In Partial Fulfilment of the Requirements in

BUS530M

Management Action Research

Improving Perception on HIV/AIDS in the workplace to reduce stigma and discrimination

Submitted by:

Analyn D. Caindoy (11787961)

Submitted to:

Dr. Benito L. Teehankee

Submitted on:

August 21, 2018

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Table of Contents
Purpose and Rationale of Research ....................................................................................... 3

Context ....................................................................................................................................... 3

Forms of Stigma ................................................................................................................ 6

Self-Stigma ................................................................................................................... 6

Governmental Stigma ................................................................................................. 6

Healthcare Stigma ....................................................................................................... 6

Employment Stigma ...................................................................................................... 6

Organizational Chart .................................................................................................... 6

Method ...................................................................................................................................... 7

First Person (ORJI) ....................................................................................................... 8

First Person (Ladder of Inference) ................................................................................ 9

Second Person (Four Parts of Speech) ........................................................................ 10

Third Person (Force Field Analysis) ........................................................................... 10

Meta-Learning

Constent ...................................................................................................................... 11

References ................................................................................................................................ 13

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Purpose and Rationale of the Research

The purpose of this action research is to find opportunities to advance the HIV/AIDS policy
in the workplace to improve the perception of the workforce on HIV/AIDS, to reduce stigma
and discrimination.

CHI has an existing HIV/AIDS in the Workplace policy and has strengthened it through local
partnerships with non-government organizations (NGO) starting 2015. From the meetings
with the NGOs, it was discussed that the number one reason why people in general are not
open to discuss HIV/AIDS or get tested is the stigma attached to the topic. Despite awareness
activities such as online trainings, campaign materials, and brown bag sessions, the
workforce has a perceived stigma and discrimination on HIV/AIDS.

By addressing the issue, this action research hopes to identify and address the gaps to
improve perception on HIV/AIDS and for the employees to perceive the company as a safe
place for people with HIV/AIDS.

Additionally, taking on this topic as action research it supports the RVR COB code of ethics
specifically on Beneficence and Non-maleficence – to raise quality of life and help build a
just, peaceful, stable and progressive Filipino nation; Collaboration in Research also applies
as I discuss the partnership with NGOs in the country. Management of Data is strictly
confidential and will not be used for personal advantage of any party. No identification can
be linked to PLHIVs or their families and friends.

Collaborators on this topic agreed to participate in this action research. By addressing the
issue, this action research hopes to improve the perception on HIV/AIDS in the workplace.

Context

HIV cases in the Philippines increased to 3,147% higher in 2017 compared with the 342 HIV
infections reported in 2007. According to the latest (April 2018) HIV/AIDS registry in the
Philippines (HARP) from the Department of Health (DOH), there are 924 new infections
which translates to 31 new cases every day. Median age is 28 and more than half are from the
age group 25-34 years old. Data from HARP noted that more than half were from 25-34 years
old while 28% were from the youth (15-24). Based on Philippine Statistics Authority (PSA),
the working age population in the country is 15-64 years old at a specified time. Clearly this
is an alarming state because the age group of the talents that we need in the company are the

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ones mostly affected with HIV/AIDS. For an organization who is primarily on services and
relies on the skills and talents of its people, the business will be significantly impacted.

avert.org cited UNAIDS (2015) in their works on Stigma and Discrimination that “HIV-
related stigma and discrimination refers to prejudice, negative attitudes and abuse directed at
people living with HIV and AIDS. In 35% of countries with available data, over 50% of
people report having discriminatory attitudes towards people living with HIV.”

Additionally, avert.org cited UNAIDS (2017) that “Stigma and discrimination also makes
people vulnerable to HIV. Those most at risk to HIV (key affected populations) continue to
face stigma and discrimination based on their actual or perceived health status, race,
socioeconomic status, age, sex, sexual orientation or gender identity or other grounds. Stigma
and discrimination manifests itself in many ways. Discrimination and other human rights
violations may occur in health care settings, barring people from accessing health services or
enjoying quality health care.3 Some people living with HIV and other key affected
populations are shunned by family, peers and the wider community, while others face poor
treatment in educational and work settings, erosion of their rights, and psychological damage.
These all limit access to HIV testing, treatment and other HIV services.

