DUSHANBE, December 2, 2013, Asia-Plus — New International Labor Organization (LO) study finds that people with jobs are more likely to keep to HIV treatment.
People living with HIV who are employed are almost 40 per cent more likely to stick to HIV treatment than those without a job, says a new ILO study released ahead of World AIDS Day.
The report – The Impact of Employment on HIV Treatment Adherence – analyses the findings of 23 studies on the relationship between employment and HIV treatment, and covers more than 6,500 people living with HIV. The analysis was supplemented by a series of surveys and telephone interviews carried out by the ILO.
The study found evidence that people living with HIV maintain treatment more successfully when they have a job than when they do not. This is mainly because they have regular financial means to pay for related health services, medications and support, and to afford sufficient food.
The report includes findings from low, middle and high-income countries in Africa, Asia and North America. It found that unemployment, particularly in low and middle-income countries, affects people’s ability to afford treatment, which can lead to interruptions, low viral suppression and ultimately treatment failure.
Joblessness may also result in depression, and in behaviors and situations that have been shown to be factors in non-adherence, including low self-care, substance abuse and homelessness. In some cases it could lead to criminal activity that results in imprisonment.
Women are more likely to have access to anti-retroviral therapy (ART) in most regions of the world, especially those areas with high HIV prevalence. As a result treatment adherence is stronger overall for females. However, employment is a key factor in helping men keep to treatment regimens as they experience better financial and food security and may have access to ART services at their workplace.
People living with HIV who are in informal work tend to experience difficulties keeping to treatment regimens.
In certain countries such as the USA, where safety nets are in place to provide people living with HIV with access to a disability grant, the impact of unemployment on treatment adherence is less severe.
But stigma was found to affect those with jobs, with some people not revealing their HIV status because of fear of stigmatization and therefore not accessing ART, while others miss doses because they are concerned colleagues will see them taking treatment at work.
Currently, only 34 per cent of the more than 28 million people who are eligible for treatment in low and middle-income countries are accessing it, according to the latest figures from the World Health Organization. Furthermore, UNAIDS estimates that around half of all people living with HIV globally do not know their status, and therefore are not accessing treatment.
The report makes several specific recommendations to help improve ART adherence.
