Taking the plunge: how to return to work

This article originally appeared in HIV Treatment Update, a newsletter published by NAM between 1992 and 2013.
This article is more than 12 years old. Click here for more recent articles on this topic

In February, HTU looked at how changes in benefits might affect people with HIV. We quoted a doctor and a patient rep who both said that if people could manage a return to work, it often paid huge dividends in terms of health and self-esteem. Sue Murphy, careers adviser at London HIV charity Positive East, provides a step-by-step guide to rejoining the workforce. Thanks also to Chris Morley from George House Trust for his contribution.

Returning to employment or entering the labour market for the first time can be a daunting prospect, especially if you have been out of the workplace for a long time or are looking for your first job. It is important to think about the work you want to do and how this can be managed in relation to your physical and mental health. For some, this might mean returning to a previous occupation. For others this may not be possible; a change of direction may not only be a more realistic option but can also provide an opportunity to take a step back and think “What would I really like to do?”. Thinking about work choices may also include decisions about full- or part-time work, education or training, or updating skills and experience in other ways.

People living with HIV who are looking to return to work, seeking a first job or looking for employment in the UK for the first time, need to be confident that the advice they receive is confidential, impartial and informed.



A healthcare professional’s recommendation that a person sees another medical specialist or service.


Studies aim to give information that will be applicable to a large group of people (e.g. adults with diagnosed HIV in the UK). Because it is impractical to conduct a study with such a large group, only a sub-group (a sample) takes part in a study. This isn’t a problem as long as the characteristics of the sample are similar to those of the wider group (e.g. in terms of age, gender, CD4 count and years since diagnosis).


A mental health problem causing long-lasting low mood that interferes with everyday life.


In HIV, refers to the act of telling another person that you have HIV. Many people find this term stigmatising as it suggests information which is normally kept secret. The terms ‘telling’ or ‘sharing’ are more neutral.


Having symptoms.


I find there are three major issues faced by long-term unemployed people: loss of confidence; lack of knowledge about the current labour market; and, especially, that market’s requirements for qualifications and skills. There are two additional concerns more specific to people with HIV: working with a fluctuating health condition, and disclosure. People are often particularly concerned about variable health and whether they will have the stamina for a full-time job; that’s why it’s important to talk to a careers or return-to-work adviser about what kind of work, and what hours, might suit you.

At Positive East, we provide advice to people in east London through face-to-face interviews and group courses, held in a safe environment where professional and peer support is available. We’ve designed programmes that combine practical and psychological support; using the principles of self-empowerment; we encourage service users to be independent and in control of their lives. There may be similar services local to you but, if not, you can still take control of the situation and the following tips can help.

How to start

A good starting point is to research your career goal. This should be realistic and achievable. Whether returning to a previous occupation, or if you are changing careers, it is vital to find out what skills and qualifications employers are currently looking for.

Basic requirements for many jobs are literacy, numeracy, basic IT skills and the ability to communicate appropriately. If you are rusty in these areas, make them a priority. In addition to job-specific skills, employers tell us they look for oral and written communication, flexibility, people skills, the ability to organise, the ability to work in a team and problem-solving skills.

Your CV

A logical next step is the preparation of a CV. A good CV (curriculum vitae) should be factual, containing your work and educational history and a personal profile which captures the reader’s interest. Ideally no more than two pages, keep the document simple and avoid waffle or jargon. Your personal profile can be very important as it sets you apart from others and allows you to demonstrate how you would ‘add value’ to a workplace. Get a friend or adviser to review your CV before you send it anywhere.

Many employers use application forms in their recruitment process, but some still prefer to receive a CV. Job search websites and recruitment agencies will usually ask for a CV, or will have a template. An up-to-date CV is also useful for keeping details of employment and educational history in chronological order so that the information can be transferred easily to an application form.

In addition, you’ll need the originals of qualifications and certificates as employers may ask to see them.

There are a host of sample CV layouts available free on the internet; it’s even possible to find samples tailored for specific jobs. It is really important that the CV’s style and format matches the requirements of the job.

It is a good idea to obtain an application pack for the type of job you hope to do, to make sure you have the necessary skills and up-to-date qualifications. Look at job descriptions and person specifications to identify any areas where you do not currently meet the criteria.

