Socioeconomic differences in the impact of HIV infection on workforce participation in France in the era of highly active antiretroviral therapy.
OBJECTIVE
We sought to measure the difference in employment rates between HIV-seropositive and HIV-seronegative persons and to establish whether this difference varied according to the HIV-infected persons' socioeconomic position as defined by education level.


METHODS
We used data from the VESPA (VIH: Enquête Sur les Personnes Atteintes) study, a large cross-sectional survey conducted among a nationally representative sample of 2932 HIV-infected patients in France. Age-, gender-, nationality-, and education-standardized employment rates were estimated with the French general population as the reference. The differences in employment rates with the general population were computed overall and according to education level.


RESULTS
Compared with that of the general population, the overall employment rate was 25% lower (95% confidence interval [CI]=16%, 32%) among HIV-infected patients diagnosed before 1994 and 9% lower (95% CI = 5%, 16%) among HIV-infected patients diagnosed from 1994 onward. The difference in employment rates with the general population was significantly higher among patients with a low education level. The employment rate of highly educated HIV-infected patients diagnosed from 1994 onward did not differ from that of the general population.


CONCLUSIONS
HIV infection was associated with decreased workforce participation among those with a low education level but not among highly educated individuals.
Dray-Spira
Rosemary
R
Institut National de la Santé et la Recerche Médicale, Unit 687, Saint-Maurice, France. rosemary.dray-spira@st-maurice.inserm.fr
Gueguen
Alice
A
Ravaud
Jean-François
JF
Lert
France
F
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D004522:Educational Status; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology*; D018023:HIV Seronegativity; D006679:HIV Seropositivity; D006801:Humans; D008297:Male; D008875:Middle Aged; D011287:Prejudice; D012923:Social Class; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000191:economics / Q000453:epidemiology