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Gómez W, Schustack A, Carrico AW, Ramirez-Forcier J, Batchelder A. In the Interest of Time: Assessing the Role of Resilience Across an Intergenerational Sample of People Living with HIV. Int J Behav Med 2024; 31:315-324. [PMID: 37438561 DOI: 10.1007/s12529-023-10198-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND Biomedical advances have improved the quality of life of people living with HIV (PLWH); however, barriers to optimal well-being remain. A key feature in understanding the lived experiences of PLWH is resilience. The concept of resilience is quite complex in terms of its antecedents and expressions, suggesting the need for more nuanced understandings of how it could be harnessed to better support this population. METHOD The concept of resilience was explored in a qualitative study involving 22 PLWH, selectively sampled by era of diagnosis. Through interviews focused on context and experiences of living with HIV, the sample highlighted resilience processes corresponding to Positive reappraisal of life events, Positive reappraisal of self, and Community as resilience. RESULTS Participants who have lived with HIV longer more commonly described engaging in psychological processes of resilience, whereas those who were more recently diagnosed reported engaging in more social processes. However, these processes were not mutually exclusive and the ability to perform resilience through community seems to be key to optimizing outcomes, irrespective of era of diagnosis. CONCLUSION PLWH are a heterogeneous population where engagement in distinct processes of resilience may have important implications for optimal social and health outcomes. Better understanding of the distinct and diverse pathways through which PLWH engage in resilience may inform interventions promoting optimal well-being.
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Affiliation(s)
- Walter Gómez
- Jane Addams College of Social Work, University of Illinois Chicago, 1040 West Harrison Street (MC309), Chicago, IL, 60607-7134, USA.
| | | | - Adam W Carrico
- Department of Public Health Sciences, University of Miami, Miami, FL, USA
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McKinney-Prupis E, Chiu YCJ, Grov C, Tsui EK, Duke SI. Psychosocial and Health-Related Behavioral Outcomes of a Work Readiness HIV Peer Worker Training Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4322. [PMID: 36901333 PMCID: PMC10001842 DOI: 10.3390/ijerph20054322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/22/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
Targeted work readiness training is an important approach to help people living with HIV (PLHIV) to overcome their unique barriers to work, while addressing social determinants of health needs. This study assesses the psychosocial impacts of a work readiness training and internship program among HIV peer workers in New York City. From 2014 through 2018, 137 PLHIV completed the training program, and 55 individuals completed both the training and the six-month peer internship. Depression, HIV internalized stigma, self-esteem, HIV medication adherence, patient self-advocacy, and safer sex communication apprehension were used as outcome measures. Paired t-tests were performed to determine if significant score changes occurred at the individual level before and after each training. Our results show that participating in the peer worker training program significantly decreased depression and internalized HIV stigma, and significantly increased self-esteem, medication adherence, and patient self-advocacy. The study underscores that peer worker training programs are important tools to improve not only the work readiness of PLHIV, but also psychosocial and health outcomes. Implications for HIV service providers and stakeholders are discussed.
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Affiliation(s)
| | | | - Christian Grov
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY 10017, USA
| | - Emma K. Tsui
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY 10017, USA
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Perri M, Craig-Neil A, Gaspar M, Hunter C, Kendall C, Alexander O, Pinto AD. A qualitative study of barriers to employment experienced by people living with HIV in Toronto and Ottawa. Int J Equity Health 2021; 20:36. [PMID: 33446215 PMCID: PMC7807879 DOI: 10.1186/s12939-020-01356-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/10/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Effective treatment has extended the life expectancy and reduced disability in people living with HIV (PLWH). However, previous research has found 45-65% of working-age PLWH were unemployed compared to 5-10% in the general public of North America and Europe. We examined the barriers to gaining employment among PLWH. METHODS Thirty-five in-depth interviews were conducted in person or over the phone with PLWH living in Toronto or Ottawa. This included PLWH who were unemployed but actively seeking employment, as well as PLWH who had successfully gained employment through an agency that specifically supported PLWH funded by the AIDS Committee of Toronto. Interviews were conducted between February 2019 and March 2020. All interviews were audio-recorded, transcribed and analyzed using thematic analysis. RESULTS The majority of participants were between the ages of 40-55 and identified as male. Participants shared many common barriers when describing their attempts to attain or maintain employment. Although varying in employment status at the time of the study, consistent barriers included experiencing HIV stigma in workplaces, challenges overcoming mental health illnesses, and difficulties in navigating social assistance and unemployment insurance programs when pursuing a return to work. CONCLUSIONS PLWH face significant barriers when attempting to engage with employment opportunities. Health providers and organizations can do more to support campaigns to end HIV stigma, to support individuals in pursuing employment, and to advocate for policy change that supports reentry into the workforce for PLHA.
