Special Issue of the Journal of Vocational Rehabilitation

Journal of Vocational Rehabilitation: HIV/AIDS and Employment

Liza Conyers and Phil Rumrill have co-edited a special 1.5 volume issue of the Journal of Vocational Rehabilitation devoted exclusively to HIV and employment. This issue highlights several theoretical foundations for the vocational rehabilitation of individuals with HIV/AIDS that draws from the substantial vocational rehabilitation literature on substance abuse and psychiatric rehabilitation combined with pragmatic information for researchers and practitioners alike. See below for abstracts of the manuscripts included in this special issue.

The JVR issue was published in the Spring of 2005 and is available from IOS Press

Contributing authors include:

Lisa A. Razzano, Ph.D. & Marie M. Hamilton, LCSW, University of Illinois at Chicago
Karen Escovitz, MSS and Kathleen R. Donegan, Ed.D., The Matrix Center at Horizon House, Inc.
David J. Martin, Ph.D., Robert A. Chernoff, Ph.D., & Michael Buitron, Research & Education Institute at Harbor-UCLA Medical Center
David Geffen, UCLA School of Medicine
Liza Conyers, Ph.D., CRC, LPC, Penn State University
Nancy L. Breuer, M.A., WorkPositive, Inc.
Betty Kohlenberg, Kohlenberg & Associates Vocational Counseling Services
Peter Goldblum , UCSF AIDS Health Project
Eric C. Ciasullo, San Francisco Dept. of Public Health
Brandon Hunt, Ph.D., CRC, LPC, Penn State University
Jhan D. Doughty, D.Ed., CRC, University of Cincinnati-Clermont College
Amy Paul-Ward, Brent Braveman, Gary Kielhofner, Mara Levin, Jerome Bond,
 and Gregory Braxton, University of Illinois Chicago
Phil Rumrill, Ph.D., Kent State University


Conyers, L. M. (2005). HIV/AIDS as an emergent disability: The response of vocational rehabilitation. Journal of Vocational Rehabilitation, 22 , 67-73.

This manuscript describes the formation of the National Working Positive Coalition and provides a review of the emerging field of HIV/AIDS and employment research. A concise summary of each manuscript in the special issue is also provided.

Doughty-Berry, J., & Hunt, B. (2005). HIV/AIDS 101: A primer for vocational rehabilitation counselors. Journal of Vocational Rehabilitation, 22 , 75-83.

This paper provides a comprehensive overview of the most current medical, psychosocial, and vocational information on HIV/AIDS as it relates to vocational rehabilitation. Counseling strategies and suggestions are given for vocational rehabilitation professionals to use when working with this population.

Goldblum, P., & Kohlenberg, B. (2005). Vocational counseling for people with HIV: The client-focused considering work model. Journal of Vocational Rehabilitation, 22, 115-124.

This article discusses the factors that impact many people with HIV who face new decisions regarding work as a result of the increased efficacy of HIV antiviral medications and subsequent improvement in health status. The Client-Focused Model of Considering Work describes the interplay between four domains of influence (medical, financial/legal, psychosocial, and vocational). In each of these domains, persons with HIV can experience both pressures to make work related changes and barriers to making these changes. A nonlinear decision-making process is articulated in four phases. The authors discuss and contrast this model with other rehabilitation models, describe its implications for planning and delivery of rehabilitation services, and cite research results from a career counseling program based on the model.

Razzano, L. A., & Hamilton, M. M. (2005). Health-related barriers to employment among people with HIV/AIDS. Journal of Vocational Rehabilitation, 22, 179-188.

This article describes that with the advent of more advanced treatments and therapies, people with HIV/AIDS are experiencing significant improvements in physical and mental health, making many of their ongoing career goals more realistic. However, many people with HIV/AIDS who are unemployed but would like to work continue to have major concerns regarding the impact of employment on their benefits and entitlements. In addition to issues regarding potential financial hardships, many people living with HIV/AIDS express uncertainty related to their health status, and they worry that some working conditions could deleteriously affect their health. The present evaluation focuses on two major issues identified in previous research: health perceptions and sources of insurance and health benefits. In addition, the study utilizes a standardized instrument, the MOS-HIV Scale, designed specifically to characterize aspects of health and well-being among people with HIV/AIDS.

Paul-Ward, A., Braveman, B., Kielhofner, G., & Levin, M. (2005). Developing employment services for individuals with HIV/AIDS: Participatory action strategies at work. Journal of Vocational Rehabilitation, 22 , 85-93.

This paper details the development and implementation of employment and independent living services for people living with HIV/AIDS over year one of a three-year project. Specifically, we describe the ongoing collaborative process, based on participatory action strategies, that is being utilized in the development of this multi-faceted, intensive, personalized and coordinated program of services. Further, we provide preliminary results regarding the benefits of this model of service provision for addressing the employment needs of individuals living with HIV/AIDS. We conclude with a detailed discussion of the challenges and successes of these efforts.

