Impact of antiretroviral therapy on vocational rehabilitation.

This study evaluates the impact of a free antiretroviral therapy (ART) programme on the employment status of people living with HIV/AIDS. Patients on ART were interviewed regarding the employment status before and after ten months of enrollment into therapy. We included patients who were started on the free ART program of Kerala state at the Medical College, Thrissur. We documented the demographic details, indication for starting ART, disease status, WHO staging and CD4 count (whenever available) and the job status at the time of enrollment into the study. We collected data about the patient's job status at the end of ten months of ART. We excluded patients below 20 years of age, those who died during the study period and those lost for follow-up before the end of ten months from the analysis. We looked at factors associated with having employment at the end of ten months of ART using logistic regression. At the end of ten months of therapy the employment status improved significantly (p<0.01) to 74% (77 patients). We found that 96.4% of those previously employed are at present employed, while 65.8% of those previously unemployed are employed at present. A history of previous employment (p=0.014) was associated with acquisition of employment; sex, duration on ART, stage of disease or age does not significantly influence the present employment status. This study suggests that the provision of free ART by the state can significantly improve the employment status of PLWHA.