Improved Employment and Education Outcomes in Households of HIV-Infected Adults with High CD4 Counts: Evidence from a Community Health Campaign in Uganda

Citation

Thirumurthy, Harsha; Chamie, Gabriel; Jain, Vivek; Kabami, Jane; Kwarisiima, Dalsone; Clark, Tamara D.; Geng, Elvin H.; Petersen, Maya L.; Charlebois, Edwin D.; & Kamya, Moses R., et al. (2013). Improved Employment and Education Outcomes in Households of HIV-Infected Adults with High CD4 Counts: Evidence from a Community Health Campaign in Uganda. AIDS, 27(4), 627-634. PMCID: PMC3809760

Abstract

BACKGROUND: There is limited evidence on the association between socio-economic outcomes and CD4 counts in a population that includes HIV-infected adults who have high CD4 counts or have not been diagnosed. We examined this association among adults in a rural Ugandan parish.
METHODS: A community health campaign offering diagnostic and treatment services for HIV and other diseases was conducted with Ministry of Health support. Data on campaign participants' education and employment were collected and a detailed household socio-economic survey was conducted among a subset of participants. Regression analyses were used to assess relationships between CD4 count and employment and education outcomes.
RESULTS: 2,323 adults (74% of the community) participated in the campaign. 179/2,282 (7.8%) tested HIV-positive and 46% were newly diagnosed. Among HIV-infected adults not on ART, those with CD4>/=500 worked 6.9 more days/month (p < 0.01; 39% more) and 2.5 more hours/day (p < 0.05, 44% more) than those with CD4<200. These effects were not significantly different from the effects for those with CD4 350-499. Children aged 6-11 years in households of adults with CD4>/=350 did not have significantly different school enrollment rates than children in households of adults with CD4<350, but effects were larger among children aged 12-18 years.
CONCLUSIONS: Outcomes of HIV-infected adults with CD4>/=350 were better than those of adults with CD4<200 and resembled those of HIV-uninfected adults. The results suggest that early ART initiation may generate economic benefits by preventing a decline in socio-economic status, but further research is needed to determine the CD4 threshold at which these benefits would be largest.

URL

http://dx.doi.org/10.1097/QAD.0b013e32835c54d8

Reference Type

Journal Article

Year Published

2013

Journal Title

AIDS

Author(s)

Thirumurthy, Harsha
Chamie, Gabriel
Jain, Vivek
Kabami, Jane
Kwarisiima, Dalsone
Clark, Tamara D.
Geng, Elvin H.
Petersen, Maya L.
Charlebois, Edwin D.
Kamya, Moses R.
Havlir, Diane V.
The SEARCH Collaboration,

PMCID

PMC3809760

ORCiD

Thirumurthy - 0000-0002-3308-7603