Action planning

When you have identified any training or qualification needs, then writing an action plan is a useful process. It should not be a huge wish-list of ambitions. It is a tool to help you break down longer-term goals into small steps that can be achieved progressively. You could plan to complete a couple of actions that are ‘STARs’ – specific, time-limited, achievable and realistic – within a certain time period (usually a month, or even a week): applying for a course, downloading and completing a CV form, contacting a specific number of organisations to ask about employment - whatever you choose. Highlight your priorities and regularly review your progress.

Volunteering, apprenticeships and internships

Employers are naturally wary about gaps in the employment history on a CV. Many people with HIV feel this is a significant barrier to finding work, especially at a time when unemployment is high. The National AIDS Trust (NAT) booklet Advice for job applicants living with HIV gives practical advice on dealing with employment gaps which relate to health, such as “explain that gaps in your CV are the result of a disability covered by the Equality Act, but one which does not impact on your eligibility for consideration for…a particular role”, or “state that gaps in employment result from a specific health condition which is now managed and you would be happy to provide further information to an occupational health specialist if required”. (This booklet is available online and from NAT.)

Think about skills you have developed in other ways. Many people reading this will have volunteered even when they were unable to do paid work. Employers often look favourably on periods of volunteering and are happy to consider them as a valid alternative to paid employment. If you are finding it hard to get paid work or want to reintroduce yourself gradually, volunteering can be a great way to gain valuable experience in a chosen field, with opportunities to update your skills, re-engage with the work environment and obtain a current reference.

It is important to make sure that volunteering does not conflict with the terms of any benefits you are receiving. The Citizens Advice Bureau (CAB) volunteering factsheet (PDF) gives an overview, or your local Volunteer Centre or other advice centre should be able to give guidance.

Although the Equality Act 2010 doesn’t give volunteers disability rights protection at work, most organisations should follow the legal and good practice standards that apply to their employees – see the George House Trust article in Help and advice.

Another way to deal with employment gaps before going for a permanent job is by seeking temporary work through agencies. Downsides include low wages and job insecurity, but it can help you regain confidence and see how you cope with working, while only doing the hours you think you can manage.

Other routes into specific fields of employment are apprenticeships and internships. Not all apprenticeship schemes have an upper age limit. Apprentices earn a wage and work alongside staff to obtain job-specific skills, usually receiving training towards qualifications. The minimum salary is £80 per week but it can be more; you should seek advice on other benefit entitlements.

Competition for apprenticeship places is fierce, but more are planned. So is the competition for internships, particularly within sectors like fashion, media and journalism. Internships are offered by employers to provide on-the-job training and may be paid, unpaid or part-paid. If, as an intern, you do work of value for the employer, rather than just ‘shadowing’ others, you are likely to have a right to the national minimum wage.

Apprenticeship, internship and volunteer or work placement opportunities are often advertised online and newspapers.

Training and qualifications

If you need additional qualifications for the job you want, details of courses can be found online, from helplines or from your local library.

Fee reductions may be available for people on benefits; look online, or call or visit colleges offering the courses you are interested in.

Disabled Student Allowances (DSA) are available for undergraduate and postgraduate courses, including distance learning, to help meet extra costs students may face as a result of a disability or ongoing health condition. They don’t have to be repaid and are based on need, covering items such as specialist equipment, non-medical helpers and travel costs. You can check eligibility criteria on www.direct.gov.uk or with Disabled Student Advisers at colleges and universities.

Help for people with a disability

When you are ready to start looking for employment, help is available. If you are claiming benefits and feel that your health issues are impeding your search for work, you may be able to get specialist help from Jobcentre Plus by requesting a referral to a Disability Employment Adviser (DEA).

Services include assessments to identify what type of work or training is most suitable for you, and appropriate referrals. This may be to a Jobcentre Plus personal adviser, or to two work programmes for disabled people, Work Choice or Access to Work. DEAs may also be able to offer a job-matching service and referral to specific employment initiatives but there can be up to eight weeks’ wait for an appointment. Any disclosure made to Jobcentre Plus will be kept on file and should remain confidential.

