Work and economic well-being among people with HIV/AIDS living in the New York City metropolitan region

Background: The HAART era promises that persons living with HIV/AIDS(PLWHA) could look forward to both a longer life and one of improved quality. The promise of longer life has been substantially fulfilled, but the promised improvements in quality of life, particularly with respect to employment, remains po0rly documented. We report on rates of employment and the factors influencing current work status for PLWHA in the New York Metropolitan region. Methods: Data were obtained from three rounds of interviews with representative cohorts of PLWHA in New York City (N= 692) and the Tri-County region north of the City (N=396). New York City interviews were conducted between 2002 and 2006 and the Tri-County interviews between 2000 and 2005. Analysis includes descriptive statistics on trends in employment and logistic regression analyses investigate correlates of current work status. Results: Approximately 15% of the NYC cohort and just over 25% of the Tri-County cohort reported current employment. There was at best a very modest rise in current employment during the study period. Reasons for the low level of employment are a combination of low physical and mental health functioning and low levels of human capital. Conclusion: Ten years after the introduction of HAART, the low level of employment, quality of life remains and unfulfilled promise of these medications. Study findings suggest that substantial increases in employment for PWLHA will require a combination of HIV-specific job training and restructuring of the workplace and jobs that accommodate to the medical needs and continuing health limitations of PWLHA.