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Affiliation(s)
- Melissa Perri
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, 30 Bond St, Toronto, Ontario, M5B 1W8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, Ontario, M5T 3M7, Canada
| | - Amy Craig-Neil
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, 30 Bond St, Toronto, Ontario, M5B 1W8, Canada
| | - Mark Gaspar
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, Ontario, M5T 3M7, Canada
| | - Charlotte Hunter
- Casey House, 119 Isabella St, Toronto, Ontario, M4Y 1P2, Canada
- Department of Family and Community Medicine, St. Michael's Hospital, 500 University Ave, Toronto, Ontario, M5G 1V7, Canada
| | - Claire Kendall
- Department of Family Medicine, University of Ottawa, 600 Peter Morand Crescent Suite 201, Ottawa, Ontario, K1G 5Z3, Canada
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, 85 Primrose Ave, Ottawa, Ontario, K1R 6M1, Canada
- Institut du Savoir Montfort, Montfort Hospital, 713 Montreal Rd, Ottawa, Ontario, K1K OT2, Canada
- Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, Ontario, K1H 8L6, Canada
- Li Ka Shing Knowledge Institute, 209 Victoria St, Toronto, Ontario, M5B 1T8, Canada
| | - Ower Alexander
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, 30 Bond St, Toronto, Ontario, M5B 1W8, Canada
| | - Andrew D Pinto
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, 30 Bond St, Toronto, Ontario, M5B 1W8, Canada.
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, Ontario, M5T 3M7, Canada.
- Department of Family and Community Medicine, St. Michael's Hospital, 500 University Ave, Toronto, Ontario, M5G 1V7, Canada.
- University of Toronto Practice-Based Research Network, 500 University Avenue, Toronto, Ontario, K1H 8L6, Canada.
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Abstract
Employment is a social determinant of health that is important for understanding health behaviors, health outcomes and HIV transmission among people living with HIV. This study is a scoping review of the literature that addresses (a) the relationship between employment and the HIV continuum of care, (b) determinants of employment among PLWH and (c) experiences with employment. We searched two databases, PubMed and Embase, and identified a total of 5622 articles that were subjected to title and abstract review. Of these, 5387 were excluded, leaving 235 articles for full-text review. A total of 66 articles met inclusion criteria and were included in the study. The literature suggests that employment status is positively associated with HIV testing, linkage to HIV care, retention in HIV care, and HIV medication adherence. Guided by a social-ecological framework, we identified determinants of employment at the individual, interpersonal, organizational, community, and policy levels that are amenable to public health intervention. Experiences with employment, including barriers, facilitators, advantages, disadvantages, and needs, provide additional insight for future research and programs.
