Antiretroviral therapy, labor productivity, and gender: a longitudinal cohort study of tea pluckers in Kenya
Identifieur interne : 001954 ( Ncbi/Merge ); précédent : 001953; suivant : 001955Antiretroviral therapy, labor productivity, and gender: a longitudinal cohort study of tea pluckers in Kenya
Auteurs : Bruce. A. Larson [États-Unis] ; Matthew P. Fox [États-Unis] ; Margaret Bii [Kenya] ; Sydney Rosen [États-Unis] ; Julia Rohr [États-Unis] ; Douglas Shaffer [Kenya] ; Fredrick Sawe [Kenya] ; Monique Wasunna [Kenya] ; Jonathon L. Simon [États-Unis]Source :
- AIDS (London, England) [ 0269-9370 ] ; 2013.
Abstract
To estimate the impact of antiretroviral therapy (ART) on labor productivity and income using detailed employment data from two large tea plantations in western Kenya for HIV-infected tea pluckers who initiated ART.
Longitudinal study using primary data on key employment outcomes for a group of HIV-infected workers receiving anti-retroviral therapy (ART) and workers in the general workforce.
We used nearest-neighbor matching methods to estimate the impacts of HIV/AIDS and ART among 237 HIV-positive pluckers on ART (index group) over a four year period (2 years pre- and post-ART) on four monthly employment outcomes—days plucking tea, total kilograms harvested, total days working, and total labor income. Outcomes for the index group were compared to those for a matched reference group from the general workforce.
We observed a rapid deterioration in all four outcomes for HIV-infected subjects in the period before ART initiation and then a rapid improvement after treatment initiation. By 18–24 months after treatment initiation, the index group harvested 8% (males) and 19% (females) less tea than reference subjects. The index group earned 6% (males) and 9% (females) less income from labor than reference subjects. Women’s income would have dropped further if they had not been able to offset their decline in tea plucking by spending more time on non-plucking assignments.
HIV-infected workers experienced long-term income reductions before and after initiating ART. The implications of such long-term impacts in low-income countries have not been adequately addressed.
Url:
DOI: 10.1097/QAD.0b013e32835a5b12
PubMed: 23014516
PubMed Central: 4078026
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title>
<p id="P1">To estimate the impact of antiretroviral therapy (ART) on labor productivity and income using detailed employment data from two large tea plantations in western Kenya for HIV-infected tea pluckers who initiated ART.</p>
</sec>
<sec id="S2"><title>Design</title>
<p id="P2">Longitudinal study using primary data on key employment outcomes for a group of HIV-infected workers receiving anti-retroviral therapy (ART) and workers in the general workforce.</p>
</sec>
<sec id="S3"><title>Methods</title>
<p id="P3">We used nearest-neighbor matching methods to estimate the impacts of HIV/AIDS and ART among 237 HIV-positive pluckers on ART (index group) over a four year period (2 years pre- and post-ART) on four monthly employment outcomes—days plucking tea, total kilograms harvested, total days working, and total labor income. Outcomes for the index group were compared to those for a matched reference group from the general workforce.</p>
</sec>
<sec id="S4"><title>Results</title>
<p id="P4">We observed a rapid deterioration in all four outcomes for HIV-infected subjects in the period before ART initiation and then a rapid improvement after treatment initiation. By 18–24 months after treatment initiation, the index group harvested 8% (males) and 19% (females) less tea than reference subjects. The index group earned 6% (males) and 9% (females) less income from labor than reference subjects. Women’s income would have dropped further if they had not been able to offset their decline in tea plucking by spending more time on non-plucking assignments.</p>
</sec>
<sec id="S5"><title>Conclusions</title>
