Thomas, Ranjeeta; Friebel, Rocco; Barker, Kerrie; Mwenge, Lawrence; Kanema, Sarah; Vanqa, Nosivuyile; Harper, Abigail; Bell-Mandla, Nomtha; Smith, Peter C; Floyd, Sian; +6 more... Bock, Peter; Ayles, Helen; Fidler, Sarah; Hayes, Richard; Hauck, Katharina; HPTN 071 (PopART) Study Team; (2019) Work and home productivity of people living with HIV in Zambia and South Africa. AIDS, 33 (6). pp. 1063-1071. ISSN 0269-9370 DOI: https://doi.org/10.1097/QAD.0000000000002160
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Abstract
OBJECTIVE: To compare number of days lost to illness or accessing healthcare for HIV-positive and HIV-negative individuals working in the informal and formal sectors in South Africa and Zambia. DESIGN: As part of the HPTN 071 (PopART) study, data on adults aged 18-44 years were gathered from cross-sectional surveys of random general population samples in 21 communities in Zambia and South Africa. Data on the number of productive days lost in the last 3 months, laboratory-confirmed HIV status, labour force status, age, ethnicity, education, and recreational drug use was collected. METHODS: Differences in productive days lost between HIV-negative and HIV-positive individuals ('excess productive days lost') were estimated with negative binomial models, and results disaggregated for HIV-positive individuals after various durations on antiretroviral treatment (ART). RESULTS: From samples of 19 330 respondents in Zambia and 18 004 respondents in South Africa, HIV-positive individuals lost more productive days to illness than HIV-negative individuals in both countries. HIV-positive individuals in Zambia lost 0.74 excess productive days [95% confidence interval (CI) 0.48-1.01; P < 0.001] to illness over a 3-month period. HIV-positive in South Africa lost 0.13 excess days (95% CI 0.04-0.23; P = 0.007). In Zambia, those on ART for less than 1 year lost most days, and those not on ART lost fewest days. In South Africa, results disaggregated by treatment duration were not statistically significant. CONCLUSION: There is a loss of work and home productivity associated with HIV, but it is lower than existing estimates for HIV-positive formal sector workers. The findings support policy makers in building an accurate investment case for HIV interventions.
Item Type | Article |
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Faculty and Department |
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology & International Health (2023-) Faculty of Infectious and Tropical Diseases > Dept of Clinical Research |
Research Centre | Population Studies Group |
PubMed ID | 30946160 |
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