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Forms of Stigma and Discrimination

HIV/AIDS-related stigma can lead to discrimination like PLHIVs banned from travelling
from outside the country and some doctors would refuse providing treatment to PLHIVs.

Self-Stigma

Due to fear of discrimination, it breaks down the person’s confidence to seek help which
results to self-blame, depression, worthlessness. This self-stigma creates a big road block to
early intervention and easy access on health care. (PLHIV Stigma Index (10 October 2015)).

Governmental Stigma

While Philippines has enacted R.A. 8504 (Philippine AIDS prevention and control act of
1998), the government has prohibited the NGOs and health workers to dispense clean needles
because it promotes drug-use. Needle sharing is one of the ways to spread the virus.

Healthcare Stigma

Avert.org cited UNAIDS (2017), that It can take many forms, including mandatory HIV
testing without consent or appropriate counselling. Health providers may minimize contact
with, or care of, patients living with HIV, delay or deny treatment, demand additional
payment for services and isolate people living with HIV from other patients.

Employment Stigma

In the workplace, people living with HIV may suffer stigma from their co-workers and
employers, such as social isolation and ridicule, or experience discriminatory practices, such
as termination or refusal of employment. Evidence from the People Living with HIV Stigma
Index suggests that, in many countries, HIV-related stigma and discrimination are as
frequently or more frequently a cause of unemployment or a denial of work opportunity as ill
health. Avert.org cited The PLHIV Stigma Index (2012).

With the enactment of R.A. 8504 (Philippine AIDS Prevention and Control Act of 1998) and
the Department of Labor and Employment (DOLE) Department Order No. 102-10, Series of
2010, stating that private organizations should have an existing guideline on the control and
prevention of HIV/AIDS in their workplaces, Manila Services has strengthened the current
HIV/AIDS policy in the workplace by implementing local partnerships with non-government

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organizations. Despite the policy in place at Manila Services, there is still perceived stigma
and discrimination on HIV/AIDS.

Manila Services serves as the back office for an oil and gas company. The company has a
dedicated health and medical team to ensure the health and well-being of its employees. The
health and medical team is led by one country medical manager who reports to the HR
Manager for administrative work and directly reports to the Regional Medical Manager. I
directly work with the country medical manager on planning, designing, implementing and
evaluation of the health programs in the workplace. I am also responsible on collaborating
with the Wellness Specialist, Health Metrics Specialist, OH Nurse and NGOs or other
external vendors.

Organizational Chart

Manila Services has five operating business units and is being supported by the Health and
Medical team in terms of health and wellness programs and initiatives. The Health and
Medical team is being headed locally by the Country Medical Manager who functionally
reports to the Regional Medical Manager and administratively reports to the HR Manager for
alignement on budget, resources and others.

I directly report to the country medical manager and also coordinates the programs I handle
to the regional medical manager. I am also responsible for program management of the
various health and wellness promotions that is why I have subject matter experts (SME) such
as the Wellness Specialist, Health Metrics and Reporting Specialist. I collaborate with these
SMEs on the programs.

Additionally, the Occupational Health Nurse implements the programs in his area. Externally,
I collaborate and partner with NGOs and other vendors for more extensive and sustainable
programs.

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Method

Techniques in Action Research were used to address the concern on the perceived stigma and
discrimination on HIV/AIDS in the workplace at Manila Services.

