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HIV and Disability: Updating the Social Security Listings (2010)

Chapter: Appendix D: Literature Tables

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Suggested Citation:"Appendix D: Literature Tables." Institute of Medicine. 2010. HIV and Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12941.
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Appendix D
Literature Tables

METHODS

A review of published literature was conducted related to disability and HIV/AIDS to examine current evidence of related employment capability. Extensive search terms were used, yielding initial results of 9,295 studies published between January 1993 and October 2009. The studies were reviewed, analyzed, and categorized (see Box D-1). The most relevant studies were identified as Category 1, totaling 32 articles for more detailed review. The topics of these studies include return to work for people living with

BOX D-1

Definitions of Categories

  • Category 1: Studies on clinical measures of treatment outcomes, diagnostic techniques, or health status indicators as they relate to employment capability (i.e., return to work, employability) for U.S.-based populations with HIV/AIDS.

  • Category 2: Studies on one or more parameters of disability (e.g., comorbid conditions, quality of life, morbidity, mortality) as they affect functional capacity for populations with HIV/AIDS.

  • Category 3: Studies on disability or employment factors, but which do not explicitly address, measure, or estimate medical treatment or functional capacity of populations with HIV/AIDS.

  • Category 4: Studies not related to HIV disability and employment.

Suggested Citation:"Appendix D: Literature Tables." Institute of Medicine. 2010. HIV and Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12941.
×

HIV/AIDS, the neuropsychological symptoms of HIV infection, and effect of combination antiretroviral therapy on vocational rehabilitation.

Search Strategy

The strategy of the literature review searched four databases: Medline, EMBase, Web of Science, and PsychINFO. Together these databases access information related to medicine, nursing, health care delivery, psychiatry, sociology, and psychology. Search strategies were developed for each database using text terms and Medical Subject Headings focused on eight subject areas, including HIV/AIDS, disability, employment, quality of life, functional capacity, treatment outcomes, severity of impairment, and comorbidities. Distinct terms were identified in each subject area to yield as many unique results as possible. Strategy parameters included limiting the search to human subjects, the English language, and studies published from 2004 to 2009. This time period was chosen to focus the studies on the most recent medical and scientific literature.

Preliminary Analysis and Results

A rigorous review of titles and abstracts determined which studies met the inclusion criteria. Each study was coded according to the category system. The preliminary results include 32 Category 1 articles, which focus on study populations with HIV/AIDS and employment capability. Table D-1 provides a detailed review of all Category 1 studies. An additional 331 articles were identified as Category 2 articles, which inform broader parameters potentially affecting functional capacity of populations with HIV/AIDS. These parameters include relative quality of life (with specific measurements for health-related quality of life), comorbid conditions, gender comparisons, and assessments of treatments for HIV/AIDS, or associated conditions that may lead to disability or impairment. The remaining 8,932 studies were categorized as either Category 3 or Category 4 studies. Category 3 studies informed background research during report writing. Category 4 studies did not meet the inclusion criteria and were not included in the study.

Suggested Citation:"Appendix D: Literature Tables." Institute of Medicine. 2010. HIV and Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12941.
×

Table D-1 starts on the following page.

Suggested Citation:"Appendix D: Literature Tables." Institute of Medicine. 2010. HIV and Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12941.
×

TABLE D-1 Literature Review on Employment Capability and HIV

Study

Study Purpose

Study Type

Time Frame

Disability

 

 

 

Anandan, N., B. Navaraj, B. Braveman, G. Kielhofner, and K. Forsyth. 2006. Impairments and perceived competence in persons living with HIV/AIDS. Work 27(3):255–266.

Determines occupational functioning required for various activities and describes impairments prevalent in HIV/ AIDS population; examines impact of these impairments on individuals’ perceived occupational competence

Observational

N/A

Cade, W. T., L. Peralta, and R. E. Keyser. 2004. Aerobic exercise dysfunction in human immunodeficiency virus: A potential link to physical disability. Physical Therapy 84(7):655–664.