<p id="P5">HIV-infected workers experienced long-term income reductions before and after initiating ART. The implications of such long-term impacts in low-income countries have not been adequately addressed.</p>
</sec>
</div>
</front>
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<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8710219</journal-id>
<journal-id journal-id-type="pubmed-jr-id">1493</journal-id>
<journal-id journal-id-type="nlm-ta">AIDS</journal-id>
<journal-id journal-id-type="iso-abbrev">AIDS</journal-id>
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<article-id pub-id-type="pmc">4078026</article-id>
<article-id pub-id-type="doi">10.1097/QAD.0b013e32835a5b12</article-id>
<article-id pub-id-type="manuscript">NIHMS589637</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Antiretroviral therapy, labor productivity, and gender: a longitudinal cohort study of tea pluckers in Kenya</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>LARSON</surname>
<given-names>Bruce. A.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
<xref rid="FN1" ref-type="author-notes">§</xref>
<email>blarson@bu.edu</email>
</contrib>
<contrib contrib-type="author"><name><surname>FOX</surname>
<given-names>Matthew P.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A3">3</xref>
<email>mfox@bu.edu</email>
</contrib>
<contrib contrib-type="author"><name><surname>BII</surname>
<given-names>Margaret</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
<email>mbii@wrp-kch.org</email>
</contrib>
<contrib contrib-type="author"><name><surname>ROSEN</surname>
<given-names>Sydney</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
<email>sbrosen@bu.edu</email>
</contrib>
<contrib contrib-type="author"><name><surname>ROHR</surname>
<given-names>Julia</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A3">3</xref>
<email>jrohr@bu.edu</email>
</contrib>
<contrib contrib-type="author"><name><surname>SHAFFER</surname>
<given-names>Douglas</given-names>
</name>
<xref ref-type="aff" rid="A5">5</xref>
<email>dshaffer@wrp-kch.org</email>
</contrib>
<contrib contrib-type="author"><name><surname>SAWE</surname>
<given-names>Fredrick</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
<email>fsawe@wrp-kch.org</email>
</contrib>
<contrib contrib-type="author"><name><surname>WASUNNA</surname>
<given-names>Monique</given-names>
</name>
<xref ref-type="aff" rid="A6">6</xref>
<email>Africa@dndi.org</email>
</contrib>
<contrib contrib-type="author"><name><surname>SIMON</surname>
<given-names>Jonathon L.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
<email>jonsimon@bu.edu</email>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Center for Global Health and Development, Boston University, Boston, MA, USA</aff>
<aff id="A2"><label>2</label>
Department of International Health, School of Public Health, Boston University, Boston University, Boston, MA, USA</aff>
<aff id="A3"><label>3</label>
Department of Epidemiology, School of Public Health, Boston University, Boston, USA</aff>
<aff id="A4"><label>4</label>
Kenya Medical Research Institute, Kericho, Kenya</aff>
<aff id="A5"><label>5</label>
United States Army Medical Research Unit-Kenya, Walter Reed Project, Kericho, Kenya</aff>
<aff id="A6"><label>6</label>
Kenya Medical Research Institute, Nairobi, Kenya</aff>
<author-notes><corresp id="FN1"><label>§</label>
Author for correspondence: Crosstown Center, 3<sup>rd</sup>
Floor, 801 Massachusetts Ave, Crosstown 3rd Floor, Boston, MA 02118, Tel: 617-414-1260, <email>blarson@bu.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>29</day>
<month>5</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="ppub"><day>2</day>
<month>1</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>02</day>
<month>7</month>
<year>2014</year>
</pub-date>
<volume>27</volume>
<issue>1</issue>
<fpage>115</fpage>
<lpage>123</lpage>
<pmc-comment>elocation-id from pubmed: 10.1097/QAD.0b013e32835a5b12</pmc-comment>
<abstract><sec id="S1"><title>Objective</title>
