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Barriers to employment, self-regulation, and physical health quality of life in people living with HIV/AIDS

Abstract

Background: Previous studies established that unemployment is associated with poorer self-reported physical health quality of life among people living with HIV/AIDS (PLHA). The present cross-sectional study tested a Social Action Theory model in which difficulties with self-regulation mediate the association of perceived barriers to employment with poorer physical health quality of life.

Methods: 108 PLHA from a vocational rehabilitation program in San Francisco were enrolled from December of 2011 to January of 2012. Hierarchical linear regression was applied to examine whether difficulties with self-regulation mediated the association between perceived barriers to employment and poorer physical health quality of life.

Results: PLHA with income less than $12,000 per year reported greater perceived barriers to employment. Perceived personal, career, and job barriers to employment were associated with self-regulation difficulties (e.g., lower coping self-efficacy). Perceived personal and career barriers were associated with poorer physical health quality of life. Lower coping self-efficacy partially mediated the associations of perceived personal barriers to employment (Sobel test Z = -2.25, p < .05) and perceived career barriers to employment (Sobel test Z = -2.33, p < .05) with poorer physical health quality of life.

Conclusion: PLHA with greater perceived barriers to employment report poorer physical health quality of life. Clinical research is needed to examine if vocational rehabilitation and interventions targeting self-regulation processes improve physical health quality of life among PLHA.

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