Grant: Fellowship - PA: Health Services/Population Health HIV/AIDS Research

Employment has long been identified as intrinsically linked to individual health. Among HIV-infected people who use illicit drugs, employment may be a key influence on addiction recovery and other health outcomes. Previous research with HIV-positive and at-risk drug using populations identified a range of individual, contextual and structural barriers to employment over and above drug use, including HIV-infection. It also identified employment attributes that encourage labour market participation. Given the potential health benefits and high barriers to labour market participation for HIV-positive and at-risk people who use illicit drugs, alternative labour market participation models appropriate to individuals who face episodic interruptions in their ability to work are badly needed. Under the supervision of Drs. Thomas Kerr at the University of British Columbia and Tom Patterson at the University of California at San Diego, the proposed post-doctoral project seeks to develop and pilot an adaptive employment intervention for HIV-infected illicit drug users. The proposed intervention design will be based on feasibility assessments and will draw on innovative work models such as Amazon.com's Mechanical Turk, where individuals voluntarily undertake tasks suited to their ability and availability and are paid on a task-by-task basis. Participants will have access to a community generated job bank where they can undertake paid activities compatible with their drug use, health status and health and social services access. Prospective participants will be randomized for participation from an existing CIHR/NIH-funded cohort study of injection drug users (n=750) that collects socio-demographic, behavioural and clinical HIV-related measures. This will facilitate evaluation strategies that match existing longitudinal data with intervention participation outcomes. Evaluation will focus primarily on impact of intervention participation on HIV viral suppression.