Impacts on employment and income among adults receiving ART

December 21, 2010

Two-year impacts on employment and income among adults receiving antiretroviral

therapy in Tamil Nadu, India: a cohort study

Thirumurthy, Harshaa,b; Jafri, Aishac,d; Srinivas, Govindarajulue; Arumugam,

Viswanathanf; Saravanan, Ramasamy Mf; Angappan, Sathish Kg; Ponnusamy,

Manivannang; Raghavan, Subhasreeg; Merson, d; Kallolikar, Shambhuf

AIDS: 14 January 2011 - Volume 25 - Issue 2 - p 239–246

doi: 10.1097/QAD.0b013e328341b928

Epidemiology and Social

Abstract

Objectives: To estimate the economic impact of antiretroviral therapy (ART) on

employment and income of treated patients as well as a comparison group of

pre-ART patients who receive care and support in Tamil Nadu, India.

Methods: A cohort of 1238 HIV-infected patients was followed between 2005 and

2007. Socioeconomic data were collected at 6-month intervals. A total of 515

patients initiated ART during the study period, whereas a comparison group of

723 patients were pre-ART.

The impact of ART on four employment outcomes was analyzed: participation in

economic activities in the past week, number of hours worked in the past week,

individual income earned in the past 30 days and 6 months. Regression models

including patient fixed effects were estimated. Data from the comparison group

of patients were used to adjust for time trends in employment outcomes.

Results: At 6 months after initiation of ART, patients were 10 percentage points

more likely to be economically active (P < 0.01) and worked 5.5 additional hours

per week (P < 0.01).

These increases were over and above those experienced by the comparison group.

The estimated 24-month impacts represent a doubling of patients' employment

levels at baseline.

At 24 months after ART initiation, employment increases remained large and

significant. Effects were almost twice as large for men compared with women.

Income earned in the past 30 days and 6 months also rose significantly.

Conclusion: ART resulted in a rapid and sustained increase in employment and

income for patients. The results demonstrate that ART can improve the economic

outcomes of HIV-infected patients.

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