By  Professor Sydney Rosen  Dr. Bruce Larson   Rohr J  Professor Ian Sanne  Mongwenyana C  Dr. Alana Brennan  Galarraga O  |  | 

Large-scale provision of antiretroviral therapy (ART) for HIV/AIDS began   in South Africa in 2004 and has scaled up steadily since then. A decade later, large numbers of patients are now reaching five, eight, or
even more years on ART. The long-term biomedical outcomes of  treatment have been well documented in South Africa, where antiretroviral provision has been associated with reductions in HIV-associated mortality and increases in life expectancy. Much less is known about the “non-biomedical” outcomes of treatment, in South Africa and else where. A handful of studies have  considered the implications of ART for   quality of life, employment, and other economic and social indicators, but these studies have largely been limited to the one to two years after initiation of treatment. They have generally reported large improvements in the indicators they measured in the first 6-24 months after treatment initiation. In view of the lifelong commitment that ART requires, however, it is important to know whether these improvements persist, increase, or deteriorate in later years on treatment. To begin to describe the long-term effect of ART on patients’ economic well-being, we conducted a 6-year study of symptom prevalence, ability to perform normal activities, employment and job performance, and reliance on external support. Each of these outcomes reflects the ability of South African ART patients to contribute to their own, their households’, or society’s economic activity.

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