Labor Market Outcomes of People with HIV Pre- and Post-Diagnosis in the Netherlands

Abstract

Abstract In the current era of effective antiretroviral therapy, HIV has become a manageable chronic condition. Little is known about the consequences of HIV on individuals’ labor market outcomes. We study the impact of an HIV diagnosis using linked clinical data (the Dutch ATHENA cohort) and administrative data. A causal effect is estimated by comparing outcomes of people with HIV diagnosed between 2010 and 2022 ( n  = 5960) to a matched control group ( n  = 59,600) in a difference-in-difference design. We find that people with HIV are less likely to be employed, work fewer hours, earn less income, and are more likely to receive disability benefits up to 7 years after diagnosis. These effects are more pronounced for those diagnosed with late-stage HIV disease. Those with a non-late stage diagnosis experience a deterioration of socioeconomic outcomes, despite being less likely to experience clinically relevant symptoms at diagnosis. These findings highlight the need for continued efforts in prevention and early detection of HIV.