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Affiliation(s)
- Catherine H Maulsby
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Rm. 904C, Baltimore, MD, 21205, USA.
| | - Aneeka Ratnayake
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Donna Hesson
- Welch Medical Library, Johns Hopkins University, Baltimore, MD, USA
| | | | - Carl A Latkin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Hergenrather KC, Zeglin RJ, Conyers L, Misrok M, Rhodes SD. Persons Living With HIV/AIDS: Employment as a Social Determinant of Health. REHABILITATION RESEARCH POLICY AND EDUCATION 2016. [DOI: 10.1891/2168-6653.30.1.4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Purpose: For persons living with HIV/AIDS (PLWHA), the advent of highly active antiretroviral therapy has increased their longevity and quality of life. As HIV progresses, many PLWHA present declined domains of functioning that impede their ability to work. The authors explore employment as a social determinant of health to identify issues impacting employment outcomes for PLWHA.Methods: The authors reviewed the literature addressing HIV across the domains of mental health functioning, neurocognitive functioning, and physical function and employment.Results: When providing employment services to PLWHA, considerations for rehabilitation practitioners and educators include HIV/AIDS education, functional assessment, social support, considerations for women with HIV, highly active antiretroviral therapy (HAART), HIV/AIDS stigma, and employment resources for PLWHA.Conclusion: With more than 1.2 million PLWHA in the United States, and most of new infections among persons 25–44 years of age, the prevalence of PLWHA seeking employment and inclusive of the U.S. workforce will continue to increase. Proving employment services for PLWHA is a complex process that is best served by an integrative service approach.
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Razzano LA, Hamilton MM, Yost C, Pashka NJ, Perloff JK. Employment Outcomes for Individuals With HIV/AIDS and Co-Occurring Mental Health Factors. AMERICAN JOURNAL OF PSYCHIATRIC REHABILITATION 2015. [DOI: 10.1080/15487768.2015.1001700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wagener MN, van Opstal SEM, Miedema HS, Brandjes DPM, Dahmen R, van Gorp ECM, Roelofs PDDM. Employment-related concerns of HIV-positive people in the Netherlands: input for a multidisciplinary guideline. JOURNAL OF OCCUPATIONAL REHABILITATION 2014; 24:790-797. [PMID: 24806772 DOI: 10.1007/s10926-014-9510-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE Finding and keeping employment is difficult for people with HIV. To improve supportive care for people with HIV and employment-related problems, a multidisciplinary guideline was developed in the Netherlands in 2010/2011. To identify the employment-related concerns of people with HIV and to formulate the key questions for the guideline, we conducted a qualitative study. The results of this study are described in this article. METHODS This study was performed in three HIV-treatment centers in the Netherlands. In total 18 participants participated in three focus-group interviews and nine participants were interviewed individually. The data were transcribed ad verbatim and were analyzed according to the principle of constant comparison. RESULTS Our findings indicate that people with HIV in the Netherlands face many work-related concerns. The themes which emerged from this study were disclosure, stigma and discrimination, knowledge about HIV, physical and psychological factors, working conditions, absenteeism, reintegration, and dismissal and counselling. CONCLUSIONS This study provides insight into employment-related concerns for people with HIV living in a Western country. It formed the basis for the key questions which were addressed in a multidisciplinary, evidence-based guideline "HIV and work". Finally, it gives leads for further scientific research and opportunities for improving the vocational guidance of people with HIV.
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Affiliation(s)
- M N Wagener
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, P.O. Box 25035, 3001 HA, Rotterdam, The Netherlands,
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Wagener MN, Roelofs P, Miedema HS, Brandjes DPM, Dahmen R, van Gorp ECM. The development of a multidisciplinary, evidence-based guideline for "HIV and employment". AIDS Care 2014; 27:133-41. [PMID: 25187184 DOI: 10.1080/09540121.2014.952612] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The objective of this study was to develop a multidisciplinary guideline that supports the care and vocational rehabilitation of HIV-infected people with employment-related problems. The guideline was developed according to the "evidence-based guideline development" method developed by the Dutch Institute for Health Care Improvement. This method consists of the following steps: forming a multidisciplinary core group and an expert panel, formulating key questions, searching and appraising the available literature, formulating considerations and recommendations, peer reviewing the draft guideline, and authorizing the final guideline. All relevant professional associations were represented in the core group that was assembled to develop the guideline, i.e., HIV doctors, HIV nurses, general practitioners, occupational health physicians, psychologists, social workers, occupational health nurses, vocational experts, and insurance physicians. Five key questions for the guideline were formulated with the following themes: determinants of employment, disclosure and stigma, self-management, interventions, and the organization of care. In the literature review on these topics, 45 studies met the inclusion criteria. The methodological quality of the included articles was poor. Factors such as patient preferences and medical/ethical issues were considered. The recommendations in the guideline are a weighting of the scientific evidence and the considerations of the core group. The guideline, as well as its summary for daily practice, clarifies the most important barriers and facilitators to people with HIV either staying at work or returning to work, and it constitutes a clinical, easy-to-use guideline for health-care providers and how they can support people with HIV who want to work.
