Amsterdam 2015
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| Abstract #2329 - Poster 2 | ||||
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Session: 59.14: Poster 2 (Poster) on Tuesday in Chaired by Authors: Presenting Author: Mr. Walter Gómez - University of California, San Francisco, United States |
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| Additional Authors: | ||||
| Aim: HIV-positive persons commonly experience difficulties with employment that are associated with declining physical health. While the direction of this relationship remains unclear, receipt of disability benefits (i.e., SSI/SSDI) may be an important marker for functional impairments that limit engagement in the workforce. This mixed methods study with HIV-positive persons sought to: (1) examine whether individuals receiving SSI/SSDI displayed poorer vocational rehabilitation outcomes and (2) describe structural and social barriers that HIV-positive persons experience to achieving better vocational rehabilitation outcomes as a function of SSI/SSDI status. | ||||
| Method / Issue: We enrolled 108 HIV-positive persons who had recently initiated a vocational rehabilitation program in San Francisco. Participants completed self-report measures of perceived barriers to employment, employment status, income, and housing stability over a 12-month follow-up. From this larger cohort, 22 participants were purposively sampled based on time since HIV diagnosis and self-reported social standing for a qualitative sub-study focused on exploring the process of navigating vocational rehabilitation goals. We employed a grounded theory approach to develop themes relevant to the study and utilized Atlas.ti to analyze transcripts of qualitative interviews conducted at baseline. | ||||
| Results / Comments: The majority of participants were middle-aged (M = 46.6 SD = 9.3) gay or bisexual men (84%). Forty-five percent of participants were Caucasian, 19% Hispanic/Latino, 16% African American, 19% of multicultural or “other” heritage, and 1% Asian/Pacific Islander. Participants had been diagnosed with HIV for 14.6 (SD = 8.4) years on average and 62% were receiving SSI/SSDI benefits at baseline. Irrespective of baseline SSI/SSDI status, participants reported significantly increased odds of being employed at least part-time (Adjusted Odds Ratio [AOR] = 10.19 95% CI = 2.40 – 43.21 p < .01) and decreased odds of any unstable housing (AOR = 0.21 95% CI = 0.05 – 0.90 p < .05). However, reductions in perceived barriers to employment (Group x Time Unstandardized Beta = 3.65 t = 2.41 p < .05) and increases in income (Group x Time Unstandardized Beta = -4,035, t = -2.13 p < .05) were more prominent among those not receiving SSI/SSDI at baseline. Qualitative findings suggest that participants who were not receiving SSI/SSDI benefits described bureaucratic hurdles that often prevented them from qualifying for these benefits and endorsed a stronger sense of urgency to re-join the workforce. Those who were not receiving SSI/SSDI benefits also commonly described anticipated stigma related to accessing disability benefits. On the other hand, the participants receiving SSI/SSDI benefits more often described instances of experienced stigma, which coupled with stringent bureaucratic barriers to workforce re-entry made them more dependent on these disability benefits. | ||||
| Discussion: Findings highlight the unique structural, social, and contextual factors that influence the pursuit of vocational rehabilitation among HIV-positive persons. Tailored approaches are needed to support the delivery of vocational rehabilitation services to HIV-positive persons, taking into account SSI/SSDI status. | ||||
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