Suchergebnisse

HIV/AIDS poses a unique challenge to businesses, particularly those operating in Southern Africa. The region is home to one third of the worldwide HIV positive population (as measured by those aged 15 to 49) yet as a whole contributes a diminutive proportion of the total worldwide population by the same measure (UNAIDS, 2016; World Bank, 2016). Relative to its size, the epidemic has introduced disparately large economic strain due to the fact that the highest HIV prevalence rates coincide with the most productive years of people's lives, with prevalence rates peaking around the 30 to 34-year-old stratum (Shisana, et al., 2012). Loss of business productivity as a result of HIV related illness through a combination of absenteeism and so called 'presenteeism'1 as well as death due to AIDS and the resultant increase in employee turnover, has motivated companies to implement workplace HIV education, prevention and treatment programmes over and above governments' efforts to curb the effect of the disease on business operations and the associated economic costs (Granich et al., 2012; Meyer-Rath et al., 2012, 2015).

This study examines whether labour outcomes of HIV-infected workers treated with antiretrovirals depend on the stage of the disease when commencing therapy. We use data on employment separation and absenteeism from the workplace health programme of South Africa's largest coal mining company over the period January 2009 to March 2017 in a Cox proportional hazards model.When treatment was initiated at a CD4+ T cell count above 350 cells/μl, the risk of separating from the company was 36 per cent lower and the risk of absence was 21 per cent lower than initiating at a CD4 count below 200 cells/μl and these differences persist over time. Also, we find that ART initiation at CD4>=350 results in a 11 per cent lower risk of absence prior to treatment.While many companies and the South African government have adopted universal test-and-treat policies aiming to initiate all HIV-infected people as early as possible, most HIV patients still start treatment late in the disease course when their CD4 counts have fallen to low levels. Our results indicate early HIV detection and treatment could have large productivity gains.