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Affiliation(s)
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- a Research Centre Innovations in Care , Rotterdam University of Applied Science , Rotterdam , The Netherlands
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Martin DJ, Chernoff RA, Buitron M, Comulada WS, Liang LJ, Wong FL. Helping people with HIV/AIDS return to work: a randomized clinical trial. Rehabil Psychol 2012; 57:280-9. [PMID: 23148715 PMCID: PMC3839569 DOI: 10.1037/a0030207] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE New treatments introduced in the mid-1990s led many people with HIV/AIDS who previously had been disabled by their disease to contemplate workforce reentry; many remain unemployed, and little is known concerning interventions that might help them return to work. We report the results of a randomized clinical trial of an intervention designed to help people with HIV/AIDS reenter the workforce. DESIGN We tested a mixed (group-individual) modality intervention that incorporated elements of Motivational Interviewing (Miller & Rollnick, 2002), skills building from Dialectical Behavior Therapy (Linehan, 1993), and job-related skills (Price & Vinokur, 1995). A total of 174 individuals participated in either the intervention or in standard of care and were followed for 24 months. RESULTS Compared with individuals referred for standard of care, participants in the intervention engaged in more workforce-reentry activities over time and, once employed, were more likely to remain employed. Dose-response analyses revealed that among intervention participants, participants who attended more than 1 individual session engaged in more workforce-reentry activities than individuals who attended 1 or fewer individual sessions, whereas frequency of group session participation did not effect a difference between participants who attended more than 6 group sessions and participants who attended 6 or fewer group sessions. CONCLUSION Theoretically based workforce-reentry assistance programs can assist disabled people with HIV/AIDS in their return-to-work efforts.
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Affiliation(s)
- David J Martin
- Geffen School of Medicine at UCLA, University of California, Los Angeles, CA, USA.
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Ellis WL. Perceived stress levels among HIV/AIDS-infected mothers: the role of over-the-counter products. SOCIAL WORK IN HEALTH CARE 2012; 51:850-867. [PMID: 23078015 DOI: 10.1080/00981389.2012.699022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The purpose of this study was to identify correlates of perceived stress levels among 49 HIV/AIDS-infected mothers enrolled in a social services agency that provides HIV/AIDS support services in North Carolina. The author found in an Ordinary Least Squares regression analysis that the CD4 t-cell count, receipt of advice or support from church pastor, annual household income, and employed were all negatively related to seropositive mothers' perceived stress scores. Conversely, the need to have borrowed money from family members or friends to help pay for over-the-counter products like nutritional drinks, vitamins, or minerals was found to be positively related to these scores. The accessibility of these over-the-counter products could not only help to lower seropositive mothers' perceived stress levels but also potentially improve the functioning of their body's immune system. Implications for the Medicaid Program's prescription drug policy that excludes these over-the-counter products and prescription drug representatives are discussed.
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Affiliation(s)
- Walter L Ellis
- Social Work Program, Livingstone College, Salisbury, North Carolina 28144, USA.
