Economic costs to business of the HIV/AIDS epidemic.

HIV infection is a devastating disease for individuals and society. The economic burden of employees with HIV infection is a matter of increasing concern for employers. The purpose of this paper was to conduct a comprehensive review of published studies which measured/estimated economic costs incurred by HIV-infected employees, and evaluate the potential economic impact of the HIV/AIDS epidemic on business in different countries. This review finds a conceptual consensus in the literature that suggests that the HIV/AIDS epidemic has a potentially sizable economic cost to business, primarily due to increased costs for employment-based insurance premiums, welfare benefits, lost productivity, new hiring and training, and a downsized economy and labour market. Based on published data in the US, accounting for the first three major cost items, in 2002 an HIV-infected worker would cost an employer in the US an estimated 37,320 US dollars for asymptomatic individuals and 50,374 US dollars for symptomatic individuals per person-year. However, this review found little consistent empirical data in the literature regarding the scale of disease costs specific to businesses in different settings. In addition, the current literature offers little guidance in terms of well designed, validated, and easily replicated analytical frameworks for conducting a comprehensive cost analysis from a business perspective. Future research is needed to improve both the theoretical modelling and empirical work in assessing the full economic impact of the HIV/ADIS epidemic on patients, businesses and society at large.