Syndemic of Substance Abuse, Depression, and Type 2 Diabetes and Their Association with Retention in Care Among People Living with HIV.

Substance abuse (SA), depression, and type 2 diabetes (DM2) often co-occur among people living with HIV (PLHIV). Guided by a syndemic framework, this cross-sectional retrospective study examined the cumulative and interaction effects of SA, depression, and DM2 on retention in HIV care (RIC) among 621 PLHIV receiving medical care in central Pennsylvania. We performed logistic regression analysis to test the associations between SA, depression, and DM2 and RIC.

Exploring the Impact of an Integrated Trauma-Informed HIV and Vocational Intervention for Black/African American Women Living with HIV.

Given the increased recognition of the role of social determinants of health on the prevalence of HIV in the United States, interventions that incorporate and address social determinants of HIV are essential. In response to the health disparities facing Black/African American women living with HIV, HIV activists and mental health specialists developed an innovative integrated HIV prevention and vocational development intervention, Common Threads, that underscores and addresses key economic and other social determinants of health experienced by Black/African American women within a trauma-informed care (TIC) framework. This research study applied grounded theory methods to conduct a qualitative study of Common Threads based on interviews with 21 women who participated in the Common Threads intervention.

Measuring Phases of Employment Decision-Making and the Need for Vocational Services as a Social Determinant of the Health of Employed People Living with HIV.

(1) Background: Secure employment has been recognized as a social determinant of health for people living with HIV (PLHIV), but limited research has been conducted to understand the employment needs and vocational decision-making process of those who are employed. The purpose of this study is to examine the applicability of the client-focused considering-work model to assess the employment outcomes and employment decision-making phases of a sample of employed PLHIV. (2) Methods: This study analyzed data of 244 employed PLHIV who completed National Working Positive Coalition's Employment Needs Survey which included a 20-item Considering Work Scale-Employed version (CWS-Employed) and a single-item Classification of Employment Status Scale (CESS).

Counseling in Aphasia: Information and Strategies for Speech-Language Pathologists.

Purpose The purpose of this tutorial is to provide an overview of mental health concerns of persons with aphasia (PWAs), strategies that speech-language pathologists (SLPs) can use to address the mental health concerns of PWAs within their scope of practice, guidance related to how SLPs can help facilitate access to appropriate mental health services, and suggestions for the future of pre- and postcertification education regarding counseling in aphasia for SLPs. Method This tutorial begins with a case study that is used as a reference point throughout the tutorial. It then introduces the gap in mental health services for PWAs that prompted this work, walks SLPs through common mental health concerns PWAs experience, and provides guidance for SLPs related to counseling techniques they can utilize within their sessions and referral to counseling professionals.

Linking hope factors, barriers to employment and health outcomes for individuals living with Human Immunodeficiency Virus (HIV).

Background: Employment and hope have been correlated with improved health outcomes in individuals with disabilities.

Objective: The objective of this study was to investigate the relationship among barriers to employment and hope theory factors and whether those factors mediate between barriers to employment and health outcomes in individuals living with Human Immunodeficiency Virus (HIV).

Methods: The sample from this study consisted of 1,702 participants who completed the National Working Positive Vocational Development and Employment Needs Survey NWPC-VDENS and identified as unemployed.

A Critical Review of Health, Social, and Prevention Outcomes Associated With Employment for People Living With HIV.

A growing need has emerged among HIV service providers, policymakers, and researchers to understand ways in which employment, as a key social determinant of health, can be leveraged toward improved health outcomes among people living with HIV (PLHIV) and the prevention of HIV transmission. This critical review summarizes and assesses current research related to (a) the employment needs and challenges among populations disproportionately impacted by HIV, (b) the relationship between employment and important health outcomes associated with the HIV Care Continuum, and (c) implications for policy, service provision, and future research. As a first step to deepening an understanding of these issues, this analysis identifies gaps in knowledge to underscore the need and direction for future research so that well-targeted interventions can be designed and evaluated and more responsive policies can be developed to address the public health implications of the vocational development and employment needs of PLHIV.

Validating the client-focused considering work model for people living with HIV and quantifying phases of change of commitment to work.

The primary purpose of this study was to validate the client-focused considering work model and to gain a better understanding of the nature of the relationship among the four domains purported to influence the considering work process (medical, psychosocial, financial/legal and vocational). A second goal of the study was to quantify the relationship between these four domains and the phases of considering work (contemplation, preparation, action, resolution). Structural equation modeling was used to analyze data of 1702 diverse (43% Black, 31% White, 19% Latino 7% other) unemployed respondents who were recruited from AIDS Service Organizations (ASO) and networks across the United States to complete the National Working Positive Vocational Development and Employment Needs Survey (NWPC-VDENS).

