Promoting Employment in Persons Living With HIV/AIDS

Study Overview
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Brief Summary
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Many persons living with HIV/AIDS (PLWHA) are unemployed, with estimates indicating rates as high as 60%. 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 for engaging in job-related activities each week. Participants will receive study treatments for 16 weeks and complete follow-up evaluations throughout 18 months. 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.

Detailed Description
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Many persons living with HIV/AIDS (PLWHA) are unemployed, with estimates indicating rates as high as 60%. 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 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. The investigators 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. The investigators 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.

Official Title
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Promoting Employment in Persons Living With HIV/AIDS

Conditions
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Unemployment, HIV

Intervention / Treatment
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* Behavioral: activity contracting
* Behavioral: contingency management for activity completion


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: HIV positive aged 18+ years not working in the formal economy Exclusion Criteria: have a condition that may hinder study participation

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Job activity contracting<br>Standard services plus job activity contracting | Behavioral: activity contracting<br>* Participants will complete job-related activity contracts each week with the goal of obtaining employment.<br>|
| Experimental: Reinforcement for completing activities<br>Standard services plus job activity contracting plus reinforcement for completing job-related activities | Behavioral: activity contracting<br>* Participants will complete job-related activity contracts each week with the goal of obtaining employment.<br>Behavioral: contingency management for activity completion<br>* Participants will earn chances to win prizes for completing specific job-related activities.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| job attainment | self-report of job attainment: yes/no | 18 months | 
| proportion of days worked for pay | self-report of number of days worked | 18 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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contingency management