The determinants of employability of people living with HIV/AIDS in Turkey

BACKGROUND: 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. METHODS: 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. 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. CONCLUSIONS: 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.