Martin, D. J., Chernoff, R. A., & Buitron, M. (2005). Tailoring a vocational rehabilitation program to the needs of people with HIV/AIDS: The Harbor-UCLA experience. Journal of Vocational Rehabilitation, 22, 95-103.

This article describes new treatments introduced in the early to mid 1990s led to greatly improved health and quality of life for many people with HIV/AIDS, prompting some to consider workforce reentry. In this paper, we relate three projects we have undertaken since 1996 in which we have worked to develop and understanding of the workforce reentry process for people with HIV/AIDS. In the first, a survey of HIV/AIDS case management clients throughout Los Angeles County , we noted a substantial need for workforce reentry assistance services, and noted six broad categories of workforce-reentry concern for people with HIV/AIDS. Our second project was designed as a demonstration project to assist people with HIV/AIDS in their efforts to return to work. We found, among other things, that significant obstacles unrelated to employment also thwarted workforce reentry efforts. Finally, in our current clinical-trials study, we continue to learn from participants in their efforts to rejoin the workforce. We discuss our cumulative results to date, and highlight certain future directions for research and service.

Escovitz, K., & Donegan, K. (2005). Providing effective employment supports for persons living with HIV: The KEEP project. Journal of Vocational Rehabilitation, 22, 105-114.

This paper discusses project KEEP, a 3-year Special Demonstration Project, was charged with identifying effective employment service strategies for people living with HIV/AIDS in Philadelphia , PA. Strategic outreach was done to ensure that participants would reflect the demographics of HIV/AIDS in urban settings. Individualized employment services, based in principles of psychosocial rehabilitation, were provide to 148 individuals. Longitudinal data were collected to track services, employment experiences, disclosure, self-reported health measures, and quality of life. This paper discusses the results of the project, giving particular attention to the strong employment outcomes and the value of "rapid-attachment", intensive support once working, and the impact of work on self-reported quality of life. Implications for service delivery as well as directions for future services research are discussed.

Conyers, L. M. & Boomer, K. B., (2005). Factors associated with disclosure of HIV/AIDS to employers among individuals who use job accommodations and those who do not. Journal of Vocational Rehabilitation, 22 , 189-198.

This article presents the findings from a research study investigating the patterns of job accommodation use and factors associated with disclosure of HIV/AIDS status to employers among a sample of 84 employed individuals with HIV/AIDS. Overall, more than half of the sample (52%, n = 43) used some form of job accommodation. Of these, 14% reported that they could not work without their accommodations and 34% indicated that they did not know if they could work without accommodation. Logistic regression analyses indicated that the factors associated with disclosure of HIV/AIDS status to employers are different among participants who used accommodations and those who did not. Implications for rehabilitation practice and research are discussed.

Breuer, N. L. (2004). Teaching HIV-positive client how to manage the workplace. Journal of Vocational Rehabilitation, 22 , 163-169.

The article describes that clients living with HIV/AIDS need specific skills not only to manage their medications and their diagnosis, but also to manage successfully in their own workplaces. Helping HIV-positive clients to be employed productively means preparing them to navigate disclosure, confidentiality, use of leave time, taking medications on the job and negotiating reasonable accommodation. Best practices for vocational counseling apply on these issues, but they require some adaptations for clients living with HIV/AIDS.

Conyers, L. M., Unger, D, & Rumrill, P. (2005). A comparison of equal employment opportunity commission case resolution patterns of people with HIV/AIDS and other disabilities. Journal of Vocational Rehabilitation, 22 , 171-178.

This article describes findings from an empirical investigation of the pattern of Americans with Disabilities Act (ADA) Title I case resolutions by the United States Equal Employment Opportunity Commission (EEOC) involving people with HIV/AIDS ( n =2,078) in comparison to the pattern of ADA Title I case resolutions involving all other people with disabilities between 1993 and 2002 ( n =187,684). Chi-square analysis revealed that people with HIV/AIDS are significantly more likely than other complainants to receive settlement benefits from their employers, to have their cases resolved with findings of reasonable cause, and to have their cases closed administratively by the EEOC. People with HIV/AIDS are less likely than other complainants to have charges resolved with a finding of no reasonable cause and to have their complaints resolved via other closures. Implications of these findings for vocational rehabilitation practice are presented.

Ciasullo, E. C. & Escovitz, K. (2005). Positive futures: The need for paradigm shift in HIV/AIDS services. Journal of Vocational Rehabilitation, 22, 125-128.

This manuscript describes the need for a paradigm shift within HIV/AIDS services. The authors argue for the need to place greater emphasis on helping people with HIV/AIDS plan for a positive future, including the opportunity to develop skills, engage in productive activities, and improve their economic well-being.