Interventions for improving employment outcomes for workers with HIV

Robinson, Rachel; Okpo, Emmanuel; Mngoma, Nomusa

doi:10.1002/14651858.cd010090.pub2

Cited by 7 publications

(5 citation statements)

References 38 publications

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“…However, limited data exist on interventions for improving employment for individuals living with HIV and its potential impact on outcomes. 27 Unemployment is interconnected with other social determinants of health, including poverty, education, and insurance, and it is likely that the larger socioeconomic context contributes to ongoing health disparities in HIV outcomes. 28 Due to these social support needs, engagement in CM has been shown to improve linkage to care for newly diagnosed HIV patients 16 and CM continues to be a critical component of comprehensive HIV care.…”

Section: Discussionmentioning

confidence: 99%

Missed Initial Medical Visits: Predictors, Timing, and Implications for Retention in HIV Care

Nijhawan

Liang

Vysyaraju

et al. 2017

AIDS Patient Care and STDs

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HIV disproportionately affects racial/ethnic minorities and individuals living in the southern United States, and missed clinic visits account for much of this disparity. We sought to evaluate: (1) predictors of missed initial HIV medical visits, (2) time to initial visit, and (3) the association between initial visit attendance and retention in HIV care. Chart reviews were conducted for 200 consecutive HIV-infected patients (100 in Dallas, 100 in San Antonio) completing case management (CM) intake. Of these, 52 (26%) missed their initial visit, with 22 (11%) never presenting for care. Mean age was 40 years, 85% were men, >70% were of minority race/ethnicity, and 28% had a new HIV diagnosis. Unemployment (OR [95% CI] = 2.33 [1.04-5.24], p = 0.04) and lower attendance of CM visits (OR = 3.08 [1.43-6.66], p = 0.004) were associated with missing the initial medical visit. A shorter time to visit completion was associated with CD4 ≤ 200 (HR 1.90 [1.25-2.88], p = 0.003), Dallas study site (HR = 1.48 [1.03-2.14], p = 0.04), and recent hospitalization (HR = 2.18 [1.38-3.43], p < 0.001). Patients who did not complete their initial medical visit within 90 days of intake were unlikely to engage in care. Initial medical visit attendance was associated with higher proportion of visits attended (p = 0.04) and fewer gaps in care (p = 0.01). Missed medical visits were common among HIV patients initiating or reinitiating care in Texas. Employment and CM involvement predicted initial medical visit attendance, which was associated with retention in care. New, early engagement strategies are needed to decrease missed visits and reduce HIV health disparities.

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Section: Discussionmentioning

confidence: 99%

Missed Initial Medical Visits: Predictors, Timing, and Implications for Retention in HIV Care

Nijhawan

Liang

Vysyaraju

et al. 2017

AIDS Patient Care and STDs

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“…Results of this study showed that at the 2-year follow-up, self-efficacy and fatigue improved significantly more in the experimental than the control group; however, job satisfaction did not differ significantly between groups. Another systematic review looked at strategies to increase employment outcomes for persons with HIV (Robinson, Okpo, & Mngoma, 2015) and found that only antiretroviral therapy interventions may increase employment outcomes in HIV+ people.…”

Section: Resultsmentioning

confidence: 99%

Evidence-Based Interventions for Increasing Work Participation for Persons With Various Disabilities

Smith

Atmatzidis

Capogreco

et al. 2017

OTJR: Occupational Therapy Journal of Research

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Title I of the Americans With Disabilities Act prohibits discrimination in employment; however, 26 years later, employment rates for persons with disabilities hover at 34%. This systematic review investigates the effectiveness of evidence-based interventions to increase employment for people with various disabilities. Forty-six articles met the inclusion criteria for evidence-based interventions. The majority of studies assessed interventions for persons with mental health disabilities. Strong evidence was found for ongoing support and work-related social skills training prior to and during competitive employment for persons with mental health disabilities. Moderate evidence supported simulation and use of assistive technology, especially apps for cueing and peer support to increase work participation for persons with intellectual disabilities, neurological/cognitive disabilities, and autism spectrum disorder. Many of the strategies to increase work participation were appropriate for occupational therapy intervention. Suggestions were made for research, specifically looking at more rigorous evaluation of strategies in the long term.

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“…The results obtained from these programmes cannot be extrapolated to other frameworks and need further adaptation and evaluation, as they might be subject to some environmental and country-specific factors, such as social, economic and cultural issues. On the other hand, interventions with antiretrovirals did seem to have positive outcomes across different settings in terms of employment probabilities and number of hours worked [57], leaving room for improvement in the existing evidence, and for research into the effectiveness of jobrelated interventions for people living with HIV.…”

Section: Discussionmentioning

confidence: 99%

“…Nor were we able to include information about treatment received, as it was only available until 2010. Controlling for antiretroviral therapy in the multivariate probit regressions, for example, could have provided significant results, as it has been proved to be associated with higher employment probabilities among people living with HIV, as well as with longer working times [57]. Furthermore, a limitation of our study is that we had no information about the type of contract, occupational sector, professional category or other relevant job characteristics of people living with HIV, which could have been crucial for an analysis of employment status [58].…”

Section: Discussionmentioning

confidence: 99%

The employment situation of people living with HIV: a closer look at the effects of the 2008 economic crisis

2021

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This study aims to assess the determinants of employment probabilities among people living with Human Immunodeficiency Virus (HIV) during a 15-year period (2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016) in Spain, focusing on the possible effects of occurrences such as the 2008 economic crisis. The probability of people living with HIV having a job was evaluated by applying several multivariate probit regression models. Differences between the employment status of people living with HIV and that of the general population were evaluated by applying genetic matching regression models. With respect to the former evaluation, for people living with HIV, the period before the crisis (2001)(2002)(2003)(2004)(2005)(2006)(2007) was associated with a probability of being employed that was 2.43 percentage points (p.p.) higher than during the crisis, and the period after the crisis (2014-2016) with a probability that was 7.58 p.p. lower than during the crisis. Greater effects were also observed among males, the probability of being in employment before the economic crisis being higher (by 2.26 p.p.) and lower after the crisis (− 3.41 p.p.) than among women, and among those infected through drug use (6.18 p.p. and − 7.34 p.p. before and after the crisis, respectively), than among those infected through sex. When analysing the differences with respect to the general population, people living with HIV reported lower probabilities of being employed: by − 18 p.p. before the crisis, by − 15 p.p. during the crisis (years 2008-2013) and by − 10 p.p. after the crisis, implying a convergence in the prospects of employment with the passage of the years. Those differences were greater for people of basic educational level (− 23 to − 16 p.p.), a weaker immune system (− 34 p.p. to − 21 p.p.) and those infected through the use of drugs (− 31 p.p. to − 26 p.p.). Although the results suggest that the economic crisis had a greater effect on the employment prospects of people living with HIV, and that effect is still felt by that group, our findings also point towards a convergence of their employment prospects with those of the general population, over the 15-year period assessed. An analysis of the employment situation of people living with HIV might have helped when designing job-seeking methods and policies on the working environment, especially through the 15-year period considered, when the economic crisis had a greater effect on the job market.

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Interventions for improving employment outcomes for workers with HIV

Cited by 7 publications

References 38 publications

Missed Initial Medical Visits: Predictors, Timing, and Implications for Retention in HIV Care

Missed Initial Medical Visits: Predictors, Timing, and Implications for Retention in HIV Care

Evidence-Based Interventions for Increasing Work Participation for Persons With Various Disabilities

The employment situation of people living with HIV: a closer look at the effects of the 2008 economic crisis

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