Back on the job: with a new lease on life, people with HIV cope to reenter the workforce.

When Mark Misrok first heard about AIDS in the early 1980s, he figured his life would be brief. "I had expected to get sick almost the first minute I heard of AIDS," Misrok recalls. Besides the toll it took on him emotionally, the specter of illness also made him curtail his career choices. Knowing he was HIV-positive, he took a job as a cabdriver in San Francisco. "I did nothing to develop any kind of thoughtful career, " he says.

Then something happened--or more accurately, something did not happen "I found myself not getting sick," Misrok says. By 1992, tired of his dead-end job, he fumed to Positive Resource, an employment program for people with HIV. Now Misrok is program coordinator for the agency, which offers job training and counseling.

Misrok may have been ahead of the curve when he decided to jump-start his career, but he is no longer alone. With advances in AIDS treatment improving the quality of life of people with HIV, many of them are reconsidering their futures in the workplace. For some it is a matter of resuming to work after being out on disability. For others it means rethinking the job they are in. But for all of them it involves reconsidering what it means to be a person with HIV.

"It's a larger issue in terms of giving up life versus returning to goal setting," says Joni Lavick, clinical administrator of mental health at the Los Angeles Gay and Lesbian Center. "That's one of the biggest problems with people who are now trying to return to work. Their goals have all been short-term. Now it's a total realignment."

More and more people with HIV are undertaking such a reevaluation of their lives. In 1993 Positive Resource placed 162 individuals in new jobs. Last year the number was 437. This year Misrok expects the agency to have placed about 550 people.

"I think more and more people will use their HIV status to change their careers for the better, like myself," says Tom Swift, a financial adviser at Horton Investment Advisory Group in San Francisco. Swift, a former executive director of Impact, a Chicago-based gay rights group, quit working a few years ago after he seroconverted. "I moved to San Francisco, thinking this was it," he says. When his health remained intact, he decided to become a financial adviser to help other HIV-positive men plan for their unanticipated future.

Roger Gross, a San Francisco attorney, started with a practice consisting largely of clients from gay businesses in 1974. By the mid '80s his focus was almost entirely on wills and HIV-related business bankruptcies. Now he finds himself working with gay businesses again. "What's fascinating to me is that in the past, by this time of year, I'd have opened ten probates," Gross says. "Instead I've helped clients organize that many businesses."

Part of the interest in reestablishing a career has to do with the pleasure many people derive from working. "I can't tell you how many people talk about being bored," Gross says.

Not all return to their old careers. In fact, says Paul Causey, executive director of AIDS Benefits Counselors, surveys indicate that only 15% of the people are returning to the same job or the same company.

Causey says clients list a variety of reasons for the change, including the stress of high-powered jobs. Lavick notes that for those people with a gap in their resume, expecting to pick up where they left off is often just not realistic. "The opportunities available for people who are returning, particularly if they were somebody like a vice president at Wells Fargo [Bank], are not going to be the same opportunities other people have," she says.

Practical considerations are not the only reason for the changes in career. For many people with HIV, the experience of their diagnosis produces a profound shift in their value systems and the things they hold important. "People think if they've been given a life they didn't think they were going to have, it's an opportunity to do something that really matters to them," says Causey.

Swift says his "second chance" made him think about a new direction for his activism. He sees his new career as an extension of his past work. "We need to build our economic strength," he says, "and therefore our political strength, because that's how the system works."

Reconsidering a career is not without its problems. Many individuals find that they no longer define themselves in terms of their work. Moreover, the lingering questions about how long the new treatments will remain effective makes many people hesitant about effecting radical changes.

Financial considerations also are important. "People are afraid of losing their benefits," Gross says. However, most disability programs allow beneficiaries to dip their toes in the workplace without penalties.

That can be a boon to people who hated giving up work in the first place or felt they had to pick a lesser career because they were HIV-positive. "A significant part of the hit that somebody living with AIDS takes is often being severed from their careers," Misrok says. "A tremendous amount of an individual's identity and self-esteem comes from his or her work." As many people with HIV are discovering, it may be possible to have that self-esteem once again.