Working people living with HIV: who are they?

1. Working people living with HIV: who are they? Lavoie, René1; Otis, Joanne2,3; Godin, Gaston4,5 and the MAA Study Group 1 COCQ-SIDA 2 Department of Sexology, Université du Québec à Montréal 3 Canada Research Chair in Health Education 4 Department of Nursing, Université Laval 5 Canada Research Chair on Behaviours and Health Annual Canadian Conference on HIV/AIDS Research CAHR Quebec, May 27th 2006 Study funded by the CIHR HHP-64511

2. MAA Study Group • Richard Lalonde, collaborator, Institut thoracique de Montréal • Normand Lapointe, co-investigator, Centre maternel et infantile sur le sida, Hôpital Sainte-Justine • René Lavoie, co-investigator, COCQ-sida • Roger LeBlanc, collaborator, Clinique médicale Projet L.O.R.I • Nima Machouf, co-investigator, Montreal CHEST Institute • Danielle Rouleau, co-investigator, Département de microbiologie médicale et infectiologie, Hôpital Notre-Dame du CHUM • Emil Toma, co-investigator, Département de microbiologie médicale et infectiologie, Hôpital Hôtel-Dieu du CHUM • Benoît Trottier, collaborator, Clinique médicale de l’Actuel • Jean Vincelette, co-investigator, Département de microbiologie médicale et infectiologie, Hôpital Saint-Luc du CHUM • Maria Victoria Zunzunegui, co-investigator, Département de médecine sociale et préventive, Université de Montréal • José Côté, co-investigator, Faculté des sciences infirmières, Université de Montréal • Michel Alary, co-investigator, Unité de recherche sur la santé des populations, Hôpital du Saint-Sacrement du CHA • Eduard Beck, co-investigator, Direction de santé publique Montréal-Centre • Pierre Côté, co-investigator, Clinique médicale du Quartier Latin • Joseph J. Cox, co-investigator, Centre de traitement de l’immunodéficience, Hôpital général de Montréal • André Dascal, co-investigator, Maladies infectieuses et microbiologie, Hôpital général Juif SMBD • Neil Gaul, collaborator, Département de médecine familiale, Hôpital Maisonneuve-Rosemont

3. Study Objective To describe the socio-demographic, psychosocial and sexual characteristics of working people living with HIV (PLWHIV).

4. Methodology • Data were gathered from MAA, an ongoing longitudinal study documenting the quality of life (QoL) and associated factors among PLWHIV. • Recruitment undertaken through the 11 collaborating clinical sites and with the help of community groups • Participants were seen at 6-month intervals (T0, T1, T2, T3) • Face-to-face interviews • Consultation of medical files for CD4 and viral load results • 842 participants were recruited (at baseline) from November 2004 to April 2006: • Men = 81.1% • Heterosexual = 39.8% • Mean age = 44.1 years • Currently working = 39.0%

5. Methodology Study variables • Socio-demographic characteristics (gender, age, education, annual income, sexual orientation, etc.) • Illness trajectory (transmission, lifespan with HIV, lifespan with Tx, number of symptoms, etc.) • Anxiety and depression (HAD scale; 2 subscales; Zigmond & Snaith, 1983) • Coping strategies (COPE scale; 8 subscales; Carver et al., 1989) • Quality Of Life (MQoL-HIV scale and 10 subscales; New England Research Institutes, 1991) • Sexual behaviours (sexual relations with penetration, unprotected sex with HIV- or HIV? partners, type of partners)

6. Analyses • Bivariate analyses: Pearson’s Chi2 tests, Student’s t-test • Multivariate analysis: logistic regression (method: stepwise) on working status (yes, no)

7. ResultsSocio-demographic characteristics

8. ResultsSocio-demographic characteristics (continued)

9. ResultsIllness and treatment trajectories M=mean

10. ResultsSexual behaviours

11. ResultsQuality of life Scale varying from (1) « very low » to (7) « very high » (M) = Mean

12. ResultsQuality of life (continued) Scale varying from (1) « very low » to (7) « very high » (M) = Mean

13. ResultsAnxiety and depression Scale varying from (1) « very low » to (4) « very high » (M) = Mean

14. ResultsCoping strategies Scale varying from (1) « never » to (4) « very often » (M) = Mean

15. ResultsMultivariate analysis Working PLWHIV were: • More likely to have a level of education higher than high school • Adjusted O.R. = 1.73; 95% CI = 1.24-2.42 • More likely to be gay or bisexual • Adjusted O.R. = 1.90; 95% CI = 1.32-2.74 • Less likely to have contracted HIV through injection drug use • Adjusted O.R. = 0.52; 95% CI = 0.31-0.86 • More likely to have had penetrative sex in the last six months • Adjusted O.R. = 1.98; 95%CI = 1.42-2.76

16. ResultsMultivariate analysis (continued) Working PLHIV were: • Less likely to use religion as a CS • Adjusted O.R. = 0.86; 95% CI = 0.73-0.99 • More likely to have a higher level of physical functioning • Adjusted O.R. = 1.39; 95% CI = 1.20-1.61 • More likely to have a higher level of social functioning • Adjusted O.R. = 1.27; 95% CI = 1.12-1.43 • More likely to have fewer symptoms • Adjusted O.R. = 0.96; 95% CI = 0.92-0.99

17. Conclusion • Distinction between working PLWHIV and non working PLWHIV does not seem to be directly explained by illness trajectory • currently undergoing Tx (ns) • lifespan with Tx (ns) • lifespan with HIV (ns) • Need for more investigation in order to verify the associations between working status, CD4 count level and viral load

18. Conclusion (continued…) • However, having a job appears to be associated with several factors including the quality of life, in particular regarding physical and social functioning • It remains to be documented if working status is an antecedent or a consequence of improved quality of life

19. Conclusion • These findings concerning working status in PLWHIV are similar to other results of research conducted in France (Dr Delfraissy, ANRS, Journées Québécoises VIH, 2006) • Considering these findings, new questions have been included in the MAA study questionnaires in order to furthur pursue this line of research

20. We would like to take this opportunity to thank all the participants, as well as community organizations and research staff who devoted their time and efforts to make this study possible