Antiretroviral Treatment Helps Keep HIV Patients in South Africa Employed
(Got from Havard School of Public Health)
Antiretroviral drug treatment for HIV appears to have more payoffs than the promise of better health and a longer life – it also seems to help people living with HIV stay employed or get new jobs, according to a new study by researchers at Harvard School of Public Health (HSPH) and the University of KwaZulu-Natal’s Africa Centre for Health and Population Studies. In a study of a large population cohort, the investigators found that four years after initiating therapy, HIV patients were 90% as likely to be working as they were three to five years before starting treatment. Many patients initiated treatment early enough so that they were able to avoid any loss of employment due to HIV.
While antiretroviral therapies are known to reduce HIV transmission and prolong lives of many HIV patients, less is known about the economic benefits of treatment. This is the first study to assess the economic impact of antiretroviral therapy (ART) in a population-based cohort.
“We found antiretroviral therapy does not only postpone mortality, it enables HIV patients to lead economically productive lives,” said lead author Jacob Bor, SD’14, an HSPH doctoral candidate in global health and population
HIV Patients on Antiretroviral had Nearly Full Recovery of Employment
Antiretroviral therapy for HIV may have important economic benefits for patients and their households. We quantified the impact of HIV treatment on employment status among HIV patients in rural South Africa who were enrolled in a public-sector HIV treatment program supported by the President’s Emergency Plan for AIDS Relief. We linked clinical data from more than 2,000 patients in the treatment program with ten years of longitudinal socioeconomic data from a complete community-based population cohort of more than 30,000 adults residing in the clinical catchment area. We estimated the employment effects of HIV treatment in fixed-effects regressions. Four years after the initiation of antiretroviral therapy, employment among HIV patients had recovered to about 90 percent of baseline rates observed in the same patients three to five years before they started treatment. Many patients initiated treatment early enough that they were able to avoid any loss of employment due to HIV. These results represent the first estimates of employment recovery among HIV patients in a general population, relative to the employment levels that these patients had prior to job-threatening HIV illness and the decision to seek care. There are large economic benefits to HIV treatment. For some patients, further gains could be obtained from initiating antiretroviral therapy earlier, prior to HIV-related job loss.

Antiretroviral reduce transmission of HIV
In 2011, a large multi-country study by the HIV Prevention Trials Network showed that antiretroviral (ARVs) cut transmission of HIV by 96% within couples where one partner is HIV-positive and the other is not infected. A later study in South Africa reinforced these findings.
“When people take antiretroviral, the amount of HIV in their body is decreased, making them much less likely to pass the virus to others,” says Dr. Gottfried Hirnschall, Director of the HIV Department at WHO. “If we can get, and keep, more people on treatment, and reduce their virus levels, we can reduce the number of new people who are infected.”
Increased coverage and early treatment cost-effective
Providing ARVs to people living with HIV who have HIV-negative partners, pregnant women and high risk populations, regardless of their immune status, would increase the number of people eligible for treatment in low- and middle-income countries from the current figure of 15 million to 23 million. While this will increase the cost of providing treatment in the short term, studies predict that the economic benefits of early treatment will substantially offset, and likely exceed, programme costs within 10 years of investment. This economic benefit derives from the fact that the workforce is healthier and more productive and that costs of treatment and orphan care are reduced.
Got from World Health Organization (WHO) 18 July 2012/ GENEVA/ WASHINGTON DC
Breast is always best, even for HIV-positive mothers
The World Health Organization (WHO) advised HIV-positive mothers to avoid breastfeeding if they were able to afford, prepare and store formula milk safely. But research has since emerged, particularly from South Africa, which shows that a combination of exclusive breastfeeding and the use of antiretroviral treatment can significantly reduce the risk of transmitting HIV to babies through breastfeeding.
On 30 November 2009, WHO released new recommendations on infant feeding by HIV-positive mothers, based on this new evidence. For the first time, WHO is recommending that HIV-positive mothers or their infants take antiretroviral drugs throughout the period of breastfeeding and until the infant is 12 months old. This means that the child can benefit from breastfeeding with very little risk of becoming infected with HIV.
Instrumental in guiding the new recommendations were two major African studies that announced their findings in July 2009 at the fifth International AIDS Society conference in Cape Town. The WHO-led Kesho Bora study found that giving HIV-positive mothers a combination of antiretrovirals during pregnancy, delivery and breastfeeding reduced the risk of HIV transmission to infants by 42%. The Breastfeeding Antiretroviral and Nutrition study held in Malawi also showed a risk of HIV transmission reduced to just 1.8% for infants given the antiretroviral drug nevirapine daily while breastfeeding for 6 months.