|
|
 |
Abstract
The impact of antiretroviral therapy on employment outcomes of HIV-infected individuals and their families: evidence from rural Western Kenya
H. Thirumurthy1, J. Graff Zivin2, M.P. Goldstein3
1Yale University, Department of Economics, New Haven, United States, 2Mailman School of Public Health, Columbia University, Department of Health Policy and Management, New York, United States, 3The World Bank, Poverty Reduction Group, Washington, DC, United States
Background: The well-documented health benefits of antiretroviral therapy (ART) have the potential to dramatically improve socio-economic outcomes of individuals and families affected by HIV/AIDS. Yet even as treatment programs are scaled-up, there is little empirical evidence on the socio-economic impact of ART in Africa. Using household survey data, this study offers the first examination of how ART affects employment outcomes of patients and their family members.
Methods: Socio-economic data were prospectively collected for all individuals in the households of 191 adult patients receiving ART at an HIV clinic in western Kenya between March 2004 and February 2005. Changes in two self-reported employment outcomes were analyzed: participation in the labor force (including self-employed agriculture) and number of hours worked in the past week. Socio-economic data were also collected simultaneously from 503 households chosen randomly from villages in the rural clinic’s catchment area (population 6,643 households). These data were used to control for confounding factors that influence employment, such as seasonality in agricultural and weather patterns.
Results: Within six months after the initiation of treatment, patients’ labor force participation rates rose 12.3 percentage points (p=0.03) and weekly hours worked rose 6.9 hours (p=0.09). Relative to pre-treatment employment levels, weekly hours worked rose by 35 percent. Young boys (between 8-12 years) in patients’ households worked significantly fewer hours after treatment was initiated for the patient. There was no change in employment activities of girls and other adults in patients’ households.
Conclusions: ART resulted in a rapid increase in employment for patients and reduced the need to work among boys living with patients. The reduction in child labor due to ART could also result in improved nutritional and schooling outcomes for children. The results demonstrate that ART provides significant non-health benefits for individuals and households in resource-poor settings.
Back
|