Jobcentre Plus offers support for people on any benefit that may be issued on condition that the claimant returns to work within a specific time – as the new Employment and Support Allowance (ESA) often does. The new Work Programme, being introduced this year, replaces the old Pathways to Work scheme for ESA or Incapacity Benefit claimants. Jobcentre Plus support is available until claimants are referred to the Work Programme, or as an alternative when they are not referred. It will, according to the Department of Work and Pensions, “be available to customers across all working age benefits” and “will be delivered by advisers whose skills are developed to support customers according to their need rather than benefit type”. For more on ESA and the other new and planned benefits, see HTU 203.

The condition management programme, based on cognitive behavioural therapy (CBT), helps people manage their health in relation to work.

People who take a job may be eligible for Return to Work Credit, £40 per week (tax-free) for up to 52 weeks. There are a number of conditions attached; Return to Work Credit is not paid to anyone on Jobseeker’s Allowance (JSA).

Some people can receive ESA and do some paid work, described as Permitted Work. The rules are complex and earnings from Permitted Work affect other benefits – always get advice from a benefits expert and ask them for a detailed ‘better off’ calculation to help you decide.

Disability-friendly employers

When you are ready to start making applications, it is worth considering employers who display the disability symbol (two ticks inside a circle and the words ‘positive about disabled people’) on vacancy advertisements. It is awarded to employers who have committed to a set of principles on employing, keeping and developing the abilities of staff who “consider themselves to be disabled”. These employers guarantee to interview all disabled applicants who meet the minimum criteria for the vacancy and to consider them on their abilities. Symbol-holder employers are also required to develop appropriate levels of disability awareness and ensure disabled people are not disadvantaged in terms of training, retention or consultation.

Under the Equality Act 2010, people living with HIV are considered to have a disability from the point of diagnosis, with rights and protections against discrimination and harassment at work. You are covered whether you consider yourself ‘disabled’ or not.

Making yourself known

Think about how you can give yourself as many advantages as possible. Be proactive: target organisations you would like to work for and send out CVs with a clear and concise covering letter explaining why.

Vacancies are often circulated through networks and may even be filled through personal contacts, so let people know what you are looking for, attend job fairs and think about posting your CV online. This is also another good reason for volunteering – to get your foot in the door and make yourself known.

Applying for a job

Once you’ve found a job you want to apply for, read the application details carefully. If the employer asks you to submit a CV, revisit your CV and think about it in relation to this specific job. Find out about the employer by looking at the company website and yearly accounts. This will allow you to tailor your CV, but will also give you confidence at interview.

If the employer asks you to complete an application form, read the instructions and complete the form carefully.

Often employers will ask you to address each point on the person specification or job description in turn, so the process of filling in the form can take some time, but not doing this, or simply sending a CV instead, will not make a good first impression.

Make sure you send the application form or CV in by the advertised deadline. If emailing them, check that your email address does not send the wrong message!

It’s a good idea to keep a copy of your completed application form, along with the job description and person specification, so you can refer back to it later, when preparing for an interview, or applying for another job.

Disclosing HIV status

NAT, alongside other disability and mental health charities, succeeded in their campaign to ban the use of pre-employment health questionnaires (except in very limited circumstances) from October 2010, through an amendment to the Equality Act (except in Northern Ireland – see box).

In all but the most exceptional situations you cannot legally be asked for details about your health or disability until after a job offer has been made. Since there is no risk of HIV transmission in everyday work situations, there is no need – or legal requirement – for the vast majority of employers to know about someone’s HIV status after this point either, unless the person chooses to tell them.

A distinction needs to be made between asking about your medical status on the application form and asking about whether you have a disability on an equal opportunities (EO) monitoring form. EO forms are usually detachable and should be processed confidentially and anonymously. They are also optional (you don’t have to fill them in). If in doubt, ask the employer how they process EO forms.

Currently, there are a few exceptional circumstances when an employer can ask about health or disability prior to a job offer: these are mainly healthcare jobs involving ‘exposure-prone procedures’. The armed forces are also exempt from the Equality Act and can vet people for HIV. The Department of Health is currently reviewing guidelines in this area.

