HIV disease severity and employment outcomes in affected households in Zambia
Nyasha Tirivayi & John R Koethe
#2015-018
The relationship between immune status and employment outcomes in
HIV-infected patients on long-term antiretroviral therapy (ART) in
sub-Saharan Africa and their HIV-affected households is not well
understood. We assessed the relationship between CD4+ T-cell counts of
ART-treated adults at public-sector clinics in Lusaka, Zambia (median
treatment duration 973 days) and labour force participation in the
HIV-affected households using clinical and survey data. In multivariable
models, patients with a CD4+ count >350 cells/µl were 22 percentage
points more likely to be engaged in labour (95% CI: 0.02, 0.42) and
worked approximately 6 more days per month compared to patients with a
CD4+ count <350 cells/µl. A similar relationship between patient CD4+
count and labour participation was observed for other adult family
members in the HIV-affected household, but it was not statistically
significant. These findings suggest interventions that promote and
maintain robust immune recovery on ART may confer economic benefits.
Keywords: HIV, Africa, CD4 count, employment, household
JEL Classification: I10, I18, J22