Examines the biological factors possibly limiting the oxidative metabolic response to physical activity for people with HIV

Review

N/A

Levin, M., G. Kielhofner, B. Braveman, and L. Fogg. 2007. Narrative slope as a predictor of work and other occupational participation. Scandinavian Journal of Occupational Therapy 14(4):258–264.

Determines the utility of the narrative slope in predicting vocational outcomes of individuals with HIV/AIDS

Observational

9 months

Suggested Citation:"Appendix D: Literature Tables." Institute of Medicine. 2010. HIV and Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12941.
×

Sample Size (Persons)

Method

Outcome Measures

Relevant Findings

35

  • Convenience sample from the ongoing federally funded research project: Enabling Self-Determination (ESD) for Persons Living with HIV/AIDS

  • Occupational Self-Assessment (OSA)

  • Sign and Symptom Checklist (SSC-HIV)

  • Impairments most commonly identified by participants:

    • Fatigue

    • Fear/worries

    • Difficulty concentrating

    • Muscle aches

    • Depression

  • Primary areas of occupational functioning where individuals reported moderate to severe impairment: managing finances and physical activities

N/A

N/A

N/A

Physical functional disability measured by:

  • Fatigue

  • Diminished capacity to engage in peak aerobic exercise capacity

  • Inability to engage in instrumental activities of daily living

65

  • SSC-HIV

  • Occupational Performance History Interview (OPHI-II) includes:

    • Occupational identity scale

    • Occupational competence scale

    • Occupational behavior settings scale

  • Model of Human Occupation

Narrative slope measure of employment status or other productive activity at 3- and 6-month follow-up

  • Positive narrative slope predictive of employment or engagement in other productive activity

  • Relationships were statistically significant at 3- and 6-month follow-up; 9-month follow-up not statistically significant

Suggested Citation:"Appendix D: Literature Tables." Institute of Medicine. 2010. HIV and Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12941.
×

Study

Study Purpose

Study Type

Time Frame

Employment

Arns, P., D. Martin, and R. Chernoff. 2004. Psychosocial needs of HIV-positive individuals seeking workforce re-entry. AIDS Care 16(3):377–386.

Examines a population entering a vocational rehabilitation program designed for individuals with HIV, examining the population’s indicated objective and subjective needs to gain employment

Observational

January 1997–December 1999

Braveman, B., G. Kielhofner, G. Albrecht, and C. Helfrich. 2006. Occupational identity, occupational competence and occupational settings (environment): Influences on return to work in men living with HIV/AIDS. Work 27(3):267–276.

Examines and describes the efforts of 12 men living with AIDS to reestablish a role in the workforce following the completion of a vocational rehabilitation program

Observational

12 months

Braveman, B., M. Levin, G. Kielhofner, and M. Finlayson. 2006. HIV/AIDS and return to work: A literature review one-decade post-introduction of combination therapy (HAART). Work 27(3):295–303.

Reviews literature on employment and combination antiretroviral therapy

Review

1995–2005

Burns, S. M., L. R. Young, and S. Maniss. 2006. Predictors of employment and disability among people living with HIV/AIDS. Rehabilitation Psychology 51(2):127–134.

Explores the relationship between employment and disability as well as selected demographic, biological, and functionality variables for people living with HIV/AIDS

Observational

N/A

Conover, C. J., P. Arno, M. Weaver, A. Ang, and S. L. Ettner. 2006. Income and employment of people living with combined HIV/AIDS, chronic mental illness, and substance abuse disorders. Journal of Mental Health Policy and Economics 9(2):71–86.

Examines the labor market outcomes of individuals diagnosed with HIV, mental disorders, and substance abuse disorders

Observational

2000–2002

Suggested Citation:"Appendix D: Literature Tables." Institute of Medicine. 2010. HIV and Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12941.
×

Sample Size (Persons)

Method

Outcome Measures

Relevant Findings

235

  • Questionnaires of individuals recruited from local health care agencies, HIV mental health programs, HIV case management programs

  • Employment status

  • Education

  • Finances

  • Housing

  • Access to health care

  • Health status

  • Employed participants exhibited a marked decline in vocational functioning relative to pre-HIV status, with related and accompanying financial declines

