Purpose Finding and keeping employment is difficult for people with HIV. To improve supportive care for people with HIV and employment-related problems, a multidisciplinary guideline was developed in the Netherlands in 2010/2011. To identify the employment-related concerns of people with HIV and to formulate the key questions for the guideline, we conducted a qualitative study. The results of this study are described in this article. Methods This study was performed in three HIV-treatment centers in the Netherlands. In total 18 participants participated in three focus-group interviews and nine participants were interviewed individually. The data were transcribed ad verbatim and were analyzed according to the principle of constant comparison. Results Our findings indicate that people with HIV in the Netherlands face many work-related concerns. The themes which emerged from this study were disclosure, stigma and discrimination, knowledge about HIV, physical and psychological factors, working conditions, absenteeism, reintegration, and dismissal and counselling. Conclusions This study provides insight into employment-related concerns for people with HIV living in a Western country. It formed the basis for the key questions which were addressed in a multidisciplinary, evidence-based guideline “HIV and work”. Finally, it gives leads for further scientific research and opportunities for improving the vocational guidance of people with HIV.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Relevant Dutch Social Security Laws and insurance:
Equal Treatment Act: This law states that unfair treatment on the grounds of a handicap or chronic illness, including HIV, in the work environment or at a private practise is prohibited.
Medical Examinations Act: the employee is under no obligation to reveal his or her HIV-status during the course of a job interview. The employee retains the right of privacy.
The Eligibility for Permanent Incapacity Benefit (Restrictions) Act: The objective of this law is to improve the chances of reintegration and/or the return to the labour market, by giving the employer and employee more responsibility for this process. In case of illness the employer is required by law to continue paying wages for 2 years.
Capacity for Work Act (WIA): After 2 years of illness the employee can apply for a WIA allowance. This amount to 75 % of the employee’s most recent salary.
Dutch Unemployment Benefit: In case of unemployment people can apply for a Dutch unemployment benefit.
Health Care Insurance: all citizens are obliged to take out Dutch Health Care insurance.
Arns PG, Martin DJ, Chernoff RA. Psychosocial needs of HIV-positive individuals seeking workforce re-entry. AIDS Care. 2004;16(3):377–86.
Ferrier SE, Lavis JN. With health comes work? People living with HIV/AIDS consider returning to work. AIDS Care. 2003;15(3):423–35.
Brooks RA, et al. Perceived barriers to employment among persons living with HIV/AIDS. AIDS Care. 2004;16(6):756–66.
Dray-Spira R, et al. Disease severity, self-reported experience of workplace discrimination and employment loss during the course of chronic HIV disease: differences according to gender and education. Occup Environ Med. 2008;65(2):112–9.
Lem M, et al. Back to work: correlates of employment among persons receiving highly active antiretroviral therapy. AIDS Care. 2005;17(6):740–6.
Martin DJ, Steckart MJ, Arns PG. Returning to work with HIV/AIDS: a qualitative study. Work. 2006;27(3):209–19.
Bedell G. Balancing health, work, and daily life: design and evaluation of a pilot intervention for persons with HIV/AIDS. Work. 2008;31(2):131–44.
Conyers LM. The impact of vocational services and employment on people with HIV/AIDS. Work. 2004;23(3):205–14.
Chan F, et al. Drivers of workplace discrimination against people with disabilities: the utility of attribution theory. Work. 2005;25(1):77–88.
Studdert DM. Charges of human immunodeficiency virus discrimination in the workplace: the Americans with Disabilities Act in action. Am J Epidemiol. 2002;156(3):219–29.
Dyer JL, Twillman N, Sequeira N. Determining the barriers to employment of HIV+ clients. J Soc Work Disabil Rehabil. 2006;5(1):21–43.
Maticka-Tyndale E, Adam BD, Cohen JJ. To work or not to work: combination therapies and HIV. Qual Health Res. 2002;12(10):1353–72.
McGinn F, Gahagan J, Gibson E. Back to work: vocational issues and strategies for Canadians living with HIV/AIDS. Work. 2005;25(2):163–71.
Jong E, et al. Predictors and treatment strategies of HIV-related fatigue in the combined antiretroviral therapy era. AIDS. 2010;24(10):1387–405.
Vetter CJ, Donnelly JP. Living long-term with HIV/AIDS: exploring impact in psychosocial and vocational domains. Work. 2006;27(3):277–86.
