This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Rabkin, J. G. Articles by Lin, S. H. Search for Related Content PubMed PubMed Citation Articles by Rabkin, J. G. Articles by Lin, S. H. Related Collections HIV/AIDS

Predictors of Employment of Men With HIV/AIDS: A Longitudinal Study

From New York State Psychiatric Institute (J.G.R., M.M., W.V.G., S.H.L.), Department of Psychiatry, College of Physicians and Surgeons, Columbia University (J.G.R., W.V.G.), New York, NY, and Weill College of Medicine, New York, NY (J.G.R., S.J.F.).

Address correspondence and reprint requests to Judith G. Rabkin, PhD, New York State Psychiatric Institute, Unit 51, 1051 Riverside Drive, New York, NY 10032. E-mail: jgr1{at}Columbia.edu

OBJECTIVE: To identify patterns and predictors of work status and number of hours employed in a group of men with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS).

METHODS: A total of 141 participants had semiannual neuropsychiatric, psychosocial, and medical assessments over a period of 30 months. These six occasions provided the basis for identifying patterns of employment (part-time, full-time, or unemployed). Those who completed neuropsychological testing, introduced at visit 4, constitute the sample used to identify predictors of number of hours employed, using multiple regression analysis with mixed procedure.

RESULTS: Over 30 months, 20% were continuously employed full-time, another 9% were continuously employed part-time, and 40% were continuously unemployed. Employment status changed for 31%: 4% who worked at baseline stopped, 13% started or increased their hours, 8% decreased their hours, and 6% showed a fluctuating pattern. The major parameters consistently associated with unemployment or partial employment, in order of influence, were financial (disability benefits), psychiatric (past/current diagnosis of major depression and/or dysthymia), medical (physical limitations), cognitive (executive function), and education. In contrast, age, ethnicity, laboratory markers of HIV illness status, vocational rank, and past or current substance dependence did not predict work status.

CONCLUSIONS: Overall, those who worked continued to work. However, despite improved health, most men who were unemployed at study baseline did not return to work. Structure of disability benefits, lifetime depressive disorder, physical limitations, and impairment in some areas of cognitive function each appear to represent significant barriers to work. Returning to work is evidently difficult, and clinicians may keep this in mind when recommending leaving work unless medically necessary. Specific interventions and policy changes regarding disability benefits may be needed to promote return to work for people with HIV/AIDS whose health is restored and who contemplate re-employment.

Key Words: employment, • HIV/AIDS, • depression, • neuropsychological tests, • disability benefits.

Abbreviations: AIDS = acquired immunodeficiency syndrome;; BDI = Beck Depression Inventory;; HIV = human immunodeficiency virus;; NP = neuropsychological;; SSD = Social Security Disability Insurance;; SSI = Supplemental Security Income.

This article has been cited by other articles:

				R Dray-Spira, A Gueguen, F Lert, and the VESPA Study Group* Disease severity, self-reported experience of workplace discrimination and employment loss during the course of chronic HIV disease: differences according to gender and education Occup. Environ. Med., February 1, 2008; 65(2): 112 - 119. [Abstract] [Full Text] [PDF]

				R. Dray-Spira, A. Gueguen, J.-F. Ravaud, and F. Lert Socioeconomic Differences in the Impact of HIV Infection on Workforce Participation in France in the Era of Highly Active Antiretroviral Therapy Am J Public Health, March 1, 2007; 97(3): 552 - 558. [Abstract] [Full Text] [PDF]

				S. J. Ferrando and C. Nims HIV-Associated Mania Treated With Electroconvulsive Therapy and Highly-Active Antiretroviral Therapy. Psychosomatics, March 1, 2006; 47(2): 170 - 174. [Full Text] [PDF]

				R. Dray-Spira, A. Persoz, F. Boufassa, A. Gueguen, F. Lert, T. Allegre, C. Goujard, L. Meyer, and The Primo Cohort Study Group Employment loss following HIV infection in the era of highly active antiretroviral therapies Eur J Public Health, February 1, 2006; 16(1): 89 - 95. [Abstract] [Full Text] [PDF]

				J. G. Rabkin, M. C. McElhiney, R. Rabkin, P. J. McGrath, and S. J. Ferrando Placebo-Controlled Trial of Dehydroepiandrosterone (DHEA) for Treatment of Nonmajor Depression in Patients With HIV/AIDS Am J Psychiatry, January 1, 2006; 163(1): 59 - 66. [Abstract] [Full Text] [PDF]