...comprise of new HIV and 20% of new AIDS cases (CDC, 2004). Similarly, in 2000 the rate of HIV infection per 100,000 Latinos was 22.5, more than three times that of Whites (CDC, 2002b). Yet, despite these statistics few studies have explored the impact of HIV/AIDS on this population.

With the introduction of highly active antiretroviral therapies in 1996, the medical treatment of people living with HIV/AIDS (PLHA) has improved (McReynolds Garske, 2001). As a result of these improvements and various policy initiatives targeted at enhancing the occupational opportunities of people with disabilities (e.g., Americans with Disabilities Act, 1990; Ticket to Work and Work Incentives and Improvement Act, 1999), a significant number of PLHA remain in, or return to, the workforce (McReynolds, 1998). For example, Brooks, Martin, Ortiz, and Veniegas (2004) found that 74% of participants who were unable to work due to HIV/AIDS-related disabilities expressed interest in reentering the workforce. Nevertheless, an estimated 45 to 65 percent of PLHA remain unemployed (Cunningham, Andersen, Katz et al., 1999; Vitry-Henry, Penalba, Beguniot, & Deschamps, 1999).

For people living with chronic or life-threatening illnesses employment provides a source of routine, normalcy, and purpose to daily living (Brooks & Klosinski, 1999). According to Koch, Rumrill Jr., Roessler, and Fitzgerald (2001), employment is directly associated with improved psychological and psychosocial functioning for people living with chronic, terminal, and life-threatening illnesses. For instance, prior research suggests employment relates to improved quality of life and self-esteem for patients with illnesses as varied as acute myelogenous leukemia, fibromyalgia, arthritis, and heart disease (De Lima, Strom, Keeting et al., 1997; Paris, Woodbury, Thompson et al., 1993; Reisine, Fifield, Walsh, & Dauser, 2004; Straaton, Maislak, Wrigley et al., 1996).

Many immigrants and racial minorities in the United States experience significant poverty (Denavas-Walt, Proctor, & Lee, 2005). In 2004, for instance, approximately 22% of Latinos living in the United States lived below the poverty level (Denavas-Waltet al., 2005). For members of these populations, employment may represent a critical means of maintaining basic income and materials essential for survival. In one of the few prior studies to explore the association of employment to HIV/AIDS among minority populations, Brooks and colleagues (2004) found that Latinos and African-Americans who were unable to work due to HIV/AIDS-related disabilities were more likely to consider workforce reentry than Caucasians. In an investigation of employment among African-American men and women with HIV/AIDS, Blalock, McDaniel, and Farber (2002) found that many participants remained employed throughout the duration of their illness. In other research, Burns, Young, and Maniss (2006) found that Latinos with HIV/AIDS were six times more likely than Caucasians to be working full or part-time. Unfortunately, these studies are the only research to the authors' knowledge to examine the impact of HIV/AIDS on the employment status of racial minorities. As such, the purpose of the current study was to explore the utility of demographic, health-related, and psychological variables in predicting employment among Latinos living with HIV/AIDS. Given the dearth of research on the influence of HIV/AIDS on the employment status of Latinos, the authors anticipate that this investigation may provide direction for continued rehabilitation research.

Predictors of Employment

Demographic Factors

According to Cherrick, Delate, Skarupski, and colleagues (1999), age may represent an important and understudied predictor of employment for PLHA. Specifically, as increased age is often associated with longer gaps in employment history and greater duration of time on disability, an individual's age may serve as a disincentive to workforce reentry (Cherrick et al., 1999). In support of this contention, Crystal, Akincigil, Sambamoorthi, and associates (2003) demonstrated that younger PLHA are more motivated than older peers to reenter, or remain in, the labor force. Similarly, Brooks and colleagues (2004) found that older PLHA were significantly less interested in workforce reentry. In other investigations, Lem, Moore, Marion, and associates (2005) and Rabkin, McElhiney, Ferrando, and colleagues (2004) found no association between age and employment in predominantly Caucasian samples. Given these inconsistencies, and the lack of prior research on the influence of age on the employment status of Latinos, further research on this association seems warranted.

Biological and Physical Factors

The presence or absence of CD4 lymphocytes may also predict employment as CD4 plays a crucial role in one's capacity to resist infection (Auld, 2002). Research by Vidrine, Amick III, Gritz, and Arduino (2003) suggested that PLHA with higher CD4 demonstrate greater work-role functioning and fulfillment of occupational obligations. In an investigation by Darko, McCutchan, Kripke, and associates (1992), higher CD4 was associated with less physical and work-related disability. Nevertheless, these studies are among the few to examine the association of CD4 to work-related outcomes, and no prior study examines this relationship for Latinos. As Latinos living with HIV/AIDS frequently exhibit lower CD4 and higher rates of opportunistic infections than Caucasians (Wohl, Lu, Simon et al., 2001), inclusion of CD4 may be particularly important in investigations of employment within this population.

While biological markers such CD4 may represent an important correlate of employment, these markers often do not fully account for occupational outcomes among PLHA. Therefore, researchers should also examine the influence of physical capacity (Flemming, Crystal, Nunes et al., 2004). Rabkin and colleagues (2004) found that while CD4 was unrelated to employment status, greater physical functioning was significantly and positively associated with employment. In related research, van Gorp, Baerwald, Ferrando, and associates (1999) demonstrated that low functional capacity was among the strongest predictors of unemployment for a predominantly Caucasian sample. In yet another study, Swindells, Mohr, Justis, and colleagues (1999) indicated that high physical functionality is associated with greater work role performance among PLHA. Unfortunately, the relationship between employment and physical functioning for Latinos remains unexamined. Given the relatively poor physical functioning of many Latinos living with HIV/AIDS (Campsmith, Nakashima, & Davidson, 2003), studies on this association...

NOTE: All illustrations and photos have been removed from this article.



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