Foley J, et al. Emerging issues in the neuropsychology of HIV infection. Curr HIV/AIDS Rep. 2008;5(4):204–11.
Braveman B, et al. HIV/AIDS and return to work: a literature review one-decade post-introduction of combination therapy (HAART). Work. 2006;27(3):295–303.
Rabkin JG, et al. Predictors of employment of men with HIV/AIDS: a longitudinal study. Psychosom Med. 2004;66(1):72–8.
Strauss A, Corbin J. Basics of qualitative research. Thousand Oaks: Sage; 1998.
Boeije HR. Analysis in qualitative research. London: Sage; 2010.
Allen S, Carlson G. To conceal or disclose a disabling condition? A dilemma of employment transition. J Vocat Rehabil. 2003;19(1):19–30.
Arnold EM, et al. HIV disclosure among adults living with HIV. AIDS Care. 2008;20(1):80–92.
Fesko SL. Disclosure of HIV status in the workplace: considerations and strategies. Health Soc Work. 2001;26(4):235–44.
Burns SM, Young LRL, Maniss S. Predictors of employment and disability among people living with HIV/AIDS. Rehabil Psychol. 2006;51(2):127–34.
Dray-Spira R, Lert F. Social health inequalities during the course of chronic HIV disease in the era of highly active antiretroviral therapy. AIDS. 2003;17(3):283–90.
Goldblum P, Kohlenberg B. Vocational counseling for people with HIV: the client-focused considering work model. J Vocat Rehabil. 2005;22(2):115–24.
Timmons JC, Fesko SL. Responding to employment needs: strategies for supporting individuals with HIV/AIDS. J HIV/AIDS Soc Serv. 2002;1(3):7–25.
Rotterdam University of applied sciences, Research Centre Innovations in Care (editor) Multidisciplinary, evidence-based guideline “HIV and work”. 2012. http://zorginnovatie.hr.nl/nl/Projecten/Zelfmanagement-en-Participatie/HIV-Arbeid/.
We would like to thank the patients for their participation. We would also like to thank the HIV-treatment centers for their participation: Slotervaart Hospital Amsterdam, Leiden University Medical Center, and Erasmus MC Rotterdam.
Appendix: Information About the Guideline “HIV and Work”
Appendix: Information About the Guideline “HIV and Work”
The multidisciplinary, evidence-based guideline was developed by a multidisciplinary core group in which all involved professional associations were represented. The guideline was developed according to “evidence-based guideline development (EBRO)” methods (CBO, 2004). The guideline is authorized by all involved professional associations and the Dutch HIV Association. The guideline and a summary for daily practice are available in Dutch. An English summary for daily practice will be digitally published in 2014.
Organization and development
Rotterdam University of Applied Sciences, Research Centre Innovations in Care, P.O. Box 25035, 3001 HA Rotterdam, The Netherlands
T. (010) 794 54 54 | www.kenniscentrumzorginnovatie.nl
The guideline is available on
the websites of the professional associations
the website of the Dutch HIV Association (www.hivnet.org)
The guideline has been authorized by
Dutch HIV Association (HVN)
Dutch Association of HIV-treating physicians (NVHB)
The Netherlands Society of Occupational Medicine (NVAB)
Professional Association of HIV/AIDS Nurses) collectively affiliated with Dutch Nurses’ Association (V&VN VCHA)
Occupational Social Workers Professional Association), part of the Dutch Association of Social Workers (NVMW)
Dutch Association of Insurance Physicians (NVVG)
Association of Occupational Health Nurses (BAV)
Dutch Institute of Psychologists (NIP)
Dutch Association of Labor Experts (NVvA)
This guideline has been compiled with the aid of
The Dutch College of General Practitioners (NHG)
Occupational Therapy Netherlands.
This guideline was developed with the financial support of ZonMw (The Netherlands Organisation for Health Research and Development) within the framework of the Kennisbeleid Kwaliteit Curatieve Zorg (KKCZ) program (Qualitative Curative Care).
29 March 2012.
About this article
Cite this article
Wagener, M.N., van Opstal, S.E.M., Miedema, H.S. et al. Employment-Related Concerns of HIV-Positive People in the Netherlands: Input for a Multidisciplinary Guideline. J Occup Rehabil 24, 790–797 (2014). https://doi.org/10.1007/s10926-014-9510-0
- Qualitative research
- Vocational guidance