According to Reason and Bradbury, “action research is a participatory, democratic process

concerned with developing practical knowledge in the pursuit of worthwhile human purposes,
grounded in a participatory worldview (2008:1).” (Coghlan and Brannick, 2014).
Based on the original Lewinian form, “the action research cycle comprises a pre-step and
three core activities: planning, action and fact-finding (Lewin, 1997 (1946):146), (Coghlan
and Brannick, 2014). Below is the action research cycle:

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On Pre-Step (context and purpose), I chose the stigma and discrimination on HIV/AIDS in the
workplace because it answers the question if it is necessary, has economic, and social impact
as well cultural forces driving change.

First Person
The ORJI Model

To be able to reflect on the topic, I used the ORJI method through the Journey app. In this
action research, I utilized the Observation, Reaction, Judgement and Intervention (ORJI) cycle
to be able to audit my thought process and internal conflicts to mitigate potential drawbacks.
“Journal notes of leaders have been shown to be a useful source of qualitative information for
reflection and sensemaking.” (Bartunek, Krim, Necochea, & Humphries, 1999; Krim, 1988).

I used the following questions as my guide to make regular reflections up to this action
research. Coghlan and Brannick (2010, p. 34) give the following guide questions for using
Schein’s ORJI framework for reflective action research:

1. What did I observe? Can I describe it?

2. How did I react? What feelings were aroused in me?
3. What was my judgment about what happened? What thoughts or evaluations did
the event triggers?
4. What did I do about it? How did I intervene? (p. 34)

These are the answers to the guide questions of Schein’s ORJI framework:
1. I noticed that during the first instructor-led training conducted in the office on HIV/AIDS,
the participants did not ask questions much because they said in the feedback that they
were shy and feared that they might be judged if they ask sex-related questions. The
participants were few (~20 employees) during the session if I compare it with the other
learning sessions that we offer. I also reflected on how I reacted to the participants’
reaction or non-reaction.
2. On the number of participants, I was expecting it because this is the first for the
organization. It somehow established that the organization is not ready to talk about such

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 topics but I also felt reassured because I also verified my observations to one of the
collaborators.
3. Based on what happened, my thoughts are that there should be more offerings on the topic
on different time slots to cover more employees. I should promote this topic more so that
more people gets educated and informed.
4. I created several sessions in 2015 to pilot the event

During reflection on the ORJI model and observation of the different stakeholders of the
program, it showed that, “the level of self-awareness required to monitor the subjective
dimension of management work requires deep reflection. Such reflective practice can be aided
by a systematic approach and this is possible through action research” (Teehankee, 2013).

Ladder of Inference

In the practice of ladder of inference, I initially gathered observable data and experience
based on the initial learning session and feedback from the participants. There were items in

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the observed data that stood out and I focused on them. I then interpreted the data to create
meaning based on data presented and made assumptions based on the meanings.

From this, I drew conclusion that the organization needs more instructor-led trainings to
desensitize the group. With this, the action I coordinated with partner NGO to provide the
training and created more sessions for the organization.

Second Person

For second person, I used Four parts of Speech by Fisher and Torbert as cited by Coghlan and
Brannick (2014).

Below are the four parts they mentioned

1. Framing – explicitly stating the purpose of speaking for the present occasion: what
dilemma you are trying to resolve, sharing assumptions about the situation.
2. Advocating – explicitly stating the goal to be achieved, asserting and option,
perception and feeling or proposal for action.
3. Illustrating – telling a bit of the concrete story that makes the advocacy concrete and
orients the others more clearly
4. Inquiring – questioning others to understand their perspectives and views.

I initially shared the topic to my SMEs. From the meeting, goals were set and and proposal
for action was planned. The plan was cascaded to the partner NGO and the same method was
used. Based on the two engagements, plan was more concrete and was solidified during my
meeting with the country and regional medical manager. During the meeting, there were
items that were put in question but I clarified these items with them and understood where the
two were coming from. We met half way to proceed with the plan. The beauty of practicing
four parts is that for me, I explained and reasoned out my concerns, and all points were
considered. It enhanced the collaborative atmosphere of the team.