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Kim J, Shin G, Park YM, Lim EJ, Nam HA. Experience of People Living with HIV Working as Caregivers for AIDS Patients. ACTA ACUST UNITED AC 2011. [DOI: 10.12934/jkpmhn.2011.20.4.334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Jiyoung Kim
- Assistant Professor, Red Cross College of Nursing, Chung-Ang University, Korea
| | - Gisoo Shin
- Professor, Red Cross College of Nursing, Chung-Ang University, Korea
| | - Young Mi Park
- Assistant Professor, Red Cross College of Nursing, Chung-Ang University, Korea
| | - Eun Ju Lim
- Assistant Professor, Red Cross College of Nursing, Chung-Ang University, Korea
| | - Hyun A Nam
- Assistant Professor, Red Cross College of Nursing, Chung-Ang University, Korea
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Samson A, Lavigne RM, MacPherson P. Self-fulfillment despite barriers: volunteer work of people living with HIV. AIDS Care 2010; 21:1425-31. [PMID: 20024720 DOI: 10.1080/09540120902814403] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
With the decline in the morbidity and mortality associated with HIV infection, the majority of people living with HIV (PWHIV) experience a higher quality of life and longer life expectancy. Since this diagnosis no longer prevents an active lifestyle, many PWHIV are re-integrating into the workplace or are contemplating this possibility. Despite the multiple advantages associated with a return to work, research has identified barriers related to work and HIV infection. These barriers could prevent an important minority of PWHIV who wish to return to work from re-integrating into this environment. In this context, volunteering could be an alternate way to regain an active lifestyle. This research found that volunteer work allowed participants to enrich their social lives, to regain a sense of psychological well-being, and to apply their abilities to the benefit of others. However, participants are restricted by their preference to volunteer for HIV-related organizations in order to avoid social stigma and rejection.
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Jung Y, Schaller J, Bellini J. Predictors of Employment Outcomes for State-Federal Vocational Rehabilitation Consumers With HIV/AIDS. REHABILITATION COUNSELING BULLETIN 2010. [DOI: 10.1177/0034355209356596] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In this study, the authors investigated the effects of demographic, medical, and vocational rehabilitation service variables on employment outcomes of persons living with HIV/AIDS. Binary logistic regression analyses were conducted to determine predictors of employment outcomes using two groups drawn from Rehabilitation Services Administration (RSA-911) data. Only service variables were found to be significantly related to employment outcomes in both groups. Job placement assistance and on-the-job supports were found to be significant predictors of a successful employment outcome at closure. Whereas higher case service expenditures increased the likelihood of achieving employment at closure, longer length of time in rehabilitation decreased the likelihood of employment at closure.
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Abstract
This article provides a reflection on the three articles that compose the Major Contribution on HIV/AIDS and employment research. It highlights the merits of the contribution in the broader context of HIV/AIDS employment research and recommends future directions for this area of inquiry, including theory integration, an investigation of HIV health outcomes, and an interdisciplinary approach to this complex line of research.
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Werth JL, Borges NJ, McNally CJ, Maguire CP, Britton PJ. The Intersections of Work, Health, Diversity, and Social Justice. COUNSELING PSYCHOLOGIST 2008. [DOI: 10.1177/0011000007309965] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although counseling psychology has discussed vocational issues, health concerns, diversity, and social justice, discussion of these topics has typically been narrowly focused. This article uses the example of persons with HIV (PWHIV) to demonstrate how these areas can be intertwined. The counseling psychology literature is also examined to determine the degree to which direction has been provided regarding clients facing health concerns, disabilities, confusion regarding career issues, or possible discrimination. Because HIV is now considered to be a chronic illness for many people, there is an increased likelihood that PWHIV will be faced with employment issues, as well as significant barriers to beginning work, returning to work, or keeping a job. After highlighting characteristics of PWHIV, we review the degree to which the vocational literature addresses the needs and issues of PWHIV. We also examine the role of social justice in relation to PWHIV who are considering work.
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Burns SM, Young LRL, Maniss S. Predictors of employment and disability among people living with HIV/AIDS. Rehabil Psychol 2006. [DOI: 10.1037/0090-5550.51.2.127] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Walch SE, Lezama MA, Giddie LT. Managing HIV in the workplace: A primer for managers and supervisors. PSYCHOLOGIST-MANAGER JOURNAL 2005. [DOI: 10.1207/s15503461tpmj0801_6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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