In 1995 the life expectancy of someone diagnosed with AIDS was approximately three years.

A dramatic shift has taken place over the past three years. Preliminary analysis of a study on employment, conducted recently by AIDS Project Los Angeles, suggests large numbers of people with AIDS are employed or interested in returning to work.

The goal of the mailed survey is to gather and analyze information on employment issues affecting people with HIV/AIDS living in Los Angeles County.

The survey was financed by the City of Los Angeles, Office of the AIDS Coordinator and the L.A. County Department of Health Services, Office of AIDS Programs and Policy. The co-principal investigators are APLA's Dr. Ronald Brooks and Dr. David Martin of Harbor-UCLA.

The survey was mailed to 5,685 individuals with HIV/AIDS who are currently case-managed by one of 13 AIDS service organizations located throughout l.a. County. The sampling design was created to reflect a representative sample of the HIV/AIDS community in l.a. County. The survey was conducted in both English and Spanish.

The response rate to the survey is on average between 30 and 40 percent for each of the participating agencies. The preliminary findings provided here are based on 1,350 surveys (90 percent male; 9 percent female; 1 percent transgender), a sample of the total surveys that have been received to date.

The findings reported on below are based on a preliminary report prepared by Ron Brooks.

Who's working? Who's not working?

Thirty-seven percent of respondents to the survey reported that they are currently working in some capacity. Fifty-eight percent of these individuals are working regular, full-time jobs with the remaining engaged in part-time work.

The remaining 63 percent of respondents reported that they are currently not working in any capacity. The average length of time individuals have been unemployed is a little more than four years.

From among those who stated they were not working, 7 percent are retired and 26 percent are disabled and completely unable to work. The remaining 67 percent indicated that they are currently unemployed or disabled.

Who's looking for work?

From the group of unemployed and disabled, 75 percent of the respondents said that they are thinking about going to work now or in the near future.

No differences were seen by age, income, education or racial/ethnic background of those indicating an interest in seeking employment. Respondents who reported feeling much better were more likely to indicate an interest in seeking employment compared with those who were not feeling better.

Major motivations in looking for work

Motivations individuals found either extremely important or important in their desire to look for work clustered around several issues:

• Economic motivations like increasing income, getting out of debt, reducing the burden on family and contributing to the support of the family.

• A desire to give back to society.

• Psychosocial issues including being around people, being physically active, feeling normal, increasing a sense of accomplishment and getting out of the home, feeling useful or productive.

Major barriers to returning to work

Some of the major obstacles of individuals who are looking for work include:

• Fears about the loss of their current health insurance including Medi-Cal or the ability to get adequate health insurance from a new employer.

• Concerns about the ability to take their HIV medications as prescribed while at work, the day-to-day changes in their health and the effect of work-related stress on their health.

• Apprehension about job skills being out of date and HIV/AIDS related discrimination in the workplace.

Employment planning issues

Most likely due to an unpredictable health status, the largest proportion (47 percent) of job-seeking respondents is "not sure" when they plan to enter the work force. Thirty-eight percent, however, did indicate that they hope to enter the work force as soon as possible or within the next three to six months.

In terms of the job schedules, 59 percent of the respondents indicated that they are looking to work 21 to 40 hours per week in a permanent position. Seventy-four percent of all job seekers are looking for a permanent, stable position as opposed to a temporary or casual assignment.

Of those looking to enter the work force, 52 percent are not planning to return to the same kind of work they have done before. This suggests that many of these individuals will need some type of assistance in helping them find work in a new area.

Service needs of job-seekers

The overwhelming majority (83 percent) of people seeking employment indicated a need for services to help them find work. The most important services included job placement, job training, skills training and benefits counseling.

Who's not looking for work?

From the group of unemployed and disabled, one-quarter of them said that they are not thinking about going to work now or in the near future.

No differences by age, income, education, or racial/ethnic background of those indicating an interest in seeking employment were seen. Respondents who reported feeling much worse were less likely to indicate an interest in seeking employment compared with those who were feeling better.

Perceived barriers

Many of the major obstacles of individuals who are not looking for work are similar to the apprehensions of those who wish to return to the workplace. They include:

• Issues about the loss of current health insurance and disability benefits, and the ability to get adequate health insurance from a new employer.

• Health concerns like day-to-day changes in their health and fear that the stress of work might affect their health.

• Concern over HIV- and AIDS-related discrimination in the workplace.

Issues of the employed

Those currently employed also provided information about their experiences and views on disclosure, discrimination, insurance and other issues.

• Fifty-seven percent of working respondents have not told their employer of their HIV status; 53 percent of respondents indicated that their co-workers do not know that they have HIV.

• Fifty-two percent of respondents indicated that work does interfere at some level with their ability to take their HIV medications as prescribed.

• Forty-seven percent of respondents stated that work has interfered at some level with their ability to see their doctor.

• Sixty-three percent of respondents indicated that their health has interfered at some level with their ability to work.

• Fifty-nine percent of respondents indicated that working negatively affected their health to some degree.

• Twenty-two percent of workers indicated that they had experienced some degree of AIDS or HIV-related discrimination at work.

• Sixty-three percent of workers indicated that their employer does not pay for their health insurance.

APLA has provided clients with employment issues assistance, including counseling and skill-building for more than a year. The Work Services program, under the direction of Phil Curtis, began in July. A comprehensive analysis of this survey will assist APLA and other organizations provide the HIV community with helpful return-to-work services.

Stay tuned for more.

Lee Klosinski directs AIDS Project Los Angeles' Education Division. He can be reached by e-mail at .

This article has been reprinted at The Body with the permission of AIDS Project Los Angeles (APLA).