If you are asked questions about your health on a pre-offer questionnaire and you’re not sure what to do, you could:

  • ask for advice from an HIV or other advice organisation 
  • query it directly with the employer
  • complain to the Equality and Human Rights Commission (EHRC) – it has powers to investigate employers and employment agencies if they do this.

After a job offer is made to you, the employer can ask health questions, although many employers do not. It is important to be honest, as knowingly giving wrong answers on a medical questionnaire is grounds for dismissal. If you are concerned about this, or about being asked to have an HIV test as part of a standard medical, you could seek advice from the EHRC or, if the employer has an occupational health service, send the health questionnaire answers direct to them.

If a job offer is withdrawn after the health questionnaire or a medical and your answers do not seem relevant to your ability to do the job, ask the EHRC helpline if you can make a disability discrimination claim, or contact an HIV organisation such as NAT or THT Direct for advice.

The NAT booklet has some good advice on disclosing your status at work, and on tackling employment discrimination.

The job interview

When you receive that all-important invitation to an interview, confirm promptly that you will be attending it. Make sure you have the details of the job description and person specification clear in your mind and have researched the organisation and its work.

There is lots of information and advice on the internet on the art of successful interviewing, including sample interview questions and suggested answers. If you do use these, make sure they are relevant to you – and that you are able to provide responses to any follow-up questions. It can be a really good idea to practise interviews with someone you know and to get some feedback on your answers.

On the day, dress smartly (as appropriate for the kind of job) and be on time!

If you are unsuccessful, ask the employer for some feedback. While some employers won’t expand much on their rejection letter, others may give really useful feedback and tips.


You may be thinking about self-employment. This is sometimes thought of as the easy option, but in reality self-employed people often work longer hours than employees; it is important not to underestimate the stress that can come with running a business in line with legal and financial requirements as well as making a reasonable living. Research and a good business plan are essential, as is well-informed advice about starting, maintaining and developing a business.

Information and advice is available from Business Link in England, which has a telephone helpline to advise on a range of topics, including start-up grants and loans. See www.gov.uk/browse/business or telephone 0845 600 9006.

Support may also be available from Jobcentre Plus for Jobseeker’s Allowance claimants, and people who have been unemployed for 13 weeks or more, with £50 per week paid for up to 16 weeks from the date you start trading or move into self-employment.

Anyone currently on benefits who is considering a job offer must get information from a benefits adviser at an HIV charity, CAB or local advice agency to clarify their position and to ensure they get relevant tax credits or entitlements.

Help and advice

There is a range of help available from HIV and other organisations.

NAT (National AIDS Trust) provides excellent resources and advice for both employers and people living with HIV about employment and the Equality Act. Visit its website www.nat.org.uk to download or order publications, including the booklet Advice for job applicants living with HIV.

The Terrence Higgins Trust helpline, THT Direct, can offer advice and direct you to local sources of support: 0845 1221 200, 10am-10pm weekdays, 10am-6pm weekends. www.tht.org.uk

Positive East in East London offers specific career guidance to people: 020 7791 2855. www.positiveeast.org.uk

NAM’s employment resources are at www.aidsmap.com/Employment/cat/1684/ and you can search for local services at: www.aidsmap.com/e-atlas.

First Point offers support and referrals to people with HIV in South London: 020 7160 0949. www.slhp.org.uk

George House Trust works across NW England: 0161 274 4499. www.ght.org.uk. Its guide to volunteering is here: http://bit.ly/gLv2KI  

PACE for LGBT people in London: 020 7700 1323. www.pacehealth.org.uk

The Next Step adult service offers careers advice online, by telephone and face-to-face: http://nextstep.direct.gov.uk or 0800 100 900.

Other useful websites:

www.direct.gov.uk information on benefit entitlement, help for disabled jobseekers and details of Jobcentres.

Citizens Advice Bureau: www.adviceguide.org.uk Its guide to volunteering is at www.adviceguide.org.uk/index/b_volunteering.pdf

Equality and Human Rights Commission (EHRC): www.equalityhumanrights.com

TUC website on internships: www.rightsforinterns.org.uk

For information on courses:

Visit www.hotcourses.com or contact one of the following helplines:

Learn Direct: 0800 101 901 or Careers Advice Service: 0800 100 900

Northern Ireland

The rights and advice in this article apply in England, Wales and Scotland. The legal situation in Northern Ireland is different. Pre-employment medical questions on application forms and in interview are still legal there, for instance.

