INSERM U, CESP, Epidemiology of Occupational and Social Determinants of Health, Villejuif, France.
AIDS. 2012 Jan 14;26(2):207-15. doi: 10.1097/QAD.0b013e32834dcf61.
Employment status is a major predictor of health status and living conditions, especially among HIV-infected people, a predominantly working-aged population. We aimed to quantify the risk of work cessation following HIV diagnosis in France in 2004-2010 and to measure the respective burden of HIV-related characteristics and of associated comorbidities on this risk.
We used data from a multicenter cohort made of a diversified sample of recently diagnosed HIV-1-infected adults, antiretroviral treatment-naive at baseline in 2004-2008 (ANRS-COPANA cohort). Detailed information on living conditions and clinical and biological characteristics were collected prospectively.
The risk of work cessation among the 376 working-aged participants employed at baseline was estimated using the Kaplan-Meier method. Characteristics associated with the risk of work cessation were identified using multivariate Cox models.
The cumulative probability of work cessation reached 14.1% after 2 years and 34.7% after 5 years. Diabetes, hypertension and, to a lesser extent, signs of depression were associated with increased risks of work cessation after accounting for socio-occupational characteristics [adjusted hazard ratios (95% confidence interval): 5.7 (1.7-18.8), 3.1 (1.5-6.4) and 1.6 (0.9-2.9), respectively]. In contrast, HIV disease severity and treatment and experience of HIV-related discrimination were not statistically associated with the risk of work cessation.
The risk of work cessation during the course of HIV disease has remained substantial in the most recent period in France. Comorbidities, but not characteristics of HIV disease itself, substantially affect chances of maintaining employment. This provides insights into strategies for limiting the burden of HIV disease for individuals and society.
就业状况是健康状况和生活条件的主要预测因素，尤其是在 HIV 感染者中，他们主要是工作年龄段的人群。我们旨在量化 2004-2010 年法国 HIV 诊断后停止工作的风险，并衡量 HIV 相关特征和相关合并症对这种风险的各自负担。
我们使用了一个多中心队列的数据，该队列由一组多样化的新诊断为 HIV-1 感染的成年人组成，这些成年人在 2004-2008 年基线时为抗逆转录病毒治疗初治（ANRS-COPANA 队列）。详细的生活条件和临床及生物学特征信息是前瞻性收集的。
使用 Kaplan-Meier 方法估计 376 名基线时就业的工作年龄参与者中停止工作的风险。使用多变量 Cox 模型确定与停止工作风险相关的特征。
在 2 年后，停止工作的累积概率达到 14.1%，在 5 年后达到 34.7%。糖尿病、高血压，以及在一定程度上抑郁的迹象，在考虑到社会职业特征后，与停止工作的风险增加相关[调整后的危险比（95%置信区间）：5.7（1.7-18.8）、3.1（1.5-6.4）和 1.6（0.9-2.9）]。相比之下，HIV 疾病的严重程度以及抗逆转录病毒治疗和 HIV 相关歧视的经历与停止工作的风险没有统计学上的关联。
在法国最近的时期，HIV 疾病过程中停止工作的风险仍然很大。合并症，但不是 HIV 疾病本身的特征，极大地影响了保持就业的机会。这为个人和社会限制 HIV 疾病负担的策略提供了思路。
