title: Navigating Barriers to Vocational Rehabilitation for HIV-Positive Persons.
abstract: This study documented the outcomes of 108 HIV-positive persons receiving vocational rehabilitation services. Over a 12-month follow-up, participants reported significantly decreased odds of any unstable housing [Adjusted Odds Ratio (AOR) = 0.21; 95 % CI 0.05-0.90; p < .05] and increased odds of being employed at least part-time (AOR = 10.19; 95 % CI 2.40-43.21; p < .01). However, reductions in perceived barriers to employment and increases in income were more pronounced among those not receiving disability benefits at baseline. This was consistent with findings from baseline qualitative interviews with 22 participants where those not on disability were subject to bureaucratic hurdles to rapidly accessing benefits and anticipated stigma of being on disability that propelled them to rejoin the workforce. Vocational rehabilitation could address key structural barriers to optimizing HIV treatment as prevention, and novel approaches are needed to improve outcomes among individuals receiving disability benefits.
authors.affiliation: School of Nursing, University of California, San Francisco, 2 Koret Way, N511M, San Francisco, CA, 94143, USA.
authors.forename: Walter
authors.initials: W
authors.lastname: Gómez
authors.affiliation: School of Nursing, University of California, San Francisco, 2 Koret Way, N511M, San Francisco, CA, 94143, USA.
authors.forename: Annesa
authors.initials: A
authors.lastname: Flentje
authors.affiliation: Positive Resource Center, San Francisco, CA, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Schustack
authors.affiliation: Positive Resource Center, San Francisco, CA, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Ramirez-Forcier
authors.affiliation: Positive Resource Center, San Francisco, CA, USA.
authors.forename: Brett
authors.initials: B
authors.lastname: Andrews
authors.affiliation: Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Samantha E
authors.initials: SE
authors.lastname: Dilworth
authors.affiliation: HIV/AIDS Division, San Francisco General Hospital, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Elise D
authors.initials: ED
authors.lastname: Riley
authors.affiliation: Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Alberto
authors.initials: A
authors.lastname: Curotto
authors.affiliation: School of Nursing, University of California, San Francisco, 2 Koret Way, N511M, San Francisco, CA, 94143, USA. adam.carrico@ucsf.edu.|Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, USA. adam.carrico@ucsf.edu.
authors.forename: Adam W
authors.initials: AW
authors.lastname: Carrico
mesh_terms: D000328:Adult; D006233:Persons with Disabilities; D004651:Employment; D016832:Employment, Supported; D005260:Female; D015658:HIV Infections / Q000534:rehabilitation*; D006801:Humans; D007182:Income; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012050:Rehabilitation, Vocational; D057545:Social Stigma
keywords: Disability; HIV/AIDS; Housing; Structural barriers; Vocational rehabilitation