Although it took almost two decades, the government recognized that there was a large number of working Americans excluded, indeed ignored by the Rehabilitation Act of 1973. Despite vociferous protest from members of the extreme right of the Republican Party to exclude PWA within the Americans with Disabilities Act of 1990 (ADA), this piece of legislation was passed in both Houses of Congress and signed into law by President Bush in 1990. O’Brien and Schiro-Geist briefly review that the ADA is designed to protect PWA from discrimination in five arenas: employment, transportation, access to mass telecommunications such as telephone service, public accommodation, and the business of local and state government. The ADA mandates that reasonable workplace accommodation be given to PWA. An example of providing reasonable accommodation to someone could be as simple as assigning an office to an employee with paraplegia that is on the first floor of a building without an elevator and ensuring wheelchair ramp access at one or more building entrances. In the case of PWA, it is logical to assume that physical access to the workplace can be attained with minimal effort or that the physical environment is free of airborne health hazards that could provoke secondary infections in a weakened auto - immune system. As far as PWA and their social and legislative advocates are concerned, employers should not regard the employee with AIDS/HIV as any different from a person with a physical handicap when providing them with reasonable workplace accommodations. Visually and relative to job performance, the employee may appear to be in satisfactory health, though the employee may need to take sick days in order to make doctors appointments or to attend to physical ailments that may not be obvious upon a superficial visual examination.

“The ADA refers to direct threat as an employer defense to alleged discriminatory decision making that protects businesses from being forced to hire or retain and individual who may pose a threat to self, others, or both within the work place”, O‘Brien and Schiro-Geist explain. .While there are very few occupations that would place an employee or customer at risk of contracting HIV/AIDS, there is legitimate cause for concern of a primary direct threat if a PWA is employed within the medical or other health care fields. If her or his occupational role demands participation in (for example) invasive, subcutaneous medical procedures as essential features of the job description, the absence of HIV infection can be argued to be a fair and realistic qualification. The possibility of transmitting the virus when participating in a medical procedure is very real and scientifically valid. In virtually any other situation this may appear to be intrusive and violate an employee's basic civil rights. In the case of medical and other health care providers such as dental assistants and public health workers providing vaccinations, one could face the very real possibility that she or he will be legally bound to provide evidence that her or his HIV/AIDS status is negative.