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

Abstract

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. For employed participants, adverse psychosocial work conditions, specifically job insecurity, psychological demands, and decision authority were associated with depressive symptoms. For the entire sample, the number of adverse psychosocial work conditions was associated with higher depressive symptoms while participants working in poor quality jobs reported similar levels of depressive symptoms than those who were unemployed or not in the labor force. This study showed that poor quality employment (as assessed by having a high number of adverse psychosocial work exposures) was associated with a similar level of depressive symptoms as unemployment, suggesting that “bad jobs” may not offer the same mental health benefits as “good jobs.” Policies to improve employment outcomes should take the quality of employment into account to maximize mental health benefits as better employment may lead to better mental health.

Keywords:

• HIV
• employment
• psychosocial work conditions
• depressive symptoms

Acknowledgments

The Employment Change and Health Outcomes (ECHO) Study Team consists of Dr Sergio Rueda (Principal Investigator), University of Toronto and OHTN; Dr Sean B. Rourke (Coprincipal Investigator), University of Toronto and OHTN; Dr Winston Husbands (Coprincipal Investigator), AIDS Committee of Toronto; Murray Jose-Boerbridge (Coprincipal Investigator), Toronto People with AIDS Foundation; Dr Alan Li (Coprincipal Investigator), Committee for Accessible AIDS Treatment and Regent Park Community Health Centre; Dr Nicole Mittmann and Dr Anita Rachlis, University of Toronto and Sunnybrook Health Sciences Centre; Dr Barry Adam, Jean Bacon, Tsegaye Bekele, and Maggie Shi, OHTN; Dr Kelly O’Brien and Dr Peggy Millson, University of Toronto; Dr Patty Solomon, Dr John Cairney, and Dr Mike Wilson, McMaster University; and Lori Lucier, Toronto Central Local Health Integration Network. We gratefully acknowledge all of the people living with HIV who volunteered to participate in this study and the work and support of ECHO's Peer Research Associates (D.B. Hintzen, Mary M., Rob Rollins, Scott de Blois, James Gough, Jasmine Cotnam, Wayne Bristow, Tim Walker, Mary Kato, Stephanie Smith, J. Lauzon, Rumaldo Rincon, Michael J. Hamilton, Andrew Miao, and Henry Luyombya) and the OHTN Cohort Study (OCS) data collectors (Shahryar Murshed, Rajendra Maharaj, and Paul MacPhee). The authors also wish to thank the following OCS investigators and staff for logistics, data linkage, and IT support: Dr Ann Burchell, Dr Sandra Gardner, and Dr Kevin Gough, and Kevin Challacombe, Robert Hudder, Lucia Light, Veronika Moravan, and Nahid Qureshi. ECHO was supported by a community-based research operating grant from the Canadian Institutes of Health Research.

Disclosure statement

No potential conflict of interest was reported by the authors.