Work is KEY!

• Represents engagement in one’s FUTURE

• Goes hand-in-hand with other FUTURE-related activities including self-care, prevention, adherence, recovery from addiction and/or mental health difficulties, stabilization of housing, development of relationships, etc.

Why HIV-specific Employment Services?

• PLHA have unique work-related issues and needs that are not well-understood by generic vocational service providers

• Current research indicates that employment services work best when integrated with other rehabilitative and support services

And…

• Current HIV service systems are glutted and need to find ways to move people towards reasonably healthy and stable self-sufficiency

Employment Support Services are especially needed for:

• Individuals from impoverished backgrounds• Individuals who have not worked or have

significant gaps in their work histories• Individuals who do not qualify for disability

benefits• Individuals who are working when they

learn their status, and wish to work for as long as possible

Evidence-based effective practices include:

• Making services available to anyone who wants to work

• Individualized services geared to help people define and pursue their own goals, and deal with the barriers they face

• Disability management education• Development of job-related problem-

solving and coping skills

Effective practices cont’d

• Access to accurate information about benefits, legal issues, finances, and employee rights (ADA, etc.)

• Opportunities to “test the waters” – IN VIVO• Recognition that there are many positive

“outcomes”• Recognition that vocational development is

not linear

Project KEEP• 3 year Service Demonstration Project• Served primarily African-American and Latino

individuals with HIV in Philadelphia• N=148 Age: 20-65 yrs.dx: 2-16• 60% m 38.5% f 1.5% tg• Approx. ½ on SS benefits, ½ not• 26% AIDS dx• Multiple barriers: MH, SA, DV, low ed, jail,

interrupted work hx, language, etc.

KEEP results• 77% achieved employment, ALL in

competitive jobs

• 63% remained in job > 90 days (compare to VR general rates of 18%!)

• Most impactful service was post-employment vocational counseling (problem solving, disability mgt, coping skills)

• Avg. 2.4 jobs/person, most jobs with small local employers

Implications• Populations served in KEEP are the same

“high risk” populations• They ARE employable• Work provides structure, future orientation,

reasons for self-care, etc• Work can provide mechanism for increased

stability – of income, housing, sobriety, adherence and possibly health

• Work can provide positive alternatives to high risk behaviors