12

  • OPHI-II

  • Completion of Employment Options Program

  • Employment history before and after onset of disability

  • Narratives

  • Narrative slope analysis

  • Resumption of roles and engagement in new activities resulted in increased confidence in occupational identity, competence, and setting

N/A

N/A

N/A

  • Employment is a possibility for HIV-infected people, but many face multiple challenges, including:

  • Side effects of treatment

  • Ongoing social stigma

  • Psychological burden associated with the disease

152

  • Questionnaire

  • Age

  • Clinical markers

  • Race

  • Time since diagnosis

  • Significant predictors of employment:

    • Minority race

    • Higher CD4 count

    • Higher mental health or physical health functioning

1,138

  • Interviews

  • HIV transmission risk activities

  • Medication adherence

  • Employment

  • Source of income

  • Less than 15 percent of sample employed, including both full- or part-time

  • High education levels and better physical health were indicators for employment

  • More than 33 percent reported not working due to a permanent disability

Suggested Citation:"Appendix D: Literature Tables." Institute of Medicine. 2010. HIV and Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12941.
×

Study

Study Purpose

Study Type

Time Frame

Conyers, L. M. 2004. The impact of vocational services and employment on people with HIV/AIDS. Work 23(3):205–214.

Explores the perceptions of 25 individuals with HIV/AIDS who engage in vocational services in attempt to return to work

Observational

N/A

Conyers, L. M. 2008. HIV/ AIDS and employment research: A need for an integrative approach. The Counseling Psychologist 36(1):108–117.

Reviews three articles on HIV/AIDS and employment that recommend future directions for theory integration, HIV health outcomes, and interdisciplinary approaches

Review

N/A

Escovitz, K., and K. Donegan. 2005. Providing effective employment supports for persons living with HIV: The KEEP project. Journal of Vocational Rehabilitation 22(2):105–114.

The Kirk Employment Empowerment Project (KEEP), a 3-year demonstration project, identified effective employment service strategies for individuals with HIV/AIDS

Observational

36 months

Goldman, D. P., and Y. Bao. 2004. Effective HIV treatment and the employment of HIV(+) adults. Health Services Research 39:1691–1712.

Examines whether combination antiretroviral therapy helps HIV-infected patients return to work, remain employed, or maintain hours of work

Observational

24 months

Suggested Citation:"Appendix D: Literature Tables." Institute of Medicine. 2010. HIV and Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12941.
×

Sample Size (Persons)

Method

Outcome Measures

Relevant Findings

25

  • Focus groups

  • Impact of vocational rehabilitation

  • Programmatic qualities of vocational services

  • Impact of employment

  • Vocational rehabilitation services led to the following:

    • Improved confidence

    • Higher motivation

    • Increased skills

    • Increased self-respect

    • Diversion from HIV

    • Improved health

  • Vocational services engender the following among participants:

  • Individualized approach to HIV management

  • Peer support

N/A

N/A

N/A

  • Integrating multiple disciplines—such as psychology, vocational rehabilitation, and community development—in addition to approaches to clinical care are important for helping individuals with HIV/AIDS return to work

148

  • Focus groups

  • Interviews at 6-month intervals

  • Employment status

  • Motivation to work

  • Quality of life

  • Most participants experienced the following barriers to employment:

    • Psychiatric disability

    • Substance abuse

    • Domestic violence

    • Low education levels

    • Incarceration history

    • Unstable housing

2,864

  • Interviews

  • Multistage sampling frame

  • Return to work within 6 months of treatment

  • Remaining employed within 6 months of treatment

  • Hours at work

  • Beginning treatment at less advanced stages of infection leads to greatest gain in employment status

  • Employed patients are more likely to remain employed because of therapy

Suggested Citation:"Appendix D: Literature Tables." Institute of Medicine. 2010. HIV and Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12941.
×

Study

Study Purpose

Study Type

Time Frame

Gorman, A. A., J. M. Foley, M. L. Ettenhofer, C. H. Hinkin, and W. G. van Gorp. 2009. Functional consequences of HIV-associated neuropsychological impairment. Neuropsychology Review 19(2):186–203.

