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International Journal of Public Health

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Open Access 01-06-2016 | Original Article

Unemployment, health, and education of HIV-infected males in Germany

Authors: Mona Groß, Annika Herr, Martin Hower, Alexander Kuhlmann, Jörg Mahlich, Matthias Stoll

Published in: International Journal of Public Health | Issue 5/2016

Abstract

Objectives

The present study on people living with HIV/AIDS (PLWHA) identifies socio-demographic and health-related factors corresponding with their labour market participation.

Methods

The study sample bases on a German observational sub-study of 527 male PLWHA. The present analysis is restricted to male PLWHA in working age. By means of a multivariate regression, we identify factors that contribute to unemployment and job loss.

Results

The probability to be unemployed is significantly negatively correlated with age above 40 years and graduation from university and positively correlated with problems with daily activities (frailty) and disease severity (CDC stage C). The probability of employment loss during the 2-year observation period is significantly negatively correlated with the educational level, whereas frailty and hepatitis C (HCV) co-infection increase the odds of employment loss.

Conclusions

As problems to manage daily activities and disease progression are associated with unemployment, an effective HIV treatment is an important cornerstone for employment. This is also true for the management of comorbidities, such as HCV co-infection, which also negatively affects employment status in our study.

Alavinia SM, Burdorf A (2008) Unemployment and retirement and ill-health: a cross-sectional analysis across European countries. Int Arch Occup Environ Health 82(1):39–45CrossRefPubMedPubMedCentral

Anandan N, Braveman B, Kielhofner G et al (2006) Impairments and perceived competence in persons living with HIV/AIDS. Work 27(3):255–266PubMed

Brook RA, Kleinman NL, Su J et al (2011) Absenteeism and productivity among employees being treated for hepatitis C. Am J Manag Care 17(10):657–664PubMed

Centers for Disease Control and Prevention [CDC] (1992) 1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR 41 (No. RR-17)

Chen YQ, Masse B, Wang L et al (2012) Statistical considerations for the HPTN 052 Study to evaluate the effectiveness of early versus delayed antiretroviral strategies to prevent the sexual transmission of HIV-1 in serodiscordant couples. Contemp Clin Trials 33(6):1280–1286CrossRefPubMedPubMedCentral

daCosta D, Bonaventura M, Gupta S et al (2012) The association of HIV/AIDS treatment side effects with health status, work productivity, and resource use. AIDS Care 24(6):744–755CrossRef

Deeks SG (2011) HIV infection, inflammation, immunosenescence, and aging. Annu Rev Med 62:141–155CrossRefPubMedPubMedCentral

DESTATIS (2013) Bevölkerung und Erwerbstätigkeit Stand und Entwicklung der Erwerbstätigkeit in Deutschland. https://www.destatis.de/DE/Publikationen/Thematisch/Arbeitsmarkt/Erwerbstaetige/StandEntwicklungErwerbstaetigkeit2010411127004.pdf?__blob=publicationFile. Accessed 24 Sept 2015

DESTATIS (2014) Tabelle zum Bildungsstand 2010–2012. https://www.destatis.de/DE/ZahlenFakten/GesellschaftStaat/BildungForschungKultur/Bildungsstand/Tabellen/Bildungsabschluss.html. Accessed 24 Sept 2015

Deutsche AIDS-Gesellschaft (DAIG) (2014) Deutsch-Österreichische Leitlinien zur antiretroviralen Therapie der HIV–Infektion 2014. http://www.daignet.de/site-content/hiv-therapie/leitlinien-1/Deutsch_Osterreichische%20Leitlinien%20zur%20antiretroviralen%20Therapie%20der%20HIV_Infektion.pdf. Accessed 24 Sept 2015

Dray-Spira R, Persoz A, Boufassa F et al (2006) Employment loss following HIV infection in the era of highly active antiretroviral therapies. Eur J Pub Health 16(1):89–95CrossRef

Dray-Spira R, Lert F, the VESPA Study Group (2007a) Living and working with HIV in France in 2003: results from the ANRS-EN12-VESPA Study. AIDS 21(Suppl 1):S29–S36CrossRefPubMed

Dray-Spira R, Gueguen A, Ravaud J-F et al (2007b) Socioeconomic differences in the impact of HIV infection on workforce participation in France in the era of highly active antiretroviral therapy. Am J Public Health 97(3):552–558CrossRefPubMedPubMedCentral

Dray-Spira R, Gueguen A, Lert F et al (2008) Disease severity, self-reported experience of workplace discrimination and employment loss during the course of chronic HIV disease: differences according to gender and education. Occup Environ Med 65:112–119CrossRefPubMed

Erlandson KM, Allshouse AA, Jankowski CM et al (2013) Association of functional impairment with inflammation and immune activation in HIV type 1-infected adults receiving effective antiretroviral therapy. J Infect Dis 208:249–259CrossRefPubMedPubMedCentral

Goldman DP, Bao Y (2004) Effective HIV treatment and the employment of HIV+ adults. Health Serv Res 39(6):1691–1712CrossRefPubMedPubMedCentral

Huckans M, Fuller B, Wheaton V et al (2015) A longitudinal study evaluating the effects of interferon-alpha therapy on cognitive and psychiatric function in adults with chronic hepatitis C. J Psychosom Res 78(2):184–192CrossRefPubMed

Huda A, Newcomer R, Harrington C et al (2012) High rate of unemployment after liver transplantation: analysis of the United Network for Organ Sharing database. Liver Transpl 18(1):89–99CrossRefPubMed

