Living and working with HIV in France in 2003: results from the ANRS-EN12-VESPA Study.

OBJECTIVES: The employment rate of people living with HIV in France remains lower than in the general population despite HAART (highly active antiretroviral therapy) availability, translating into a high disease-related socioeconomic burden. Our objective was to investigate the relationships between HIV disease and employment status.
DESIGN: We used data from the ANRS-EN12-VESPA Study.
METHODS: Analyses were restricted to the 2750 working-aged (<60 years) participants. Individuals' health characteristics were compared according to employment status and plans of access/return to work, using logistic regression models to account for sociodemographic/occupational and health characteristics.
RESULTS: The employment rate was 56.5%; 44.9% of participants had remained employed since diagnosis and 11.6% had accessed employment after diagnosis. Compared with unemployed participants, those who had maintained employment were less likely to be of fair/poor health and have a history of AIDS and hepatitis C virus co-infection, were more likely to have been diagnosed with HIV after 1996, have a history of HIV-related hospitalization and a CD4 cell count of 200 cells/microl or less. Among employed participants, 70.1% had not disclosed their HIV status at the workplace and 8.5% reported HIV-related adjustments in their working conditions. Among the unemployed, 64.5% reported plans of access/return to work and 58.2% of those had attempted to do so. Motivations for access/return to work were mainly of a social, psychological and financial nature.
CONCLUSION: The employment status of people living with HIV/AIDS is associated with sociodemographic/occupational factors in addition to health characteristics. Management of HIV infection at work remains a challenge in the HAART era.