Department of Clinical Microbiology and Infectious Diseases, Bozyaka Education and Research Hospital, University of Health Sciences, İzmir, Turkey.
Department of Economics, Yaşar University, İzmir, Turkey.
Am J Ind Med. 2020 Jan;63(1):92-98. doi: 10.1002/ajim.23056. Epub 2019 Nov 5.
This study addresses an important field within HIV research, the factors affecting the determinants of the employability of people living with HIV/AIDS (PLHIV) in Turkey. The employability of PLHIV is now even more vital because the use of antiretroviral therapy improves the quality of life of patients. In spite of this, the related literature suggests that there are serious impediments to the employment of PLHIV who face considerable levels of discrimination based on their HIV status.
This is a cohort study of 170 PLHIV of working age, treated at the Izmir Bozyaka Education and Training Hospital. We use a univariate logistic model to determine the effects of all determinants of interest with probit/logit modeling and penalized maximum likelihood estimation to avoid bias and to test the robustness of results.
Age, time since diagnosis, work status at diagnosis, wealth status, illicit drug use, and CD4 cell count were significantly related to the employability of PLHIV. Younger individuals had a higher probability of workforce participation. HIV-infected patients aged 19 to 39 and 40 to 54 years were 32% and 20% more likely, respectively, to be employed. Economically better-off PLHIV were more likely to participate in the labor force and HIV patients who were working at the time of diagnosis were more likely to be re-employed. Time since diagnosis was negatively associated with the employment status. Compared to recently diagnosed patients, PLHIV for more than a decade were less likely to be employed. Those with high CD4 cell counts were more likely to be employed. Illicit drug use was negatively associated with employment and drug-addicted HIV patients were less likely to be employed. Higher education did not significantly predict the employability of PLHIV.
Our results suggest that besides immunological status, socioeconomic factors play a substantial role in the employability of PLHIV. We suggest that even if a patient is skilled, educated, and qualified for the job, other factors such as stigma and employment discrimination in the workplace may hinder employment even among highly educated PLHIV.
本研究探讨了 HIV 研究领域内一个重要的问题,即影响土耳其 HIV 感染者(PLHIV)就业能力的决定因素。PLHIV 的就业能力现在更加重要,因为抗逆转录病毒疗法的使用提高了患者的生活质量。尽管如此,相关文献表明,PLHIV 在就业方面仍然面临着严重的障碍,他们因 HIV 状况而面临着相当程度的歧视。
这是一项对在伊兹密尔博亚卡教育和培训医院接受治疗的 170 名处于工作年龄的 PLHIV 的队列研究。我们使用单变量逻辑模型,通过概率单位/对数模型和惩罚最大似然估计来确定所有感兴趣的决定因素的影响,以避免偏差并检验结果的稳健性。
年龄、诊断后时间、诊断时的工作状态、财富状况、非法药物使用和 CD4 细胞计数与 PLHIV 的就业能力显著相关。年轻人更有可能参与劳动力市场。19 至 39 岁和 40 至 54 岁的 HIV 感染者分别有 32%和 20%的可能性被雇佣。经济状况较好的 PLHIV 更有可能参与劳动力市场,而在诊断时就已经工作的 HIV 患者更有可能重新就业。诊断后时间与就业状况呈负相关。与近期诊断的患者相比,患病超过十年的 PLHIV 不太可能被雇佣。CD4 细胞计数较高的患者更有可能被雇佣。非法药物使用与就业呈负相关,吸毒的 HIV 患者不太可能被雇佣。高等教育并没有显著预测 PLHIV 的就业能力。
我们的结果表明,除了免疫状态外,社会经济因素在 PLHIV 的就业能力中起着重要作用。我们认为,即使患者有技能、受过教育且符合工作要求,其他因素,如工作场所的污名和就业歧视,可能会阻碍就业,即使是在受过高等教育的 PLHIV 中也是如此。