A Scoping Review of Employment and HIV
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ORIGINAL PAPER
A Scoping Review of Employment and HIV Catherine H. Maulsby1,4 · Aneeka Ratnayake1 · Donna Hesson2 · Michael J. Mugavero3 · Carl A. Latkin1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Employment is a social determinant of health that is important for understanding health behaviors, health outcomes and HIV transmission among people living with HIV. This study is a scoping review of the literature that addresses (a) the relationship between employment and the HIV continuum of care, (b) determinants of employment among PLWH and (c) experiences with employment. We searched two databases, PubMed and Embase, and identified a total of 5622 articles that were subjected to title and abstract review. Of these, 5387 were excluded, leaving 235 articles for full-text review. A total of 66 articles met inclusion criteria and were included in the study. The literature suggests that employment status is positively associated with HIV testing, linkage to HIV care, retention in HIV care, and HIV medication adherence. Guided by a social-ecological framework, we identified determinants of employment at the individual, interpersonal, organizational, community, and policy levels that are amenable to public health intervention. Experiences with employment, including barriers, facilitators, advantages, disadvantages, and needs, provide additional insight for future research and programs. Keywords Employment · Return-to-work · HIV continuum of care · Social determinants of health
Introduction There is increased recognition of the role social determinants of health play in shaping health behavior and disease transmission. The National HIV AIDS Strategy calls for comprehensive care for people living with HIV (PLWH) that includes supportive services for employment [1]. Once considered a terminal illness, with the advent of antiretroviral therapy (ART), and enhancements in contemporary ART, HIV is now considered a chronic disease [2]. People living with HIV who have a timely diagnosis, access to medication, and sustained life-long HIV medication adherence are expected to live nearly as long as the general population [3]. * Catherine H. Maulsby [email protected] 1
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
2
Welch Medical Library, Johns Hopkins University, Baltimore, MD, USA
3
University of Alabama at Birmingham, Birmingham, AL, USA
4
Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Rm. 904C, Baltimore, MD 21205, USA
Given that the majority of PLWH are of working age—91% of PLWH are between the ages of 20–65 [4]—unemployment and job loss related to HIV will likely play a critical role in the social well-being and health of people living with HIV over the life course. The purpose of this scoping review is to assess the state of the science on the relationship between employment and HIV. There are several literature reviews which focus on employment among PLWH that are relevant to our study. A
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