Krebs T, Scheffel M (2013) Macroeconomic evaluation of labor market reform in Germany. IMF Econ Rev 61(4):664–701CrossRef

Kuhlmann A, Mittendorf T, Hower M et al (2015) Krankheitskosten von HIV-Patienten unter antiretroviraler Therapie in Deutschland—Ergebnisse einer 48-Wochen-Interimsanalyse im Rahmen der prospektiven multizentrischen Kohortenstudie „CORSAR“. Gesundheitswesen 77(6):e133–e142PubMed

Larson BA, Fox MP, Bii M et al (2013) Antiretroviral therapy, labour productivity, and sex: a longitudinal cohort study of tea pluckers in Kenya. AIDS 27(1):115–123CrossRefPubMedPubMedCentral

Lauer C (2003) Family background, cohort and education: a French-German comparison based on a multivariate ordered probit model of educational attainment. Labour Econ 10(2):231–251CrossRef

Leeansyah E, Cameron PU, Solomon A et al (2013) Inhibition of telomerase activity by human immunodeficiency virus (HIV) nucleos(t)ide reverse transcriptase inhibitors: a potential factor contributing to HIV-associated accelerated aging. J Infect Dis 207:1157–1165CrossRefPubMed

Likatavicius G, Van de Laar M (2012) HIV and AIDS in the European Union, 2011. Euro Surveill 17:48

March JC, Oviedo-Joekes E, Romero M (2007) Factors associated with reported hepatitis C and HIV among injecting drug users in ten European cities. Enferm Infecc Microbiol Clin 25:91–97CrossRefPubMed

McLeod CB, Lavis JN, MacNab YC et al (2012) Unemployment and mortality: a comparative study of Germany and the United States. Am J Public Health 102(8):1542–1550CrossRefPubMedPubMedCentral

Mühlbacher AC, Stoll M, Mahlich J et al (2013) Patient preferences for HIV/AIDS therapy—a discrete choice experiment. Health Econ Rev 3:14CrossRefPubMedPubMedCentral

Pichenot M, Deuffic-Burban S, Cuzin L et al (2012) Efficacy of new antiretroviral drugs in treatment-experienced HIV-infected patients: a systematic review and meta-analysis of recent randomized controlled trials. HIV Med 13:148–155PubMed

Rabkin JG, McElhiney M, Ferrando SJ et al (2004) Predictors of employment of men with HIV/AIDS: a longitudinal study. Psychosom Med 66:72–78CrossRefPubMed

Raffi F, Babiker AG, Richert L et al (2014) Ritonavir-boosted darunavir combined with raltegravir or tenofovir–emtricitabine in antiretroviral-naive adults infected with HIV-1: 96-week results from the NEAT001/ANRS143 randomised non-inferiority trial. Lancet 6736(14):1170–1173

Richardson L, Wood E, Li K et al (2010) Factors associated with employment among a cohort of injection drug users. Drug Alcohol Rev 29:293–300CrossRefPubMedPubMedCentral

Robert Koch Insitut (RKI) (2014) Analysen zur HIV-Inzidenz und -Prävalenzschätzung 2013. Epidemiol Bull 44:429–440

Robert Koch Institut (RKI) (2013) Epidemiologie 2013, Berlin 2013. http://www.rki.de/DE/Content/InfAZ/H/HIVAIDS/Epidemiologie/Daten_und_Berichte/EckdatenDeutschland.pdf?__blob=publicationFile. Accessed 24 Sept 2015

Robert-Koch-Institut (RKI) (2013) Weiterführende Analysen zur HIV-Inzidenz- und Prävalenzschätzung 2012. Epidemiol Bull 45:457–468

Sendi P, Schellenberg F, Ungsedhapand C et al (2004) Productivity costs and determinants of productivity in HIV-infected patients. Clin Ther 26(5):791–800CrossRefPubMed

Tillmann HL, Kaiser T, Claes C et al (2006) Differential influence of different hepatitis viruses on quality of life in HIV positive patients. Eur J Med Res 11:381–385PubMed

Weber A, Hörmann G, Heipertz W (2007) Unemployment and Health—a public health perspective. Dtsch Arztebl 104(43):A 2957–2962

Wichert L, Wilke R (2012) Which factors safeguard employment? An analysis with misclassified German register data. J R Stat Soc Ser A Stat Soc 175(1):135–151CrossRef

Worthington C, O’Brien K, Zack E et al (2012) Enhancing labour force participation for people living with HIV: a multi-perspective summary of the research evidence. AIDS Behav 16:231–243CrossRefPubMed

Yau AH, Yoshida EM (2014) Hepatitis C drugs: the end of the pegylated interferon era and the emergence of all-oral interferon-free antiviral regimens: a concise review. Can J Gastroenterol Hepatol 28(8):445–451CrossRefPubMedPubMedCentral

Title: Unemployment, health, and education of HIV-infected males in Germany
Authors: Mona Groß
Annika Herr
Martin Hower
Alexander Kuhlmann
Jörg Mahlich
Matthias Stoll
Publication date: 01-06-2016
Publisher: Springer International Publishing
Published in: International Journal of Public Health / Issue 5/2016
Print ISSN: 1661-8556
Electronic ISSN: 1661-8564
DOI: https://doi.org/10.1007/s00038-015-0750-3

ACC 2024 Congress

Springer Medicine

Unemployment, health, and education of HIV-infected males in Germany

Abstract

Objectives

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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