With health comes work? People living with HIV/AIDS consider returning to work

Abstract

Many people living with HIV/AIDS (PHAs) ham experienced significant improvements in their health over the last few years, to the point that many are considering returning to work. The objectives of this study were to develop a model of return to work which could apply to chronic illnesses with a fluctuating or uncertain course. Issues related to health, work and return to work were explored using in-depth interviews with 20 PHAs in Toronto, Canada, who had been on long-term disability for at least five years. Data were analyzed using a grounded theory approach. Contextual factors like the approach of disability and health (drug) insurance plans and intervening conditions like PHAs' current activities influenced their consideration of returning to work and the strategies they employed as a result of considering such a return. More than two-thirds of the sample had undertaken more activities as their health improved. The three study participants who had returned to work either had an opportunity for a low-risk trial of work or could return to their old job. Employers and disability compensation plan administrators, assisted by AIDS service organizations and governments, can facilitate return to work for PHAs by reducing the risks of and removing the barriers to returning to work.

Socioeconomic Differences in the Impact of HIV Infection on Workforce Participation in France in the Era of Highly Active Antiretroviral Therapy

“…First, HIV infection may constitute a barrier to access (or return) to work for those unemployed: studies have reported that although large proportions of unemployed HIV-infected persons have contemplated work re-entry as efficient treatments have emerged, few have actually done so [28,[34][35][36][37]. Moreover, HIV disease may constitute a cause of employment loss.…”

Enhancing Labour Force Participation for People Living with HIV: A Multi-Perspective Summary of the Research Evidence

“…[17] There are only a handful of HIVspecific employment programs in North America concentrated in large urban centres, and much work is required to address inconsistent benefit and income support structures that influence the employment options of many PHAs. [1] The most recent literature reviews and syntheses conducted by and Werth (2008) identified very few articles related to the needs and barriers influencing return to work for PHAs and the vocational services designed to address them. [3,26] Thus, very little research evidence exists to inform social policy and effective community programming that could support the employment-related needs of PHAs.…”

“…[1][2][3] Recent studies suggest that approximately half (42%-62%) of PHAs in industrialized countries are unemployed. [4][5][6][7][8] While the links between health and labour force participation are complex, it is clear that labour force participation is an important intermediate social driver and determinant of health.…”

“…[23] Several frameworks and models have been developed drawing primarily on psychological and vocational counselling perspectives and adapted based on research conducted with PHAs. [1,[23][24][25] Unfortunately, these efforts have been fragmented, often using dissimilar language to describe key concepts. [17] There are only a handful of HIVspecific employment programs in North America concentrated in large urban centres, and much work is required to address inconsistent benefit and income support structures that influence the employment options of many PHAs.…”

Living and Working with HIV/AIDS: A Lifelong Process of Adaptation

“…In certain jurisdictions, returning to work may lead to the termination of long-term disability benefits, a drawback that is compounded by PWHIV's inability to regain these benefits in the event that their health begins to deteriorate. Preoccupation with this potential loss of financial security can lead to increased stress and worry, to the point of debilitating PWHIV in their vocational decision-making (Brooks et al, 2004;Ferrier & Lavis, 2003). Brooks et al (2004) concluded that, of a sample of 536 unemployed PWHIV, 73% of those contemplating a return to work ranked the fear of losing their disability income as the most significant barrier to the resumption of professional activities.…”