The course of illness for persons with HIV/AIDS has changed dramatically in the last two years. With the introduction of combination antiretroviral therapy, and specifically, protease inhibitors, this course has taken an """"""""about face."""""""" The health of many patients has significantly improved, their immunologic profile nearly or actually normalized, and with this improvement has come the prospect of extended survival and even a """"""""second life."""""""" This study seeks to identify neuropsychiatric barriers and facilitators for persons with HIV/AIDS whose health has now improved and are attempting to return to work. Since barriers associated with medical illness are clearly recognized, we have chosen to focus on defining neurocognitive and psychiatric/psychosocial barriers and facilitators to return to work, while taking medical variables into account. Neuropsychiatric variables are important in HIV because of the relatively high prevalence of measurable cognitive impairment (up to 55% in some studies of symptomatic subjects) and other neuropsychiatric conditions in this illness. To accomplish our aims, we will enroll a group of 260 HIV+ subjects entering a non-profit agency (Multi-Tasking Service, MTS) designed to assist persons with HIV infection who wish to return to work. We will follow these individuals in this program for a period of two years. Baseline measures of neuropsychological, psychiatric and psychosocial function will be obtained, and repeated at six month intervals with three month telephone contact in between these semi- annual visits in order to identify any change in subjects' health, psychiatric and/or employment status. This will allow us to determine the relationship between neuropsychiatric variables at entry as well as during the study period and eventual success or difficulty in finding and maintaining employment. With these data, we will determine which neuropsychiatric factors (cognitive, psychiatric, and psychosocial) serve as barriers or facilitators for return to work in HIV+ individuals seeking to return to work. We will also examine whether certain patterns of neuropsychological difficulties pose particular barriers to return to work for various occupational categories.
| van Gorp, Wilfred G; Rabkin, Judith G; Ferrando, Stephen J et al. (2007) Neuropsychiatric predictors of return to work in HIV/AIDS. J Int Neuropsychol Soc 13:80-9 |
| Smith, Clifford A; van Gorp, Wilfred G; Ryan, Elizabeth R et al. (2003) Screening subtle HIV-related cognitive dysfunction: the clinical utility of the HIV dementia scale. J Acquir Immune Defic Syndr 33:116-8 |
