Promoting employment in persons living with HIV/AIDS

摘要 许多艾滋病毒/艾滋病携带者(PLWHA)失业，估计失业率高达 为60%。失业导致更低的生活质量，更严重的抑郁和物质使用，而且它是 与发病率和死亡率有关。尽管PLWHA在获得和获得 维持就业，基于行为分析和行为经济学原则的干预措施 与最佳做法就业服务一起应用，以促进行为改变和改善结果。 这些干预措施包括为行为改变的客观证据提供基于货币的增强剂。 他们可以成功地促进求职活动，即使在高度边缘化和被剥夺公民权的地方也是如此 人口。本研究将检验加强求职活动对改善就业的有效性。 希望以兼职或全职身份重返劳动力大军的PLWHA的就业结果。总的来说， 本研究将144名失业的PLWHA随机分配到两种干预措施中的一种。所有参与者将 接受通常的失业服务，重点是与艾滋病毒/艾滋病有关的具体问题，加上 鼓励完成与就业准备和获得有关的活动。增强版 干预将包括同样的待遇，外加参与的奖金从1美元到100美元不等的机会 每周参加与工作相关的活动。参与者将接受为期16周的研究治疗并完成随访- 在18个月内进行了全面的评估。结构化评估将评估就业结果、生活质量 指数、身体和认知功能、心理症状、病毒载量以及药物使用和风险 行为。假设为完成与工作相关的活动而加强的参与者将转变为 与那些没有得到与工作相关的强化的人相比，就业率更高、速度更快，工作更频繁 活动。我们还希望加强干预将提高生活质量，减少抑郁 症状，并改善医疗结果。与标准护理条件相比，它还可以保持或 改善认知功能和服药依从性，减少传播传染性的危险行为 疾病。我们将评估关键就业和健康结果的主持人和调解人，并 强调探索工作条件(临时的、秘密的、实际的或 情感要求高的工作等。)影响心理社会和身体健康。我们将进行成本效益分析 分析以估计这种干预的广泛传播的潜力，如果有效的话。 好了！

Abstract Many persons living with HIV/AIDS (PLWHA) are unemployed, with estimates indicating rates as high as 60%. Unemployment results in lower quality of life, greater depression and substance use, and it is associated with morbidity and mortality. Although PLWHA face substantial challenges in obtaining and maintaining jobs, interventions based upon behavior analytic and behavioral economics principles can be applied alongside best practices employment services to enhance behavior change and improve outcomes. These interventions involve provision of monetary-based reinforcers for objective evidence of behavior change. They can successfully enhance job-seeking activities, even in highly marginalized and disenfranchised populations. This study will examine the efficacy of reinforcing job-acquisition activities for improving employment outcomes in PLWHA who desire to return to the workforce in part- or full-time capacity. In total, this study will randomly assign 144 unemployed PLWHA to one of two interventions. All participants will receive usual unemployment services with an emphasis on specific issues related to HIV/AIDS, plus encouragement for completing activities geared toward employment readiness and acquisition. The enhanced intervention will involve that same treatment plus chances to win prizes ranging from $1 to $100 for engaging in job-related activities each week. Participants will receive study treatments for 16 weeks and complete follow- up evaluations throughout 18 months. Structured evaluations will assess employment outcomes, quality of life indices, physical and cognitive functioning, psychological symptoms, viral loads, and drug use and risk behaviors. The hypothesis is that participants reinforced for completing job-related activities will transition to employment at higher and faster rates and work more often than those who are not reinforced for job-related activities. We also expect the reinforcement intervention will increase quality of life, reduce depressive symptoms, and improve medical outcomes. Compared to the standard care condition, it may also maintain or improve cognitive functioning and medication adherence and reduce risk behaviors that spread infectious diseases. We will evaluate moderators and mediators of key employment and health outcomes, with an emphasis on exploring the extent to which work conditions (temporary, under the table, physically or emotionally demanding jobs etc.) impact psychosocial and physical health. We will conduct cost-effectiveness analyses to estimate the potential for wide scale dissemination of this intervention if efficacious. !