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Work and home productivity of people living with HIV in Zambia and South Africa

Thomas, Ranjeeta, Friebel, Rocco, Barker, Kerrie, Mwenge, Lawrence, Kanema, Sarah, Vanqa, Nosivuyile, Harper, Abigail, Bell-Mandla, Nomtha, Smith, Peter C., Floyd, Sian, Bock, Peter, Ayles, Helen, Fidler, Sarah, Hayes, Richard, Hauck, Katharina and Team, on behalf of the HPTN 071 (PopART) Study (2019) Work and home productivity of people living with HIV in Zambia and South Africa. AIDS, 33 (6). pp. 1063-1071. ISSN 0269-9370

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Identification Number: 10.1097/QAD.0000000000002160

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
Additional Information: © 2019 Wolters Kluwer Health, Inc.
Divisions: Health Policy
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Date Deposited: 12 Feb 2019 14:45
Last Modified: 21 May 2019 23:06
URI: http://eprints.lse.ac.uk/id/eprint/100083

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