Reviews the implications of HIV-associated neuropsychological disorders (HAND)

Review

N/A

Hergenrather, K. C., S. D. Rhodes, and G. Clark. 2005. The employment perspectives study: Identifying factors influencing the job-seeking behavior of persons living with HIV/AIDS. AIDS Education & Prevention 17(2):131–142.

Explores factors influencing the job-seeking behaviors of individuals living with HIV/AIDS, using the planned behavior theory

Observational

N/A

Maguire, C. P., C. J. McNally, P. J. Britton, J. L. Werth Jr., and N. J. Borges. 2008. Challenges of work: Voices of persons with HIV disease. The Counseling Psychologist 36(1):42–89.

Provides in-depth descriptions of vocational experiences of individuals with HIV

Observational

N/A

Martin, D. J., P. G. Arns, R. A. Chernoff, and M. Steckart. 2004. Working with HIV/AIDS: Who attempts workforce reentry following disability? Journal of Applied Rehabilitation Counseling 35(3):28–38.

Compares factors influencing individuals with HIV/AIDS who attempt workforce reentry; at entry to the program, participants were unemployed and disabled

Observational

1997–2001, 24-month periods

Martin, D. J., R. A. Chernoff, and M. Buitron. 2005. Tailoring a vocational rehabilitation program to the needs of people with HIV/AIDS: The Harbor–UCLA experience. Journal of Vocational Rehabilitation 22(2):95–103.

Reviews three vocational rehabilitation programs to better understand the workforce-reentry process for individuals living with HIV/AIDS

Review

N/A

Suggested Citation:"Appendix D: Literature Tables." Institute of Medicine. 2010. HIV and Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12941.
×

Sample Size (Persons)

Method

Outcome Measures

Relevant Findings

N/A

N/A

N/A

  • Patients with HAND have limited or challenged ability to engage and persist in employment, driving, medication adherence, mood, fatigue, and interpersonal functioning

54

  • Focus groups

  • Planned behavior model

  • Responses elicited from individuals on interest in and potential barriers to employment

  • Work perceived as having value

  • Participants expressed need for assistance to address barriers to employment such as education/training or social stigma

93

  • Focus groups

  • Grounded theory approach

  • Responses elicited from individuals on interest in and potential barriers to employment

  • Primary areas of concern for participants:

    • Employment

    • Community

    • Health

235

  • Questionnaire

  • Short Form 36 (SF-36): Evaluates individuals on eight domains of functioning

  • Income and source

  • Employment status

  • CD4 count

  • Viral load

  • History of opportunistic infections

  • Individuals who attempted return to work showed more improved health status (i.e., higher CD4 counts, fewer opportunistic infections, higher SF-36 scores for physical functioning, among other measures)

N/A

N/A

N/A

  • Continuing need for workforce reentry programs exists

  • Population affected by HIV shifts; programs should reflect this change

  • Full-time employment may not be an appropriate goal for individuals with HIV/AIDS

Suggested Citation:"Appendix D: Literature Tables." Institute of Medicine. 2010. HIV and Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12941.
×

Study

Study Purpose

Study Type

Time Frame

Martin, D. J., M. J. Steckart, and P. G. Arns. 2006. Returning to work with HIV/AIDS: A qualitative study. Work 27(3):209–219.

Studies the workforce-reentry process for individuals with HIV/AIDS

Observational

24 months

Rabkin, J. G., M. McElhiney, S. J. Ferrando, W. van Gorp, and S. Hsing Lin. 2004. Predictors of employment of men with HIV/AIDS: A longitudinal study. Psychosomatic Medicine 66(1):72–78.

Identifies patterns and predictors of work status and number of hours employed in a group of men with HIV/AIDS

Observational

30 months

Razzano, L. A., and M. M. Hamilton. 2005. Health-related barriers to employment among people with HIV/AIDS. Journal of Vocational Rehabilitation 22(3):179–188.

Evaluates two issues identified in previous research on HIV/AIDS and employment: health perceptions and sources of insurance and health benefits

Observational

N/A

Razzano, L. A., M. M. Hamilton, and J. K. Perloff. 2006. Work status, benefits, and financial resources among people with HIV/AIDS. Work 27(3):235–245.

