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Labor Force Participation and Health-Related Quality of Life in HIV-Positive Men Who Have Sex with Men: The Multicenter AIDS Cohort Study

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Abstract

Too many people with HIV have left the job market permanently and those with reduced work capacity have been unable to keep their jobs. There is a need to examine the health effects of labor force participation in people with HIV. This study presents longitudinal data from 1,415 HIV-positive men who have sex with men taking part in the Multicenter AIDS Cohort Study. Generalized Estimating Equations show that employment is associated with better physical and mental health quality of life and suggests that there may be an adaptation process to the experience of unemployment. Post hoc analyses also suggest that people who are more physically vulnerable may undergo steeper health declines due to job loss than those who are generally healthier. However, this may also be the result of a selection effect whereby poor physical health contributes to unemployment. Policies that promote labor force participation may not only increase employment rates but also improve the health of people living with HIV.

Resumen

Demasiadas personas que viven con VIH han abandonado permanentemente el mercado laboral y aquellas con reducida capacidad de trabajo no han podido mantener sus puestos de trabajo. Es necesario evaluar los efectos de la participación laboral sobre la salud en personas que viven con VIH. Este estudio presenta datos longitudinales de 1,415 hombres VIH-positivos que tienen sexo con hombres, recabados del Multicenter AIDS Cohort Study. Ecuaciones de Estimación Generalizadas mostraron que el empleo esta asociado con mejor calidad de vida en relacion a la salud fisica y mental y ademas sugiere un proceso de adaptación a la experiencia de desempleo. Análisis posteriores y provisionales también sugieren que las personas físicamente mas vulnerables pueden sufrir caidas mas pronunciadas de la salud debido a la pérdida de empleo, comparados con aquellos que generalmente estan mas saludables. Sin embargo, esto también puede ser el resultado de un efecto de selección mediante el cual una salud física disminuida contribuye al desempleo. Las politicas que promueven la participación en el mercado laboral no solo podrian aumentar las tasas de empleo, sino también mejorar la salud de las personas que viven con VIH.

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Acknowledgments

The Multicenter AIDS Cohort Study (MACS) includes the following: Baltimore: The Johns Hopkins University Bloomberg School of Public Health: Joseph B. Margolick (Principal Investigator), Michael Plankey (Co-Principal Investigator), Barbara Crain, Adrian Dobs, Homayoon Farzadegan, Joel Gallant, Lisette Johnson-Hill, Ned Sacktor, Ola Selnes, James Shepard, Chloe Thio. Chicago: Howard Brown Health Center, Feinberg School of Medicine, Northwestern University, and Cook County Bureau of Health Services: John P. Phair (Principal Investigator), Steven M. Wolinsky (Principal Investigator), Sheila Badri, Craig Conover, Maurice O’Gorman, David Ostrow, Frank Palella, Ann Ragin. Los Angeles: University of California, UCLA Schools of Public Health and Medicine: Roger Detels (Principal Investigator), Otoniel Martínez-Maza (Co-Principal Investigator), Aaron Aronow, Robert Bolan, Elizabeth Breen, Anthony Butch, John Fahey, Beth Jamieson, Eric N. Miller, John Oishi, Harry Vinters, Barbara R. Visscher, Dorothy Wiley, Mallory Witt, Otto Yang, Stephen Young, Zuo Feng Zhang. Pittsburgh: University of Pittsburgh, Graduate School of Public Health: Charles R. Rinaldo (Principal Investigator), Lawrence A. Kingsley (Co-Principal Investigator), James T. Becker, Ross D. Cranston, Jeremy J. Martinson, John W. Mellors, Anthony J. Silvestre, Ronald D. Stall. Data Coordinating Center: The Johns Hopkins University Bloomberg School of Public Health: Lisa P. Jacobson (Principal Investigator), Alvaro Munoz (Co-Principal Investigator), Alison, Abraham, Keri Althoff, Christopher Cox, Gypsyanber D’Souza, Stephen J. Gange, Elizabeth Golub, Janet Schollenberger, Eric C. Seaberg, Sol Su. NIH: National Institute of Allergy and Infectious Diseases: Robin E. Huebner; National Cancer Institute: Geraldina Dominguez. UO1-AI-35042, UL1-RR025005, UO1-AI-35043, UO1-AI-35039, UO1-AI-35040, UO1-AI-35041. Website located at http://www.statepi.jhsph.edu/macs/macs.html.

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Rueda, S., Raboud, J., Plankey, M. et al. Labor Force Participation and Health-Related Quality of Life in HIV-Positive Men Who Have Sex with Men: The Multicenter AIDS Cohort Study. AIDS Behav 16, 2350–2360 (2012). https://doi.org/10.1007/s10461-012-0257-3

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