Employment
Employment and employment services are essential to address poverty and social marginalization that undermine outcomes at each point in the HIV care continuum, and contribute to continuing high rates of new HIV infections and other health risks. Research findings highlight the relationship between employment and self-care, treatment adherence, reduced health risks, and improved behavioral and physical health for people living with HIV/AIDS. HIV disproportionately affects communities and individuals with historical experience of high rates of poverty, low literacy and unemployment. For many, an HIV diagnosis reinforces, deepens or results in a life of poverty. For almost two decades, published estimates of unemployment among PLHIV range from 45% to 62% accompanied by studies documenting the negative relationship between employment status, poverty, disease progression and mental health. Surveys show many unemployed people living with HIV/AIDS reporting being able and wanting to work, but lacking information, services and supports needed to obtain employment.
Connections and coordination must be developed between the service sectors essential to meet the employment needs of PLHIV, including those providing HIV, housing, vocational rehabilitation, workforce development, education, rehabilitation and reentry services. Housing, food and nutrition services and employment are synergistically aligned, facilitating increased engagement and retention in HIV health care, treatment adherence, viral suppression and reduced risk of new infections. Employment is a key component for stable housing and food and nutrition security, with stable housing and adequate nutrition essential to effective participation in vocational rehabilitation, and to gaining and maintaining employment.
References:
- Ciasullo, E. C., & Escovitz, K. (2005). Positive futures: The need for paradigm shift in HIV/AIDS services. Journal of Vocational Rehabilitation, 22(2), 125-128. http://iospress.metapress.com/content/k0rublg0bxk9775c/
- Conyers, L. M. (2011). Overview of the National Working Positive Coalition Employment Needs Survey. HIV/AIDS Employment Roundtable Proceedings (Ed.). Washington, D.C.: U.S. Department of Labor. http://www.dol.gov/odep/pdf/20110408.pdf
- Conyers, L. M. & Boomer, K. B. (2014). Examining the Role of Vocational Rehabilitation on Access to Care and Public Health Outcomes for People Living with HIV/AIDS. Disability and Rehabilitation. doi:10.3109/09638288.2013.837968 http://informahealthcare.com/doi/abs/10.3109/09638288.2013.837968
- Hergenrather, K. C., Zeglin, R., Conyers, L., Misrok, M., & Rhodes, S. D. (in press). Persons living with HIV/AIDS: Employment as a social determinant of health. Rehabilitation Research, Policy, and Education
- Nachega JB, Uthman OA, Peltzer K, Richardson LA, Mills EJ, Amekudzi K, Ouédraogo A. Association between antiretroviral therapy adherence and employment status: systematic review and meta-analysis. Bulletin of the World Health Organization, Article ID: BLT.14.138149 http://www.who.int/bulletin/volumes/93/1/14-138149/en/
- Rueda, S., Raboud, J., Mustard, C., Bayoumi, A., Lavis, J., & Rourke, S. (2011). Employment status is associated with both physical and mental health quality of life in people living with HIV. AIDS Care, 23, 435-43. http://www.tandfonline.com/doi/abs/10.1080/09540121.2010.507952?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&#.VOUU1FPF_IJ
- Webel, A. R. (2013). The impact of social context on self-management in women living with HIV. Social Science & Medicine, 87, 147-154. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3656470/