<p id="P1">To estimate the impact of antiretroviral therapy (ART) on labor productivity and income using detailed employment data from two large tea plantations in western Kenya for HIV-infected tea pluckers who initiated ART.</p>
</sec>
<sec id="S2"><title>Design</title>
<p id="P2">Longitudinal study using primary data on key employment outcomes for a group of HIV-infected workers receiving anti-retroviral therapy (ART) and workers in the general workforce.</p>
</sec>
<sec id="S3"><title>Methods</title>
<p id="P3">We used nearest-neighbor matching methods to estimate the impacts of HIV/AIDS and ART among 237 HIV-positive pluckers on ART (index group) over a four year period (2 years pre- and post-ART) on four monthly employment outcomes—days plucking tea, total kilograms harvested, total days working, and total labor income. Outcomes for the index group were compared to those for a matched reference group from the general workforce.</p>
</sec>
<sec id="S4"><title>Results</title>
<p id="P4">We observed a rapid deterioration in all four outcomes for HIV-infected subjects in the period before ART initiation and then a rapid improvement after treatment initiation. By 18–24 months after treatment initiation, the index group harvested 8% (males) and 19% (females) less tea than reference subjects. The index group earned 6% (males) and 9% (females) less income from labor than reference subjects. Women’s income would have dropped further if they had not been able to offset their decline in tea plucking by spending more time on non-plucking assignments.</p>
</sec>
<sec id="S5"><title>Conclusions</title>
<p id="P5">HIV-infected workers experienced long-term income reductions before and after initiating ART. The implications of such long-term impacts in low-income countries have not been adequately addressed.</p>
</sec>
</abstract>
<kwd-group><kwd>HIV</kwd>
<kwd>AIDS</kwd>
<kwd>antiretroviral therapy</kwd>
<kwd>income</kwd>
<kwd>labor productivity</kwd>
<kwd>Kenya</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Kenya</li>
<li>États-Unis</li>
</country>
<region><li>Massachusetts</li>
</region>
<settlement><li>Boston</li>
</settlement>
</list>
<tree><country name="États-Unis"><region name="Massachusetts"><name sortKey="Larson, Bruce A" sort="Larson, Bruce A" uniqKey="Larson B" first="Bruce. A." last="Larson">Bruce. A. Larson</name>
</region>
<name sortKey="Fox, Matthew P" sort="Fox, Matthew P" uniqKey="Fox M" first="Matthew P." last="Fox">Matthew P. Fox</name>
<name sortKey="Fox, Matthew P" sort="Fox, Matthew P" uniqKey="Fox M" first="Matthew P." last="Fox">Matthew P. Fox</name>
<name sortKey="Larson, Bruce A" sort="Larson, Bruce A" uniqKey="Larson B" first="Bruce. A." last="Larson">Bruce. A. Larson</name>
<name sortKey="Rohr, Julia" sort="Rohr, Julia" uniqKey="Rohr J" first="Julia" last="Rohr">Julia Rohr</name>
<name sortKey="Rohr, Julia" sort="Rohr, Julia" uniqKey="Rohr J" first="Julia" last="Rohr">Julia Rohr</name>
<name sortKey="Rosen, Sydney" sort="Rosen, Sydney" uniqKey="Rosen S" first="Sydney" last="Rosen">Sydney Rosen</name>
<name sortKey="Rosen, Sydney" sort="Rosen, Sydney" uniqKey="Rosen S" first="Sydney" last="Rosen">Sydney Rosen</name>
<name sortKey="Simon, Jonathon L" sort="Simon, Jonathon L" uniqKey="Simon J" first="Jonathon L." last="Simon">Jonathon L. Simon</name>
<name sortKey="Simon, Jonathon L" sort="Simon, Jonathon L" uniqKey="Simon J" first="Jonathon L." last="Simon">Jonathon L. Simon</name>
</country>
<country name="Kenya"><noRegion><name sortKey="Bii, Margaret" sort="Bii, Margaret" uniqKey="Bii M" first="Margaret" last="Bii">Margaret Bii</name>
</noRegion>
<name sortKey="Sawe, Fredrick" sort="Sawe, Fredrick" uniqKey="Sawe F" first="Fredrick" last="Sawe">Fredrick Sawe</name>
<name sortKey="Shaffer, Douglas" sort="Shaffer, Douglas" uniqKey="Shaffer D" first="Douglas" last="Shaffer">Douglas Shaffer</name>
<name sortKey="Wasunna, Monique" sort="Wasunna, Monique" uniqKey="Wasunna M" first="Monique" last="Wasunna">Monique Wasunna</name>
</country>
</tree>
</affiliations>
</record>
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