Burden of HIV disease and comorbidities on the chances of maintaining employment in the era of sustained combined antiretoviral therapies use
Rosemary Dray-Spira, Camille Legeai, Mariette Le Den, François Boué, Caroline Lascoux-Combe, Anne Simon, Thierry May, Cécile Goujard, Laurence Meyer, ANRS-COPANA Cohort Study Group, Christine Rouzioux, Véronique Avettand-Fenoël, Olivier Lortholary, Jean-Paul Viard, Ségolène Boucly, Aline Maignan, Claudine Duvivier, Rodolphe Thiébaut, L M, Faroudy Boufassa, Marie-Aline Charles, R D-S, C L, Valentin Amon, Nacera Benammar, Remonie-Seng, Gilles Pialoux, Laurence Slama, Philippe Bonnard, Catherine Chakvetadze, Thomas L'Yavanc, Jacqueline Capeau, Corinne Vigouroux, Soraya Fellahi, Jean-Philippe Bastard, Eric Oksenhendler, Laurence Gérard, Jean-François Bourge, Véronique Bajzik, Daniel Séréni, C L-C, Claire Pintado, Olivier Taulera, Le Van Dien, Jeannine Delgado, Jean-Michel Molina, Thierry Saint-Marc, Samuel Ferret, Juliette Pavie, Jean-François Bergmann, Agathe Rami, Maguy Parrinello, Pierre-Marie Girard, Bénédicte Lefebvre, Chérif Boudraa, Bilguissa Diallo, Catherine Lupin, Serge Herson, A S, Nadia Edeb, Dominique Salmon-Céron, Loïc Guillevin, Tassadit Tahi, Marie Pierre Pietri, Laurence Weiss, Delphine Tisne-Dessus, Christelle Jalbert, Patrick Yeni, Sophie Matheron, Golriz Pahlavan, Bao Phung, Nadia El-Alami Talbi, Zahia Ramani, Giovanna Catalano, Cindy Godard, F B, Véronique Chambrin, Dominique Bornarel, Hélène Schoen, Robert Carlier, Bruno Fantin, Agnès Uludag, Caroline Poder, Robin Dhote, Michelle Bentata, Patricia Honoré, Unité Sida, Olivier Bouchaud, Xuan Tuyet, Jean-François Delfraissy, C G, Fabrice Chaix, Marie-Thérèse Rannou, Yves Levy, Alain Sobel, Cécile Dumont, André Cabié, Sylvie Abel, Sandrine Pierre-François, Véronique Beaujolais, Isabelle Poizot-Martin, Olivia Zaegel-Faucher, Caroline Debreux, Jacques Moreau, Saadia Mokhtari, Evelyne Van Der Gheynst, Marie-Christine Thiebaut-Drobacheff, Adeline Foltzer, Bruno Hoen, Jean-François Faucher, Michel Dupon, Jean-Marie Ragnaud, Isabelle Raymond, Philippe Morlat, Isabelle Louis, Mojgan Hessamfar, Jacques Reynes, Vincent Baillat, Corinne Merle De Boever, Christine Tramoni, Antoine Soufflet, Patrick Guadagnin, Frédéric Bastides, Patrick Choutet, Louis Bernard, François Raffi, Olivier Mounoury, Véronique Reliquet, Delphine Brosseau, Hervé Hue, T M, Simone Wassoumbou, Mireille Stenzel, Marie-Pierre Bouillon, Yazdan Yazdanpanah, Thomas Huleux, Emmanuelle Aïssi, Simona Pavel, David Rey, Christine Cheneau, Patricia Fischer, Marialuisa Partisani, Gilles Blaison, Mahsa Mohseni Zadeh, Martin Martinot, Anne Pachart, François Jeanblanc, Jean-Louis Touraine, Christian Trépo, Patrick Miailhes, Koffi Kouadjo, Valérie Thoirain, Corinne Brochier, Philippe Perré, Sophie Leautez, Jean Luc Esnault, Isabelle Suaud, Rosemary Dray-Spira, Camille Legeai, Mariette Le Den, François Boué, Caroline Lascoux-Combe, Anne Simon, Thierry May, Cécile Goujard, Laurence Meyer, ANRS-COPANA Cohort Study Group, Christine Rouzioux, Véronique Avettand-Fenoël, Olivier Lortholary, Jean-Paul Viard, Ségolène Boucly, Aline Maignan, Claudine Duvivier, Rodolphe Thiébaut, L M, Faroudy Boufassa, Marie-Aline Charles, R D-S, C L, Valentin Amon, Nacera Benammar, Remonie-Seng, Gilles Pialoux, Laurence Slama, Philippe Bonnard, Catherine Chakvetadze, Thomas L'Yavanc, Jacqueline Capeau, Corinne Vigouroux, Soraya Fellahi, Jean-Philippe Bastard, Eric Oksenhendler, Laurence Gérard, Jean-François Bourge, Véronique Bajzik, Daniel Séréni, C L-C, Claire Pintado, Olivier Taulera, Le Van Dien, Jeannine Delgado, Jean-Michel Molina, Thierry Saint-Marc, Samuel Ferret, Juliette Pavie, Jean-François Bergmann, Agathe Rami, Maguy Parrinello, Pierre-Marie Girard, Bénédicte Lefebvre, Chérif Boudraa, Bilguissa Diallo, Catherine Lupin, Serge Herson, A S, Nadia Edeb, Dominique Salmon-Céron, Loïc Guillevin, Tassadit Tahi, Marie Pierre Pietri, Laurence Weiss, Delphine Tisne-Dessus, Christelle Jalbert, Patrick Yeni, Sophie Matheron, Golriz Pahlavan, Bao Phung, Nadia El-Alami Talbi, Zahia Ramani, Giovanna Catalano, Cindy Godard, F B, Véronique Chambrin, Dominique Bornarel, Hélène Schoen, Robert Carlier, Bruno Fantin, Agnès Uludag, Caroline Poder, Robin Dhote, Michelle Bentata, Patricia Honoré, Unité Sida, Olivier Bouchaud, Xuan Tuyet, Jean-François Delfraissy, C G, Fabrice Chaix, Marie-Thérèse Rannou, Yves Levy, Alain Sobel, Cécile Dumont, André Cabié, Sylvie Abel, Sandrine Pierre-François, Véronique Beaujolais, Isabelle Poizot-Martin, Olivia Zaegel-Faucher, Caroline Debreux, Jacques Moreau, Saadia Mokhtari, Evelyne Van Der Gheynst, Marie-Christine Thiebaut-Drobacheff, Adeline Foltzer, Bruno Hoen, Jean-François Faucher, Michel Dupon, Jean-Marie Ragnaud, Isabelle Raymond, Philippe Morlat, Isabelle Louis, Mojgan Hessamfar, Jacques Reynes, Vincent Baillat, Corinne Merle De Boever, Christine Tramoni, Antoine Soufflet, Patrick Guadagnin, Frédéric Bastides, Patrick Choutet, Louis Bernard, François Raffi, Olivier Mounoury, Véronique Reliquet, Delphine Brosseau, Hervé Hue, T M, Simone Wassoumbou, Mireille Stenzel, Marie-Pierre Bouillon, Yazdan Yazdanpanah, Thomas Huleux, Emmanuelle Aïssi, Simona Pavel, David Rey, Christine Cheneau, Patricia Fischer, Marialuisa Partisani, Gilles Blaison, Mahsa Mohseni Zadeh, Martin Martinot, Anne Pachart, François Jeanblanc, Jean-Louis Touraine, Christian Trépo, Patrick Miailhes, Koffi Kouadjo, Valérie Thoirain, Corinne Brochier, Philippe Perré, Sophie Leautez, Jean Luc Esnault, Isabelle Suaud
Abstract
Objectives: Employment status is a major predictor of health status and living conditions, especially among HIV-infected people, a predominantly working-aged population. We aimed to quantify the risk of work cessation following HIV diagnosis in France in 2004-2010 and to measure the respective burden of HIV-related characteristics and of associated comorbidities on this risk.
Design: We used data from a multicenter cohort made of a diversified sample of recently diagnosed HIV-1-infected adults, antiretroviral treatment-naive at baseline in 2004-2008 (ANRS-COPANA cohort). Detailed information on living conditions and clinical and biological characteristics were collected prospectively.
Methods: The risk of work cessation among the 376 working-aged participants employed at baseline was estimated using the Kaplan-Meier method. Characteristics associated with the risk of work cessation were identified using multivariate Cox models.
Results: The cumulative probability of work cessation reached 14.1% after 2 years and 34.7% after 5 years. Diabetes, hypertension and, to a lesser extent, signs of depression were associated with increased risks of work cessation after accounting for socio-occupational characteristics [adjusted hazard ratios (95% confidence interval): 5.7 (1.7-18.8), 3.1 (1.5-6.4) and 1.6 (0.9-2.9), respectively]. In contrast, HIV disease severity and treatment and experience of HIV-related discrimination were not statistically associated with the risk of work cessation.
Conclusion: The risk of work cessation during the course of HIV disease has remained substantial in the most recent period in France. Comorbidities, but not characteristics of HIV disease itself, substantially affect chances of maintaining employment. This provides insights into strategies for limiting the burden of HIV disease for individuals and society.
Conflict of interest statement
Conflicts of Interest
The authors have no conflict of interest to disclose.
Source: PubMed