This study evaluates the impact of antiretroviral treatment (ART) on employment-related outcomes using prospective, longitudinal analysis. 602 treatment-naïve clients in one rural clinic and one clinic in the capital Kampala were interviewed starting in January 2008 about their medical history, psychosocial and socioeconomic adjustment at baseline and month six and twelve. Half of the sample was eligible to receive ART, while the other half was also in HIV care but not yet eligible for ART, thus providing a comparison group that is similar to the treatment group in that its members are HIV-positive and have made the decision to enroll in HIV care. We find improvements in general health, reductions in the incidence of pain and health interfering with work, as well as improvements in work-related self-efficacy for both groups over time, but significantly more so for the group receiving ART treatment. At baseline less than half of the people in the ART-group worked, but after six months more than three quarters of them do, surpassing the fraction of people working in the control group after one year. Another key finding of the study is the importance of mental health as a key mediator for employment-related outcomes. These data indicate that ART clients experience greater improvements compared to pre-ART clients, and not only with regard to general health but also in restoring confidence in and ability to work, as well as actual work status.
Available at: http://works.bepress.com/sebastian_linnemayr/12/