Attitudes and barriers to employment in HIV-positive patients

Abstract

Background: Unemployment in the human immunodeficiency virus (HIV) population remains a major issue. Recent changes in the benefits system have triggered concerns about (re)integration into work for adults with HIV. Aims: To examine attitudes and barriers to employment in HIV patients. Methods: We undertook a cross-sectional study in the Royal Free HIV outpatient department from December 2008 to February 2009. The questionnaire collected data on demographics, date of HIV diagnosis, combination antiretroviral therapy, CD4 count, employment status, attitudes to work, psychological health and perception of barriers to employment. Logistic regression analyses were used to assess factors associated with not working. Results: Five hundred and forty-five HIV patients took part. Overall, 26% were not working and of these, half (53%) had been unemployed for>5 years. Associations with not working were having been diagnosed with HIV>10 years before, poor psychological health and poor attitudes to employment. There was no association between objective measures of health (CD4 count) and employment status. Those not working were less likely to agree with that 'work is good for physical and mental health' (90 versus 97%: P< 0.01) and more likely to agree that 'should only work if 100% fit and well' (76 versus 51%: P< 0.001) compared to workers. Those currently not working had negative perceptions of their abilities to gain employment and to remain in work. Conclusions: There are opportunities for HIV services to provide psychological support around attitudes associated with unemployment and to help HIV-positive men in particular obtain and remain in work. © The Author 2010. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved.