Understanding the psychosocial context of employment and occupational productivity among women living with HIV: A mixed-methods study

Article type: Research Article

Authors: Wise, Jenni M.^{a; *} | Konkle-Parker, Deborah^{b; c} | Raper, James L.^d | Heaton, Karen^a | Vance, David E.^a | Azuero, Andres^a | Wingood, Gina^e | Adimora, Adaora A.^{f; 1} | Topper, Elizabeth F.^g | Kempf, Mirjam-Colette^{a; d; h; i}

Affiliations: [a] Department of Family, Community and Health Systems, University of Alabama at Birmingham, Birmingham, AL, USA | [b] Department of Medicine, University of Mississippi Health Care, Jackson, MS, USA | [c] School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA | [d] Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA | [e] Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA, USA | [f] Department of Medicine, University North Carolina at Chapel Hill, Chapel Hill, NC, USA | [g] Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA | [h] Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA | [i] Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA

Correspondence: [*] Address for correspondence: Jenni Wise, PhD, MSN, RN, University of Alabama at Birmingham, School of Nursing, Nursing Building 573C, 1701 University Boulevard, Birmingham, AL 35294, USA. Tel.: +1 205 213 8226; Fax: +1 205 975 6194; E-mail: [email protected].

Note: [1] Published posthumously.

Abstract: BACKGROUND:Women living with HIV (WLHIV) are particularly vulnerable to poor employment outcomes, impacting their socioeconomic independence and personal sense of empowerment. OBJECTIVE:This article presents the results of a mixed methods study, which examined the personal, clinical, and socioeconomic contexts associated with employment and occupational productivity among employed WLHIV (n = 164) in the Southern United States. METHODS:The Stanford Presenteeism Scale-6 was used to assess the perceived impact of HIV disease on the ability to maintain focus and complete tasks at work. Correlational and hierarchical regression techniques were applied to examine the relationships between personal, clinical, and socioeconomic contexts and occupational productivity. RESULTS:In this sample, 62% of women perceived no impact on their ability to work or capacity to complete work related to living with HIV. In multivariable modeling, empowerment, neurocognition, socioeconomic status, and psychological health were associated with occupational productivity. In-depth interviews (n = 29) provided rich contexts and meaning surrounding employment among WLHIV, and indicated that quality of life, work-life balance, empowerment, social support, and psychological health influenced the experience of work. CONCLUSION:Psychosocial and structural interventions are needed to improve occupational outcomes in this vulnerable population.

Keywords: Employment, women living with HIV, occupational productivity, mixed-methods study

DOI: 10.3233/WOR-230363

Journal: Work, vol. Pre-press, no. Pre-press, pp. 1-13, 2024