Linnemayr S., Glick P., Kityo C., Mugyeni P., Wagner G.
RAND Corporation, 1776 Main Street, Santa Monica CA 90407, United States; Joint Clinical Research Center, Kampala, Uganda
Linnemayr, S., RAND Corporation, 1776 Main Street, Santa Monica CA 90407, United States; Glick, P., RAND Corporation, 1776 Main Street, Santa Monica CA 90407, United States; Kityo, C., Joint Clinical Research Center, Kampala, Uganda; Mugyeni, P., Joint Clinical Research Center, Kampala, Uganda; Wagner, G., RAND Corporation, 1776 Main Street, Santa Monica CA 90407, United States
This study evaluates the impact of antiretroviral treatment (ART) on employment-related outcomes using prospective, longitudinal analysis. Starting in January 2008, 602 treatment-naïve clients in one rural clinic and in one clinic in the capital Kampala were interviewed about their medical history, and psychosocial and socioeconomic adjustment at baseline and at months 6 and 12. Half of the sample was eligible to receive ART, while the other half was also in HIV care, but not yet eligible for ART, therefore providing a comparison group that is similar to the treatment group in that its members are HIV-positive and have made the decision to enroll in HIV care. We found improvements in general health, reduction in the incidence of pain and health interfering with work, as well as improvements in work-related self-efficacy for both groups over time, but significantly more so for the group receiving ART treatment. At baseline, less than half of the people in the ART group worked, but after 6 months more than three quarters of them were working, surpassing the fraction of people working in the control group after 1 year. Another key finding of the study was the importance of mental health as a key mediator for employment-related outcomes. These data indicate that ART clients experience greater improvements compared to pre-ART clients, and not only with regard to general health, but also in restoring confidence in their ability to work, as well as actual work status. © Mary Ann Liebert, Inc.
anti human immunodeficiency virus agent; adult; antiretroviral treatment; antiviral therapy; article; clinical trial; cohort analysis; employment; female; human; Human immunodeficiency virus infection; major clinical study; male; prospective study; self concept; Uganda; Adaptation, Psychological; Adult; Anti-Retroviral Agents; Employment; Female; Follow-Up Studies; HIV Infections; Humans; Incidence; Male; Middle Aged; Prospective Studies; Quality of Life; Socioeconomic Factors; Treatment Outcome; Uganda; Young Adult