Vocational rehabilitation services for African-American women with HIV/AIDS: An examination of acceptance rates and employment outcomes

BACKGROUND: Previous research identifies employment as a social determinant of health for persons with HIV/AIDS, specifically African American women. OBJECTIVE: The purpose of this study was twofold: (1) to examine the eligibility/acceptance and competitive employment rates of African American women diagnosed with HIV/AIDS in comparison to the general population of persons with disabilities in the state-federal vocational rehabilitation (VR) system and (2) to determine the relationship between (a) demographic variables (i.e., age, education level at the time of application for VR services, and receipt of cash benefit) and VR services received (e.g., job placement) and (b) employment outcomes for this population. METHODS: Chi square analysis was used to determine if there was a significant difference in acceptance/eligibility rate between the target population of African American women with HIV/AIDS and the general disability population. Multiple logistic regression analysis was used to determine the relationship between demographic variables and vocational rehabilitation services received on employment outcomes for the target population. RESULTS: Results indicate that the African American women with HIV/AIDS were found ineligible for services at a lower rate, 14%, than the general population of persons with disabilities served, 17%. However, even though they are more likely to be accepted for services, the competitive employment outcomes are lower than the general population of persons with disabilities. Results also indicate that the hypothesized demographic and VR service-related predictor variables were significantly related to competitive employment outcomes. Specifically, receipt of cash benefits and diagnostic /treatment VR services had a negative impact on employment outcomes. Factors positively associated with employment outcomes included receipt of job placement and maintenance services. CONCLUSIONS: Vocational rehabilitation counselors, researchers and other key stakeholders must identify the most effective strategies to assist African American women with HIV/AIDS in navigating the VR process from application to closure as competitively employed.