hide their status to earn a living. Their stories are a call to action. Workplaces are still hostile territory for people living with HIV. And until real change happens, Letsema and Lisebo, like many others, will continue to live in the shadows, fighting for the right to work without fear.

HIV in focus

This news story has been published as part of our HIV in focus news network. This is a network of writers and journalists from focus countries, dedicated to delivering news on HIV and sexual health. The network aims to amplify the voices of communities most affected by HIV and share the stories that matter to them.

About the writer

Ntsoaki Motaung is an award-winning journalist passionate about covering community health stories in Lesotho with attention on sexual and reproductive health and rights as well as HIV.