Focuses on the factors related to employment status, sources of health benefits, and entitlements among people with HIV/ AIDS; results demonstrate differences in work status, benefits, and financial support received based on gender

Observational

6 months

Suggested Citation:"Appendix D: Literature Tables." Institute of Medicine. 2010. HIV and Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12941.
×

Sample Size (Persons)

Method

Outcome Measures

Relevant Findings

104

  • Questionnaire

  • Income

  • Health indexes

    • CD4 count

    • Viral load

  • Work in the past month

  • Employment barriers include:

    • Poor physical health

    • Poor mental health

    • Education deficiencies

    • Lack of motivation

    • Social barriers

    • Cognitive deficits

    • Substance abuse

    • Incarceration history

141

  • Beck Depression Inventory

  • Axis I diagnosis of lifetime and current depressive disorders

  • Medical measures (CD4 count, viral load, physical limitations)

  • Hours employed: (full or part time, unemployed)

  • Financial measures (SSI, SSDI)

  • Neuropsychological measures (seven tests—not listed)

  • 20 percent of men were continuously employed full time

  • 9 percent of men were continuously employed part time

  • 40 percent of men were continuously unemployed

  • Barriers to work included:

    • Structure of disability benefits

    • Depressive disorder

    • Physical limitations

    • Cognitive impairment

63

  • Beck Depression Inventory

  • Medical Outcome Survey-HIV Health Survey (MOS-HIV)

  • Functional status

  • Well-being

    • Pain

    • Mental health

    • Energy/fatigue

    • Health distress

    • Quality of life

  • Changes in health status (i.e., CD4 count, viral load)

  • Patients faced health-related barriers to employment, including personal concerns of health and functional status

  • Depression affected the ability to consider or continue work

  • Physical impairments remained despite higher CD4 counts

98

  • Medication Adherence Program Study (MAPS protocol)

  • Employment status

  • Health benefit sources

  • Medication adherence

  • Alcohol or drug use

  • Physical and mental health indicators

  • Employment status

  • Financial status

  • More men than women reported working at 6-month follow-up

  • Men receive higher Social Security Disability Insurance benefit based on higher average lifetime earnings

  • Employment and gender affect amount of benefits and financial resources for individuals living with HIV/AIDS

Suggested Citation:"Appendix D: Literature Tables." Institute of Medicine. 2010. HIV and Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12941.
×

Study

Study Purpose

Study Type

Time Frame

Timmons, J. C., and S. L. Fesko. 2004. The impact, meaning, and challenges of work: Perspectives of individuals with HIV/ AIDS. Health & Social Work 29(2):137–144.

Reveals the value and significance of employment for individuals with HIV/ AIDS, concerns related to Social Security benefits

Observational

N/A

van Gorp, W. G., J. G. Rabkin, S. J. Ferrando, J. Mintz, E. Ryan, T. Borkowski, and M. McElhiney. 2007. Neuropsychiatric predictors of return to work in HIV/AIDS. Journal of the International Neuropsychological Society 13(1):80–89.

Followed individuals with HIV/AIDS who initiated return to work processes to identify existing supports or barriers to employment

Observational

24 months

Suggested Citation:"Appendix D: Literature Tables." Institute of Medicine. 2010. HIV and Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12941.
×

Sample Size (Persons)

Method

Outcome Measures

Relevant Findings

29

  • Focus groups

  • Employment status

  • Perceptions and intentions of participants

  • The loss of Social Security benefits was a notable concern for participants who considered returning to work

118

  • Neuropsychological tests:

    • Wechsler Adult Intelligence Scale III

    • Wide Range Achievement Test-3

    • Trail Making Test I and II

    • California Verbal Learning Test

    • Faces I and III

    • Stroop Color Interference Test

    • California Computerized Assessment Package

    • Wisconsin Card Sorting Test

  • Structured Clinical Interview for DSM (SCID)

