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

## TL;DR

People diagnosed with HIV in the Netherlands experience worse job outcomes, including lower employment rates and income, even with effective treatment.

## Contribution

This study provides causal evidence of the socioeconomic impact of HIV diagnosis using a matched control design.

## Key findings

- People with HIV are less likely to be employed and earn less income up to 7 years post-diagnosis.
- Late-stage HIV diagnosis is associated with more severe labor market consequences.
- Non-late stage HIV diagnosis still leads to worsened socioeconomic outcomes despite fewer symptoms.

## 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.

The life expectancy of people living with HIV on antiretroviral therapy is close to that of the general population but wider impacts of living with HIV are not well described. Here, the authors investigate the causal effect of receiving an HIV diagnosis on labour market outcomes using data from the Netherlands.