Ability to Work and Employment Rates in Human Immunodeficiency Virus (HIV)-1-Infected Individuals Receiving Combination Antiretroviral Therapy: The Swiss HIV Cohort Study
Author:
Elzi Luigia1, Conen Anna2, Patzen Annalea1, Fehr Jan3, Cavassini Matthias4, Calmy Alexandra5, Schmid Patrick6, Bernasconi Enos7, Furrer Hansjakob8, Battegay Manuel1, Barth J., Battegay M., Bernasconi E., Böni J., Bucher H.C., Bürgisser P., Burton-Jeangros C., Calmy A., Cavassini M., Dubs R., Egger M., Elzi L., Fehr J., Fischer M., Flepp M., Furrer H., Fux C.A., Gorgievski M., Günthard H., Hasse B., Hirsch H.H., Hirschel B., Hösli I., Kahlert C., Kaiser L., Keiser O., Kind C., Klimkait T., Kovari H., Ledergerber B., Martinetti G., Martinez de Tejada B., Müller N., Nadal D., Pantaleo G., Rauch A., Regenass S., Rickenbach M., Rudin C., Schmid P., Schultze D., Schöni-Affolter F., Schüpbach J., Speck R., Taffé P., Tarr P., Telenti A., Trkola A., Vernazza P., von Wyl V., Weber R., Yerly S.,
Affiliation:
1. Division of Infectious Diseases and Hospital Epidemiology, Departments of Medicine and Clinical Research, University Hospital Basel 2. Division of Infectious Diseases, Cantonal Hospital Aarau 3. Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich 4. Infectious Diseases Service, University Hospital and University of Lausanne 5. Division of Infectious Diseases, University Hospital Geneva 6. Division of Infectious Diseases, Cantonal Hospital, St. Gallen 7. Division of Infectious Diseases, Regional Hospital, Lugano 8. Department of Infectious Diseases, University Hospital Bern and University of Bern, Switzerland
Abstract
Abstract
Background. Limited data exist on human immunodeficiency virus (HIV)-infected individuals' ability to work after receiving combination antiretroviral therapy (cART). We aimed to investigate predictors of regaining full ability to work at 1 year after starting cART.
Methods. Antiretroviral-naive HIV-infected individuals <60 years who started cART from January 1998 through December 2012 within the framework of the Swiss HIV Cohort Study were analyzed. Inability to work was defined as a medical judgment of the patient's ability to work as 0%.
Results. Of 5800 subjects, 4382 (75.6%) were fully able to work, 471 (8.1%) able to work part time, and 947 (16.3%) were unable to work at baseline. Of the 947 patients unable to work, 439 (46.3%) were able to work either full time or part time at 1 year of treatment. Predictors of recovering full ability to work were non-white ethnicity (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.20–3.54), higher education (OR, 4.03; 95% CI, 2.47–7.48), and achieving HIV-ribonucleic acid <50 copies/mL (OR, 1.83; 95% CI, 1.20–2.80). Older age (OR, 0.55; 95% CI, .42–.72, per 10 years older) and psychiatric disorders (OR, 0.24; 95% CI, .13–.47) were associated with lower odds of ability to work. Recovering full ability to work at 1 year increased from 24.0% in 1998–2001 to 41.2% in 2009–2012, but the employment rates did not increase.
Conclusions. Regaining full ability to work depends primarily on achieving viral suppression, absence of psychiatric comorbidity, and favorable psychosocial factors. The discrepancy between patients' ability to work and employment rates indicates barriers to reintegration of persons infected with HIV.
Funder
Swiss National Science Foundation Stiftung Forschung Infektionskrankheiten
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Oncology
Cited by
15 articles.
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