  • Beck Depression Inventory

  • Endicott Quality of Life Enjoyment and Satisfaction Questionnaire

  • Wortman Social Support Scale

  • Financial status

  • Health status

  • Neuropsychological measures

  • Psychiatric/ psychosocial measures

  • Employment status assessed at each 6-month follow-up

  • Predictors of employments:

    • Younger age

    • Reporting higher quality of life

    • Performing significantly better on timed motor measure with dominant hand

    • Evidence of better learning and recall on recognition and learning memory measures

Suggested Citation:"Appendix D: Literature Tables." Institute of Medicine. 2010. HIV and Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12941.
×

Study

Study Purpose

Study Type

Time Frame

Functional Capacity

Bernell, S. L., and J. A. Shinogle. 2005. The relationship between HAART use and employment for HIV-positive individuals: An empirical analysis and policy outlook. Health Policy 71(2):255–264.

Analyzes the determinants of combination antiretroviral therapy use and employment status for individuals who are infected with HIV

Observational

1996, 2 months

Berry, J. D., and B. Hunt. 2005. HIV/AIDS 101: A primer for vocational rehabilitation counselors. Journal of Vocational Rehabilitation 22(2):75–83.

Provides an overview of medical and psychosocial, information on HIV/AIDS related to vocational rehabilitation

Review

N/A

Conyers, L., and P. Datti. 2008. The unmet vocational rehabilitation needs of women with HIV/AIDS. Work 31(3):277–290.

Discusses unique needs of women with HIV/ AIDS and their needs for vocational rehabilitation services

Observational

N/A

Suggested Citation:"Appendix D: Literature Tables." Institute of Medicine. 2010. HIV and Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12941.
×

Sample Size (Persons)

Method

Outcome Measures

Relevant Findings

2,864

  • HIV Cost and Services Utilization Study: A test of independence between individuals on therapy and those not, and unemployed and employed individuals

  • Employment status

  • Combination antiretroviral therapy

  • Covariates:

    • Comorbidities

    • Injection drug use

    • Mental health status

  • Fully or partially employed individuals were more likely to be on therapy (26 versus 22 percent)

  • Individuals on therapy were less likely to have difficulties with activities of daily living (7 versus 26 percent)

N/A

N/A

N/A

  • Vocational rehabilitation may include:

    • Training for employers to reduce stigma or discrimination of the individual with HIV/AIDS

    • Address employment gaps for individuals with HIV/AIDS

    • Improve job seeking and interviewing skills

122

  • National Working Positive Coalition Employment Needs Survey (NWPC-ENS)

  • Economic and health characteristics and how they differ by employment status

  • Patterns of employment and use of employment services of NWPC-ENS

  • Incentives to work and effect of loss of employment

  • 59 percent of study respondents were employed at time of survey (compared to 68 percent at time of diagnosis)

  • Maintaining or increasing income was cited as the most important incentive for employment

  • 70 percent of employed individuals self-reported they were mostly to very healthy, compared to 49 percent of unemployed participants

Suggested Citation:"Appendix D: Literature Tables." Institute of Medicine. 2010. HIV and Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12941.
×

Study

Study Purpose

Study Type

Time Frame

Kielhofner, G., B. Braveman, M. Finlayson, A. Paul-Ward, L. Goldbaum, and K. Goldstein. 2004. Outcomes of a vocational program for persons with AIDS. American Journal of Occupational Therapy 58(1):64–72.

Describes the development, implementation, and outcomes of a program of vocational services for individuals with HIV/AIDS

Observational

N/A

O’Brien, K. K., A. M. Bayoumi, C. Strike, N. L. Young, and A. M. Davis. 2008. Exploring disability from the perspective of adults living with HIV/AIDS: Development of a conceptual framework. Health & Quality of Life Outcomes 6(76).

Develops a conceptual framework of disability from the perspective of adults living with HIV/AIDS

Observational

N/A

Paul-Ward, A., B. Braveman, G. Kielhofner, and M. Levin. 2005. Developing employment services for individuals with HIV/AIDS: Participatory action strategies at work. Journal of Vocational Rehabilitation 22(2):85–93.

