This article discusses the abolition of the employer’s right to request HIV testing from an employee. The Human Immunodeficiency Virus (HIV) is only transmitted through direct contact: vaginal and anal sex, sharing medical syringes, and breastfeeding. AIDS, the late-stage disease caused by HIV, is classified as an endemic disease and, under Egyptian law, falls under infectious diseases, which grants the employer the right to request a virus test from workers before hiring them. The article begins with a discussion of the probability of infection in various workplaces and different professions, then moves to a discussion of Egyptian labor laws related to infection in the workplace, alongside disciplinary procedures and required forms for workers before hiring. This discussion is followed by the goals that the National Plan for Combating HIV aims to achieve and how the plan conflicts with labor laws that require tests for infectious diseases or disciplinary action based on a worker’s infection with a contagious disease. Finally, the report proposes abolishing the employer’s right to request tests unless the profession exposes workers to a high risk of infection. Lastly, the report presents ways for the gradual abolition of disciplinary action by the employer against an employee if the employer becomes aware of the employee’s HIV infection.
Job appointment includes several protocols, one of which is Form 111, which does not request tests for endemic diseases but includes a medical examination with a chest X-ray, urine test, vision test, and internal medicine and surgery examination (testimonies from private sector workers). In addition to the form, Article 135 of Labor Law No. 14 of 2025 stipulates that the worker is obligated to undergo medical tests for substance abuse and infectious diseases when requested by the employer. These procedures and laws open the door for the employer to discriminate against individuals infected with HIV. Egyptian media and independent research document many cases of arbitrary dismissal due to the employer’s knowledge of a worker’s infection. In an article by Bassem Magdy published in 2018, it is shown that a hospital shared a patient’s medical test results with his employer without the patient’s knowledge, and based on the virus infection, the employer arbitrarily dismissed the infected person. In another article published in 2022 titled “Living with ‘AIDS’ in Egypt: Stigma, Discrimination, and Wholesale Violations,” Islam Deif mentions that “abuse against HIV-infected individuals reaches the point of dismissal from their workplaces. Furthermore, there are entities that impose medical tests as a condition for job acceptance, and applicants carrying the virus are rejected regardless of their health status, even if it suits the nature of the work.” He cites the International Labour Organization that “infected people face discrimination during job search and suffer difficulties in maintaining their jobs, in addition to the infection causing a blockage in job promotions.” In a third report by Abdullah Abu Deif, he mentions the story of a worker whose medication was found at the workplace, leading to his dismissal, and his attempts to contact the employer to regain his job were unsuccessful. These reports indicate the existence of discrimination against HIV-infected individuals even without employers using their legal right to request medical tests for the virus.
These procedures discriminate against the infected person while the infected person does not harm the work environment nor is their infection transmitted to colleagues. The U.S. Centers for Disease Control and Prevention (CDC) clarifies that HIV infection is rarely transmitted in the workplace. First, in hospitals and treatment settings, which are workplaces closer to injuries and risks of HIV transmission, the CDC clarifies that even when using syringes, the infection rate is 1%, and the probability of infection approaches zero upon exposure to splashes of blood, and that even in the case of exposure to splashes of human fluids on the skin or any mucous membrane, the probability of infection remains very small. These probabilities are in the fields most exposed to HIV, such as surgery in hospitals and clinics. Second, in other fields such as factories and companies, the virus does not live outside the body and degrades upon exposure to air. Even in these cases, it is the responsibility of companies to define and implement protocols in case of general worker injury and to clean equipment and tools in case of worker injury and exposure of workplace surfaces to workers’ blood (with or without infection) as general hygiene measures.
The employer might justify their discrimination by adhering to their role in protecting male and female workers in the workplace, as Egyptian law places responsibility on the employer to protect workers in “the establishment and its branches by taking means and methods to protect workers from the risk of infection with bacteria, viruses, fungi, parasites, and all other biological hazards whenever the nature of the work exposes workers to the conditions of infection with them (Article 248 of the Labor Law of 2025). And in Article 250 of the same law, which stipulates the necessity for the employer to ensure that male and female workers in “places of cooking, handling, and consumption of food and beverages” possess “health certificates indicating they are free from epidemic and infectious diseases.”
This responsibility placed on the employer stipulates that the nature of the work must “expose workers to conditions” of infection with certain diseases, but as I explained previously, the probability of HIV infection may reach zero in the professions closest to those infected with the virus, which are professions related to providing surgical health care (using scalpels and syringes). Furthermore, in many cases, the work does not pose any risk of infection, such as the following jobs: call center, customer service, marketing, accounting, and the like, and the employer requests medical tests for infectious diseases. In other cases, the worker does not go to the establishment but works from home, and the employer still maintains their right to request infectious disease tests.
The second goal of pre-employment medical tests is to ensure the worker’s productivity, which the employer requires to be as high as possible. Indeed, Egyptian law provides protection to workers from arbitrary dismissal due to any infection as long as it has not affected the worker’s productivity, but of course, social stigma discourages workers from filing lawsuits against employers (Abdullah Abu Deif 2024). This article discusses the abolition of the HIV test request, as the latest scientific research shows a diminishing effect of the virus on worker productivity, especially after the use of Antiretroviral Therapy (ART), where the negative effect of the virus on worker productivity decreases (Ohrnberger, J., Hauck, K. (2022)). Indeed, the treatment reduces the severity of productivity loss, so much so that it may be equal to that of those not infected with the virus.
The latest update to the National Plan for Combating HIV to align with the Global AIDS Strategy (2021–2025), aims for zero new infections, zero AIDS-related deaths, and zero discrimination based on infection with the virus. Strategic Goal 8.3 stipulates “Reducing HIV-related Stigma and Discrimination” (author’s translation). Considering the labor market when analyzing discrimination resulting from HIV infection is important because discrimination against HIV-infected individuals in the labor market by denying them equal opportunities or taking disciplinary action solely based on their HIV infection reduces their opportunities to obtain a stable income that allows them to participate in Egyptian society and the labor market after receiving treatment to reach an Undetectable = Untransmittable (U=U) state.
This policy brief recommends abolishing the employer’s right to request an HIV test, and we recommend that the abolition of this right be gradual, starting with jobs where the worker does not work at the establishment, i.e., works from home, and then jobs where the risk of infection is zero, such as office work. The second phase begins with factories that have a protocol to limit the spread of infection in case of infection, and training and equipping other factories to use the same protocols. The last group of jobs where the employer’s right to request infectious disease tests is abolished are medical jobs, where the probability of infection may be slightly higher than zero, and therefore workers in these jobs receive intensive training in dealing with infected individuals with dignity and respect, and protocols that ensure non-transmission of the infection. We also recommend facilitating the worker’s ability to report the employer in case they lose their job due to the employer’s knowledge of the infection, especially if the infection did not affect the worker’s productivity.