The Equality Commission for Northern Ireland website explains employment rights and equality law in Northern Ireland: www.equalityni.org

Scott's story

After several years working erratic and unsocial hours in hospitality and a period of ill health, I decided I wanted to return to office-based work. So I went to Positive East for advice on the best route.

I found the prospect of full-time employment extremely daunting; I hadn’t worked in an office for over six years, and there were several gaps in my CV and periods of unemployment due to deteriorations in health.

I researched the web and found that Positive East offered face-to-face interviews, which I considered really important because I wanted to fully explain my circumstances without discomfort. I spoke to the Careers Adviser at the charity.

She suggested that volunteering would enable me to try out working nine-to-five again without undue pressure or worry about my benefits being affected, and to check the overall effect on my health. She explained the Equality Act and its relevance and gave me an overview of Working Tax Credit: this was important because I realised I could still receive help towards my rent whilst working. This made my financial outlook much more secure as otherwise I would get a drop in income.

I had been given the details of the Volunteering England website to try to match my skills and availability to a demand. I went back for a follow-up appointment to review my CV and do an online skills check to bring home to me how many key and transferable skills I in fact had.

I decided to volunteer at Positive East itself to ‘put something back’ as the charity had helped me so much with my housing and benefits situation. I worked a three-day week shadowing an adviser, becoming accustomed once again to office discipline, obtaining relevant experience and updating my IT skills. I received on-the-job training for a qualification.

I decided to study at night class to broaden my knowledge of Microsoft Office. This gave me the confidence to enrol on a degree course at Birkbeck College (which is geared towards adult, part-time study, much like the Open University) so that I could compete in the current job market and move into paid employment.

I found working in a busy office environment again extremely worthwhile. It helped motivate and reprioritise things for me and helped me socially as well, as I was interacting with a broader range of people.

Daniel's story

I was working in a small media company when I was diagnosed with HIV in 2001. It was one of those jobs you get married to: I found it really rewarding and had a strong personal loyalty to the company and my boss.

However I started getting really depressed in 2005. At first I put it down to Sustiva (efavirenz), one of my HIV meds, so my doctor changed them. But the depression didn’t lift and in 2007 I started taking antidepressants.

This got me talking to a clinical psychologist and I realised it might be my job that was to blame. I was working 60- to 70-hour weeks and was always travelling, spending evenings eating and drinking too much with potential customers. I realised I had an emotional attachment to my work but it was making me ill. So I resigned.

I went to see my family in Italy but when I came back I was even more depressed. I just couldn’t figure out what to do next.

So I contacted First Point, the assessment and referral service of the South London HIV Partnership. Terry, the worker there, identified several issues. There was the work one, but in addition, the job had isolated me from my old friends, and I also realised I’d never really come to terms with having HIV.

In terms of employment, the big step was getting career coaching at PACE, the lesbian and gay organisation in Islington. PACE’s coach, Pete McCormack, took me on for eight sessions after an initial assessment interview.

For the first few sessions it felt like therapy and I wasn’t sure how it was supposed to get me a job: I talked about what inspired me as a kid, things I enjoyed doing, my early fantasies about what I’d do. There was a lot of homework too. I had to complete a ‘vision board’ which confirmed that I love working with people and the media but opened up my thought processes about what I could do next.

I did the European Computer Driving Licence course and a project management course: I realised I had managed plenty of projects in my old job, they just hadn’t been called that.

A temporary employment opportunity came up in the shape of the 2011 Census, and I applied for and got a job as local co-ordinator. It’s about three months’ work, but I think it will really open doors for me once it’s finished. It’s not the sort of job I would have considered applying for before my career coaching.

I realised now my job crisis was symptomatic of my diagnosis with HIV. Yet it was the career-specific coaching that really helped me get over the bitterness and depression. My physical health has improved too, and I’ve started running again, something I haven’t done for years.

To sum it up, it helped turn “I can’t do this” into “What have I got to lose?”