Third Person

In addition to using the Journey app for placing my reflections, I also used Force Field
Analysis was used to find the initial cause/s of the issue.

HIV/AIDS stigma is considered a major barrier to effective responses to the HIV epidemic,
stigma reduction efforts are relegated to the bottom of AIDS program priorities. H/A stigma

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is cited as a major barrier to accessing prevention, care, and treatment services. (Mahajan, et
al., 2008).

As an Occupational health specialist, HIV/AIDS is an issue that presents a lot of challenges

both on a national level and in the organization but it will help me improve the existing
programs and activities that we have in the organization for HIV/AIDS. Personally, as an
advocacy, the outcome of this action research may also serve as a learning material on how to
reach more people and prevent new infections by being able to target a major barrier in the
health delivery system of HIV/AIDS.

Meta-Learning
Content

After conducting the different strategies for 1st, 2nd and 3rd person, and the continuous cycle
of action research my initial thoughts were confirmed that addressing the stigma and
discrimination on HIV/AIDS in the workplace is an important issue because it is a main
deterrent in an effective health delivery system.

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While it is difficult to change the mindset of people on HIV/AIDS, I think it is worth the
struggle because lives can be saved. Additionally, people usually fear or anger what they
don’t understand. I firmly believe that to be able to shift the culture form HIV/AIDS being a
taboo topic to it being openly discussed, education is key. When people understand that
HIV/AIDS is not a life sentence, that people living with HIV (PLHIV) can still work and
function as normal as person without it, more people will know how to better protect
themselves and ultimately prevent new infections.

Manila Services prides on its value on diversity and inclusion and extensive policy on
discrimination which was further strengthened by HIV/AIDS policy. The overall culture in
the company is diverse but I also acknowledge that the Filipino cultural beliefs and values
also plays a significant role. For me, as an action researcher in my organization and based on
the discussions and planning with the collaborators, a mindset shift will best fit the situation
starting with the leaders so that all the elements will fit together (goals, communications,
roles and practices). The leaders will be the pivotal change in the mindset of our people on
HIV/AIDS on reducing if not eliminate HIV-related stigma. The overall strategy would be to
slowly but surely build the awareness on the disease through education and progress to more
employee-engaging activities such as workshops, screenings, etc.

It also affirmed my advocacy on HIV/AIDS that nobody should die from this disease at this
age and time because resources are available, help is here. We only need to ensure an integral
health service delivery – equity in access of HIV/AIDS resources.

One way to ensure that resources are readily available is that we need to break the glass of
stigma and discrimination which is one of the main reasons why people don’t get tested and
access life-saving medicines.

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References:

Mahajan, A. P., Sayles, J. N., Patel, V. A., Remien, R. H., Ortiz, D., Szekeres, G., & Coates,
T. J. (2008, August). Retrieved August 15, 2018, from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835402/

Force Field Analysis - Knowledge Center - 12manage. (n.d.). Retrieved August 19, 2018,
from https://www.12manage.com/methods_lewin_force_field_analysis.html

Teehankee, B. Can management work be good for the soul? - DLSU: Home. Retrieved
August 19, 2018, from http://www.dlsu.edu.ph/research/centers/cberd/pdf/management-
good-for-the-soul-teehankee-final-2013.pdf

Women and girls, HIV and AIDS | AVERT. (n.d). Retrieved August 15, 2018, from
https://www.avert.org/professionals/hiv-social-issues/key-affected-populations/women

HIV Stigma and Discrimination. (2018, April 09). Retrieved August 16, 2018, from
https://www.avert.org/professionals/hiv-social-issues/stigma-discrimination

Ministry Seeks to End HIV food stigma. Retrieved August 16, 2018, from
https://jis.gov.jm/ministry-seeks-to-end-hiv-food-stigma/

Coghlan, D., & Brannick, T. (2014). Doing action research in your own organization (4th
ed.). Los Angeles: SAGE. (pp. 31-35, 71, 165).

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