Living with HIV: Implications for school and work participation

Since the introduction of combination antiretroviral treatment, HIV infection has changed into a chronic disease. When successfully treated, HIV-infected people nowadays have a near-normal life expectancy. The ability of living with HIV as a chronic disease yields new challenges. HIV-infected people are now subject to complications of chronic exposure to HIV, the lifelong use of medication, an increased risk for several co-morbidities and neuropsychological and psychosocial complications. Moreover, the social stigma attached to HIV forms a burden for people living with HIV and affects their daily living.
This thesis focusses on the long-term outcomes of people living with HIV and the implications for their participation. We presented six studies on people living with HIV, with a specific focus on school participation of perinatally HIV-infected children and work participation of HIV-infected adults. Our studies indicated that both HIV-infected children and adults are at risk to face several challenges in participation, respectively at school and work. Difficulties in psychosocial functioning, neuropsychological functioning, and physical complaints led to these challenges. In addition, an important theme in this thesis is the impact of social and contextual factors on school and work participation of people living with HIV, including stigma and disclosure.
It is important to incorporate functioning at school and work into regular clinical healthcare, in order to address experienced challenges and provide attuned support as early as possible. Recent developments, such as value-based healthcare, create opportunities to integrate functioning at school and work into daily clinical practice.