RehabWire - Volume 8, Number 11, December 2006.

HIV/AIDS

HIV/AIDS was first recognized December 1, 1981. Twenty-five years later, treatment options can mean a full, inclusive life. The projects and publications in this issue look at living with HIV/AID, instead of dying from it.

NIDRR Grantees on the Cutting Edge.

A Survey of Employment Needs of People of Color with HIV/AIDS, Liza M. Conyers, PhD (H133F060045). A. Cate Miller, PhD, Project Officer.
Abstract: Using qualitative and quantitative research methods, this project identifies the unique issues and concerns related to considering and maintaining work among people of color living with HIV/AIDS. Focus groups are organized to gain perspectives of women and people of color regarding employment related issues and the use of vocational rehabilitation services. The results of this study are reviewed by an expert panel and may result in revisions to the NWPC National Employment Needs Survey. The resulting instrument is formatted into a variety of media formats (online, paper, and pencil) allowing for maximum distribution among agencies serving people of color with HIV/AIDS. Peer recruiters engage participants for the project with approximately 60 participants participating in focus groups and 2,000 participants responding to the survey. Analyzed data and findings are reported to participating agencies, creating an understanding of (1) the extent to which employment services are needed among people of color, and (2) what factors need to be considered in the design of employment services for women and people of color.

Promoting Health, Empowerment, and Community Integration Among People with HIV/AIDS: The Medication Adherence Program Study-II (MAPS-2), University of Illinois at Chicago (H133G060224) led by Lisa A. Razzano, PhD. David W. Keer, Project Officer.
Abstract: The Center on Mental Health Services Research and Policy at the University of Illinois at Chicago (UIC) is collaborating with the Chicago Department of Public Health (CDPH) to assist people with HIV/AIDS live healthier, more productive lives. Clients at CDPH clinics are offered the opportunity to participate in an innovative program designed to improve adherence to medication and treatment regimens, promote physical health and wellness, cultivate consumer empowerment, and foster community integration. This program examines the effects of peer-delivered medication support services compared to services delivered by traditional medication specialists among people living with HIV/AIDS. The addition of the peer component builds upon the success of the UIC Medication Adherence Program Study-I (MAPS-1), a three-year, NIDRR-funded investigation of the impact of specialized medication adherence services provided to people living with HIV/AIDS.
Find out more at: www.psych.uic.edu/mhsrp

Please note: These abstracts have been modified. Full, unedited abstracts, as well as any available REHABDATA citations, are available at naric.com.

NIDRR and HIV/AIDS Since 1992, NIDRR has funded 10 projects focused specifically on HIV/AIDS. In addition, projects on rural issues, demographics, employment, and health and wellness include HIV/AIDS in their research.

photo of a red ribbon with title The Red Ribbon Project, 15 years of compassion

The Red Ribbon Project was created in 1991 by the Visual AIDS Artists Caucus (thebody.com/visualaids/about.html). It remains copyright-free, and a powerful symbol of compassion and support for people with HIV/AIDS around the world.

Current Literature: Selections from REHABDATA

Conyers, L. (2004) Expanding understanding of HIV/AIDS and employment: Perspectives of focus groups. Rehabilitation Counseling Bulletin (ARCA), 48(1), 5-18. NARIC Accession Number: J46576. Project Number: H133G60101.
Abstract: Focus groups were conducted with people who have HIV/AIDS to identify and better understand the employment issues they experienced at various stages of the employment process. Key categories that emerged from the data fell into 3 main areas: (1) impact of HIV/AIDS on the context of employment considerations, (2) motivation to work, and (3) barriers to employment. These categories help expand the 5-construct, 6-process ecological model used to conceptualize career development and employment choices and revealed many of the mediating factors that rehabilitation counselors need to consider when working with this population.

Conyers, L. (2004) The impact of vocational services and employment on people with HIV/AIDS. Work: A Journal of Prevention, Assessment, and Rehabilitation, 23(3), 205-214. NARIC Accession Number: J47092. Project Number: H133G60101.
Abstract: Twenty-five individuals with HIV/AIDS representing diverse ethnic backgrounds and various stages of the employment process were interviewed regarding their perceptions of vocational services and the impact of employment on their lives. Three key themes emerged from the data: (1) personal impact of vocational services, (2) programmatic qualities of vocational services, and (3) impact of employment. Factors that influenced each of these themes and the implications for rehabilitation counselors are discussed.

