Academic journal article The Journal of Rehabilitation

Vocational Rehabilitation Services Tailored to Employment Status of Prime Working-Age Adults with HIV/AIDS

Academic journal article The Journal of Rehabilitation

Vocational Rehabilitation Services Tailored to Employment Status of Prime Working-Age Adults with HIV/AIDS

Article excerpt

Although HIV is considered a long-term controllable infection and a chronic illness, obstacles and challenges of obtaining and maintaining employment among adults living with HIV/AIDS still remain. State vocational rehabilitation service can play an important role to help people with HIV/AIDS stay at work or return to work. It is however, unclear whether state vocational rehabilitation agencies provide tailored services that are based on the stay-at-work vs return-to-work status of clients with HIV/AIDS rather than providing the same set of services for all HIV clients. The aim of this study was to investigate whether vocational rehabilitation service provision is different between persons with HIV/AIDS who are (a) employed but applying services to maintain employment, and (b) unemployed and applying for services to gain employment. Multiple discriminant analysis (MDA) results revealed that employed and unemployed persons with HIV at application did in fact receive different sets of services directed to whether the goal of rehabilitation was to address concerns related to job retention or the goal is to find a job after a period of unemployment. Findings of this study provide empirical evidence supporting that counselors do provide services tailored to the stay-at-work and return-to-work needs of individuals with HIV/AIDS.

Due to medical advances, specifically protease inhibitors and highly active antiretroviral therapy (HAART), HIV is now a manageable, chronic health condition. The most recent data from the National HIV Surveillance System show that 62% of persons infected with the virus in the year 2011 had achieved viral suppression (Crepaz et al., 2016). In conjunction with medical advances, there is evidence that psychosocial determinants also influence health outcomes in persons with HIV. Specifically, employment has been identified as a key social determinant of health for persons with HIV in domestic (e.g., Hergenrather, Zeglin, Conyers, Misrok, & Rhodes, 2016) and international research (e.g., Barrington, Acevedo, Donastorg, Perez, & Kerrigan, 2016). As indicated by laboratory biomarkers, in comparison to unemployed persons with HIV, disease severity is lower in persons who are employed (Blalock, McDaniel, & Farber, 2002). Employment is also associated with slower disease progression and mortality (Delpierre, Cuzin, Lauwers-Cancers, Datta, Berkman, & Lang, 2008), even amongst those persons with co-occurring substance use disorders (Richardson, Millow, Kerr, Parashar, Montaner, & Wood, 2014). Furthermore, employed persons with HIV/AIDS respond higher on self-report measures of physical and mental health-related quality of life (Blalock, McDaniel, & Farber, 2002; Rueda, Raboud, Mustard, Bayomi, Lavis, & Rourke, 2011). Generally, unemployment results in adverse effects on psychological well-being and QoL of individuals due to the feeling of worthlessness, loneliness, financial limitations and poor standards of living. George, Bergin, Clarke, Courtney, & Codd, 2016).

Underemployment, unemployment and job dissatisfaction may be detrimental to the health status of persons with HIV/AIDS. In a comprehensive review of the literature, Vance, Cody, Yoo-Jeong, Jones, and Nicholson (2015) demonstrated that unemployment reduced external stimuli necessary for fostering neurocognition in persons with HIV. Their review highlights evidence showing the benefits of employment on cognition and executive functioning (Vance et al., 2015). Some persons who are employed are cognitively and socially engaged. This engagement facilitates the learning of new skills leading to improvement in memory and cognition (Park et al., 2014). As persons with HIV experience a neurocognitive decline as they age with the virus (Woods, Weber, Weisz, Twamley, Grant, & the HIV Neurobehavioral Research Programs Group, 2011), employment can be conceptualized as a protective factor for this population. However, work stress can also lead to an acceleration of HIV disease progression. …

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