October 28, 2011
According to a French study, the probability HIV-positive people will leave their job within five years of being diagnosed is 35 percent -- and not for reasons you might think. Researchers analyzed 622 patients who received HIV care between 2004 and 2010, and found that complications to HIV/AIDS and side effects to medicines were not major factors in unemployment. But other health issues, such as diabetes, high blood pressure and depression, play a large role in why people living with HIV are leaving the workforce.
"Our results provide evidence for the existence of a phenomenon of work cessation starting after the very first months following HIV diagnosis and persisting during the five subsequent years," comment the investigators. "Comorbidities frequently associated with HIV disease including diabetes, hypertension and depression substantially affect the chances of maintaining employment."
The patients enrolled in the study were a representative sample of the HIV-affected population in France. Approximately a third were women, 41 percent were migrants and 45 percent were infected with HIV via sex with another man.
Overall, 367 patients (60 percent) were employed at baseline. Individuals in employment were older (36 vs. 33) than those who were not employed. They also had a better level of education. Employed individuals were also more likely to live with their partner (58 percent vs. 51 percent) and to have disclosed their HIV status to family, friends or colleagues (79 percent vs. 59 percent).
Differences in health status were also apparent between employed and unemployed patients. Those in employment were less likely to have AIDS (5 percent vs. 10 percent), a CD4 cell count below 200 cells/mm3 (15 percent vs. 23 percent) or a viral load above 5 log10 copies/ml (22 percent vs. 29 percent).
Rates of hepatitis B or C co-infection were also lower in the employed patients than in those who were out of work. (2 percent vs. 9 percent), and economically active individuals were also less likely to have depression (32 percent vs. 43 percent).
Over the course of the study a total of 67 patients who were in employment at baseline stopped working before the official retirement age of 60.
This included 58 patients who became unemployed, four individuals who were medically retired, three who took long-term sick leave, and two who returned to education or undertook further training. However, 24 individuals subsequently returned to work meaning that 47 (13 percent) were still out of employment at the end of follow-up.
The mean unemployment duration was 20 months after entering the study.
It's pretty well understood that employment and financial stability influence health outcomes. For example, being able to pay rent is more than just having a roof overhead. Having a stable living situation means having a place to house AIDS meds. And without that security, someone living with HIV/AIDS may not be able to adhere to medications, hence worsening their health overall. The study's authors recommend that these issues be addressed in clinical settings, among employers and social workers as a means to prevent people living with HIV/AIDS from leaving the workplace.
Have you had to leave the workforce because of similar ailments?
Kellee Terrell is the former news editor for TheBody.com and TheBodyPRO.com.
Follow Kellee on Twitter: @kelleent.
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