According to the CDC, advances in antiretrovial therapies, improved treatment of opportunistic infections, and prevention of HIV infection all contributed to a drop in the rate of death from HIV/AIDS in the US. The rate dropped by 28% from 1995 to 1996 and 45% from 1997 to 1998.

a bottle of white pills

The CDC’s Division of HIV/AIDS Prevention has a full library of brochures, information sheets, and guides for people with HIV/AIDS, their families, caregivers, and health professionals available at www.cdc.gov/hiv

Conyers, L., Boomer, K. (2005) Workplace discrimination and HIV/AIDS: The national EEOC ADA research project. Work: A Journal of Prevention, Assessment, and Rehabilitation, 25(1), 37-48. NARIC Accession Number: J49426. Project Number: H133B040011.
Abstract: Article documents the employment discrimination experiences of Americans with HIV/AIDS using data from the Equal Employment Opportunity Commission (EEOC). It presents an analysis of the allegations of employment discrimination brought under Title I of the Americans with Disabilities Act (ADA) filed by people with HIV/AIDS compared to allegations filed by people with back and other physical, sensory, and neurological impairments. Researchers examined demographic characteristics of the charging parties; the industry designation, location, and size of employers against whom complaints were filed; the nature of the discrimination alleged to occur; and the legal outcomes of the complaints. Findings indicated that people with HIV/AIDS are more likely to be male, ethnic minorities, between the ages of 25-44, in white-collar jobs, in the South and West regions of the United States, and to work for businesses with 15 to 100 employees. The allegations in HIV/AIDS cases were more likely to receive merit resolution from the EEOC.

Razzano, L., Hamilton, M. (2005) Health-related barriers to employment among people with HIV/AIDS. Journal of Vocational Rehabilitation, 22(3), 179-188. NARIC Accession Number: J49475. Project Number: H133G010093.
Abstract: Study examined the relationship between employment status and concerns related to health perceptions, functioning, and the ability to sustain insurance and health benefits among people with HIV/AIDS. Discussion focuses on barriers to employment such as perceptions that work could exacerbate health and medical conditions and fears regarding the effect of employment on health insurance and non-cash benefits.

Ng, T., Kitchener, M. (2005) Medical home care waivers for persons with HIV/AIDS: Program expenditures, participants, and policies. AIDS & Public Policy Journal, 19(3/4), 95-109. NARIC Accession Number: J51403. Project Number: H133B031102.
Abstract: Article provides analyses of the data on national program participation and expenditures for all Medicaid HIV/AIDS waivers for the period 1992 to 2002. It also includes the results of a national survey of policies used on these waivers in 2002 and a comparison of the costs of serving individuals with HIV/AIDS in institutions and in Medicaid 1915(c) home and community-based services waiver programs.

(2001) Emerging disabilities series: Living with HIV/AIDS. Health & Disability Issue Brief, October 2001. NARIC Accession Number: O14348. Project Number: H133A990013.
Abstract: Provides an overview of the issues related to the long-term management and rehabilitation of persons with HIV/AIDS. Presents statistics on the incidence and prevalence of the disease and the demographic make-up of those affected. Discusses how side effects from antiretroviral drugs, fatigue, and neurological disorders affect quality of life and the performance of daily living activities. Describes issues related to relying on public programs for health care.

Moss, K. (2002) ADA Title I enforcement and people with HIV/AIDS. NARIC Accession Number: O14417. Project Number: H133G000132.
Abstract: Fact sheet presents questions and answers concerning employment discrimination provisions under the Americans with Disabilities Act (ADA) for people with HIV/AIDS. Topics include how the ADA protects workers who have HIV/AIDS, the number of complaints filed by people with HIV/AIDS, how to file a complaint, how long the process takes, results of the complaints, and factors that increase the likelihood of receiving a benefit.

(2003) Technical report - Summary findings for research component R3: HIV/AIDS, substance abuse and employment. NARIC Accession Number: O16463. Project Number: H133B970018.
Abstract: Report focuses on the results from a study to identify challenges to the delivery of vocational rehabilitation (VR) services to people living with HIV/AIDS. Interviews conducted with 15 individuals living with HIV/AIDS identified 5 major barriers to the effective delivery of VR services: (1) timely delivery of services, (2) coexisting substance abuse, (3) failure to identify limitations in ability to work, (4) accessibility of centralized services due to illness or confidentiality, and (5) consumer ignorance of eligibility for VR services.

HIV/AIDS at the Cochrane Library The Cochrane Library includes 102 systematic reviews of healthcare interventions for HIV/AIDS. In addition, there are 80 other reviews, 165 methods studies, 32 technology assessments, 468 economic evaluations, and 4347 clinical trials. There is one Cochrane Group dedicated to HIV/AIDS. Visit thecochranelibrary.org to review these resources.

Where Can I Find More? A quick keyword search is all you need to connect to a wealth of disability and rehabilitation research. NARIC’s databases hold more than 75,000 resources. Visit www.naric.com/research to search for literature, current and past research projects, and organizations and agencies in the US and abroad.

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