Details the development of employment and independent living services of a 3-year federally funded demonstration project: Enabling Self-Determination (ESD) for Persons Living with AIDS

Observational

12 months

Suggested Citation:"Appendix D: Literature Tables." Institute of Medicine. 2010. HIV and Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12941.
×

Sample Size (Persons)

Method

Outcome Measures

Relevant Findings

129

  • OPHI-II

  • Narrative slope

  • Other physical diagnoses besides HIV or AIDS

  • Mental health history

  • Substance abuse history

  • Incarceration history

  • OPHI-II scale scores

  • Narrative slope

  • Significant outcomes included return to work, school, or volunteer or intern activities:

    • 60 participants successfully completed the program

    • 30 participants did not successfully complete the program because they did not return to work or seek education or volunteer opportunities

  • An additional 39 individuals dropped out of the program prior to its completion: reasons included becoming sick, deciding vocational goals were not realistic, relapse into substance abuse, or difficulty maintaining a routine to come to the program; 39 individuals did not complete the program

38

  • Focus groups

  • Grounded theory techniques

  • Health-related challenges

  • Physical, social, and psychological areas of life affected

  • Overall impact on health

  • Participants’ concepts of disability emerged as multidimensional and episodic

  • Disability spanned physical, mental, and psychological domains

  • Inability to access needed services (e.g., housing, medications) reduced the individual’s ability to participate in society

14

  • Survey

  • Focus groups

  • OPHI-II

  • MOS-HIV

  • HIV impairment checklist

  • The Worker Role (structured interview)

Intensive, personalized, coordinated independent living services positively affect the lives of individuals living with HIV/AIDS:

  • Two clients obtained part-time jobs

  • One client returned to school

  • One client enrolled in a full-time technical training program

  • One client transitioned to independent living

Suggested Citation:"Appendix D: Literature Tables." Institute of Medicine. 2010. HIV and Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12941.
×

Study

Study Purpose

Study Type

Time Frame

Quality of Life

Martin, D. J., P. B. Arns, P. J. Batterham, A. A. Afifi, and M. J. Steckart. 2006. Workforce reentry for people with HIV/ AIDS: Intervention effects and predictors of success. Work 27(3):221–233.

Predicts the likelihood of return to work of individuals living with HIV/AIDS participating in a specialized program

Observational

24 months

Ryu, E., S. G. West, and K. H. Sousa. 2009. Mediation and moderation: Testing relationships between symptom status, functional health, and quality of life in HIV patients. Multivariate Behavioral Research 44(2):213–232.

Examines the relationships among symptoms, functional capacity, and quality of life for individuals living with HIV/AIDS

Observational

1992–1994

Severity of Impairment

Vetter, C. J., and J. P. Donnelly. 2006. Living long-term with HIV/AIDS: Exploring impact in psychosocial and vocational domains. Work 27(3):277–286.

Reviews literature addressing medical, psychological, and psychosocial challenges related to living with HIV/AIDS

Review

N/A

Suggested Citation:"Appendix D: Literature Tables." Institute of Medicine. 2010. HIV and Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12941.
×

Sample Size (Persons)

Method

Outcome Measures

Relevant Findings

235

  • Questionnaire

  • Income and income source

  • Current employment status

  • Health status:

    • CD4 count

    • Viral load

    • History of opportunistic infections

    • SF-36

  • Participants receiving Social Security Disability Income benefits were less likely to return to work

  • Participants with higher income levels prior to study were less likely to return to work than those with low income levels

  • Those with higher health status were more likely to return to work

956

  • Questionnaire

  • Symptoms

  • Functional health

  • Health-related quality of life

  • Symptom status has an indirect relationship to quality of life

  • Relationship partially mediated by functional health: having more symptoms increases disability (i.e., decreases functional health) and lowers quality of life

N/A

N/A

N/A

  • In 5 of 10 reviewed studies, respondents cited loss of medical benefits through Social Security as a barrier to seeking or resuming employment

  • Social stigma cited as a barrier to employment

  • Receiving support services after attaining employment were cited as important in one study

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The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus qualify for disability benefits. In this report, the Institute of Medicine (IOM) makes several recommendations for improving SSA's capacity for determining disability benefits more accurately and quickly using the HIV Infection Listings.

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