Is any job better than no job? Labor market experiences and depressive symptoms in people living with HIV.

The purpose of this study is to determine the relationship between the psychosocial work environment and labor market experiences (including unemployment) on mental health among adults living with HIV. We used data provided by 538 participants at clinical and community sites across Ontario, Canada. Generalized estimating equation models showed that employment was associated with lower depressive symptoms.

Examining the role of vocational rehabilitation on access to care and public health outcomes for people living with HIV/AIDS.

Purpose: The purpose of this study is to examine the role of vocational rehabilitation services in contributing to the goals of the National HIV/AIDS strategy. Three key research questions are addressed: (a) What is the relationship among factors associated with the use of vocational rehabilitation services for people living with HIV/AIDS? (b) Are the factors associated with use of vocational rehabilitation also associated with access to health care, supplemental employment services and reduced risk of HIV transmission? and (c) What unique role does use of vocational rehabilitation services play in access to health care and HIV prevention?

Method: Survey research methods were used to collect data from a broad sample of volunteer respondents who represented diverse racial (37% Black, 37% White, 18% Latino, 7% other), gender (65% male, 34% female, 1% transgender) and sexual orientation (48% heterosexual, 44% gay, 8% bisexual) backgrounds.

Results: The fit of the final structural equation model was good (root mean square error of approximation = 0.

A narrative literature review regarding job retention strategies for people with chronic illnesses.

Job retention is a major concern for individuals with chronic illnesses, who represent a rapidly growing vocational rehabilitation (VR) consumer population. The purpose of this article is to examine selected job retention considerations for consumers with chronic illnesses. The authors (a) describe distinguishing characteristics of chronic illnesses in terms of populations affected and psychosocial implications, (b) discuss the vocational implications of chronic illnesses, (c) provide general considerations for the provision of job retention services, and (d) examine job retention strategies aimed at improving employment outcomes for individuals with chronic illnesses.

The unmet vocational rehabilitation needs of women with HIV/AIDS.

This article discusses the growing population of women with HIV/AIDS as an emergent disability group with unique needs for vocational rehabilitation services. Data from the National Working Positive Coalition Employment Needs Survey for people living with HIV/AIDS was used to describe the demographic, economic, health, and employment characteristics of a sample of 122 female respondents. Findings make several contributions to understanding this emerging population and their vocational development needs including limited knowledge of employment resources, incentives and barriers to employment, and unmet needs for vocational rehabilitation services.

Workplace discrimination and HIV/AIDS: the national EEOC ADA research project.

This article utilizes data from the Equal Employment Opportunity Commission's Integrated Mission System database to document the levels of employment discrimination involving individuals with HIV/AIDS. The researchers explore the theory that the nature of HIV/AIDS related employment discrimination is rooted in deeper stigmatization than discrimination against other disability groups. Researchers compare and contrast key demographic characteristics of Charging Parties and Respondents involved in HIV/AIDS related allegations of discrimination and their proportion of EEOC merit resolutions to those of persons with other physical, sensory, and neurological impairments.

The impact of vocational services and employment on people with HIV/AIDS.

The perceptions of vocational services and the impact of employment among 25 individuals with HIV/AIDS diagnoses were explored through a qualitative study. Participants who ranged in age from 22 to 58, represented diverse ethnic backgrounds and were at various stages of the employment process. The key themes that emerged from the data fell into three main areas: (a) personal impact of vocational services, (b) programmatic qualities of vocational services, and (c) impact of employment.

A solution-focused approach to psychiatric rehabilitation.

This paper relates the values of Psychiatric Rehabilitation (PsyR) to the strategies of solution-focused therapy (SFT), exploring the applicability of SFT in a PsyR setting. A review of the literature demonstrates that SFT complements the values and principles of PsyR and is a viable course of intervention throughout recovery for empowering persons with severe mental illness. The specific application of SFT to supervision and case management is examined.

Using the Americans with Disabilities Act to the advantage of persons with severe and persistent mental illness: what rehabilitation counselors need to know.

This article explains central constructs and definitions underlying the Americans with Disabilities Act (ADA) and discusses their implications for persons with severe and persistent mental illness, as well as for rehabilitation counselors working with this population. Focus is placed upon Title I of the ADA, which prohibits discrimination in employment. The article provides a brief review of legislative history relevant to the integration of people with mental illness into public life.