Helping people with HIV/AIDS return to work: a randomized clinical trial.

OBJECTIVE: New treatments introduced in the mid-1990s led many people with HIV/AIDS who previously had been disabled by their disease to contemplate workforce reentry; many remain unemployed, and little is known concerning interventions that might help them return to work. We report the results of a randomized clinical trial of an intervention designed to help people with HIV/AIDS reenter the workforce. DESIGN: We tested a mixed (group-individual) modality intervention that incorporated elements of Motivational Interviewing (Miller & Rollnick, 2002), skills building from Dialectical Behavior Therapy (Linehan, 1993), and job-related skills (Price & Vinokur, 1995). A total of 174 individuals participated in either the intervention or in standard of care and were followed for 24 months. RESULTS: Compared with individuals referred for standard of care, participants in the intervention engaged in more workforce-reentry activities over time and, once employed, were more likely to remain employed. Dose-response analyses revealed that among intervention participants, participants who attended more than 1 individual session engaged in more workforce-reentry activities than individuals who attended 1 or fewer individual sessions, whereas frequency of group session participation did not effect a difference between participants who attended more than 6 group sessions and participants who attended 6 or fewer group sessions. CONCLUSION: Theoretically based workforce-reentry assistance programs can assist disabled people with HIV/AIDS in their return-to-work efforts.

Neuropsychological functioning as a predictor of employment activity in a longitudinal study of HIV-infected adults contemplating workforce reentry.

Cognitive deficits are associated with HIV disease, and HIV-related cognitive deficits have been associated with declines in everyday functioning and vocational status. We administered a baseline neuropsychological (NP) test battery designed to assess estimated full-scale IQ, achievement, attention/concentration, executive function, language, mental speed, motor function, nonverbal memory, verbal memory, and visual-spatial function to a sample of 174 disabled, HIV-positive individuals enrolled in a randomized, controlled trial of a vocational-rehabilitation program. We then used these NP scores to predict employment at the end of participants' study participation, using both hierarchical multiple regression and ordinal logistic regression models. The hierarchical multiple regression analyses did not predict participants' employment activities at the end of study participation. In the ordinal logistic regression model, executive functioning weakly predicted employment status at the end of study participation and inspection of the predicted classifications revealed that 63% of the participants were incorrectly classified using this model. These results suggest that although predicting workforce reentry from NP testing may be statistically significant, NP testing may be of limited clinical value for informing the workforce reentry of disabled people with HIV who are interested in returning to work.

An evaluation of a brief HIV/AIDS prevention intervention for college students using normative feedback and goal setting.

This study evaluated the ability of a 20-minute self-administered intervention to increase HIV/AIDS risk reduction among sexually active college students. The intervention presented normative data on the relatively low prevalence of HIV risk behaviors among college students for the purpose of conveying the idea that risk reduction was the prevailing social norm among their same age peers. The intervention also invited students to select specific risk reduction goals to be implemented over a 30-day follow-up period. Participants (N = 155) were assigned in alternating order to receive either the intervention or a control condition that entailed reading a general AIDS information pamphlet. Results were partially moderated by gender. Compared with controls, men in the intervention group reported significantly higher condom use, whereas women in the intervention group reported significantly fewer sexual partners.