The Impact of ART on the Economic Outcomes of People Living with HIV/AIDS

Background. Clinical benefits of ART are well documented, but less is known about its effects on economic outcomes such as work status and income in sub-Saharan Africa. Methods. Data were examined from 482 adult clients entering HIV care (257 starting ART; 225 not yet eligible for ART) in Kampala, Uganda. Self-reported data on work status and income were assessed at baseline, months 6 and 12. Multivariate analysis examined the effects of ART over time, controlling for change in physical health functioning and baseline covariates. Results. Fewer ART patients worked at baseline compared to non-ART patients (25.5% versus 34.2%); 48.8% of those not working at baseline were now working at month 6, and 50% at month 12, with similar improvement in both the ART and non-ART groups. However, multivariate analysis revealed that the ART group experienced greater improvement over time. Average weekly income did not differ between the groups at baseline nor change significantly over time, among those who were working; being male gender and having any secondary education were predictive of higher income. Conclusions. ART was associated with greater improvement in work status, even after controlling for change in physical health functioning, suggesting other factors associated with ART may influence work. 1. Introduction Since 2003, with the support from international initiatives such as the “3 × 5” campaign of the WHO, UNAIDS, and Global fund to fight AIDS, TB, and Malaria which sought to have 3 million on antiretroviral therapy (ART) by end of 2005 [1] and funding from the US government’s President’s Emergency Plan for AIDS Relief (PEPfAR), there has been a wide scale-up of ART in the region [2, 3]. Clinical effectiveness and biomedical benefits of ART have been well documented [4–7]. However, much less research has examined the extent to which these benefits translate into socioeconomic well-being for individuals and their households. One might expect that improved physical health and functioning from ART might consequently result in increased work, productivity, and labour force participation. It’s upon this hypothesis that this study examined the effects of ART on work and income levels among HIV clients in Uganda. Beard et al. [8] published a systematic review of research examining the effects of ART on economic well-being for individuals in resource constrained settings. Findings revealed that compared to patients not yet on ART, work performance improved and absenteeism decreased among patients on ART, with these changes taking place in the first 3 months of