# The influence of HIV on return to work in stroke survivors amongst a population of the eThekwini district, Kwazulu Natal: A qualitative study

## TL;DR

This study explores how HIV affects the return to work of stroke survivors in South Africa, highlighting the role of support systems and disclosure.

## Contribution

The study provides new qualitative insights into the intersection of HIV, stroke, and return to work in a South African context.

## Key findings

- Stroke-related impairments hinder daily and occupational activities for HIV-positive stroke survivors.
- Disclosure of HIV status and ART usage can foster employer understanding and improve economic productivity.
- Support systems and workplace accommodations are crucial for successful return to work.

## Abstract

Biomedical and biopsychosocial factors with an interaction of systems and stakeholders are considered determinants of participation in a return to work (RTW) process. Human Immunodeficiency Virus (HIV) potentiates the risk of stroke development and employees that may be productive are negatively impacted economically from resultant disability. Evidence on the influence of HIV on the RTW of stroke survivors is scarce.

To explore the influence of HIV in stroke survivors who either have or have not RTW.

A qualitative study with a phenomenological approach using semi-structured interviews was conducted. Twelve HIV positive stroke survivors with a history of employment prior to stroke onset, were recruited from an HIV clinic database.

Stroke related physical and cognitive impairments impacted activities of daily living and occupational tasks. Health education aided participants to accept their HIV status and antiretroviral therapy (ART) adherence which promoted longevity amidst acute side effects. During the RTW effort, disclosing the HIV status, eliminating societal barriers, and having a family support structure were considered factors that might increase the desire for continuous employment and restore an acceptable quality of life.

Workplace support structure, realistic goal setting, engagement with RTW-related professionals and support services, alleviation of negative employer attitudes and avoidance of undesirable workplace accommodation were noted to promote economic productivity.

Disclosing both HIV status and ART usage encourages adherence to medical care and explains subsequent absence from work. Full disclosure could result in understanding from the employer and resultant positive economic productivity.