Objectives: The employment rate of people living with HIV in France remains lower than in the general population despite HAART availability, translating into a high disease-related socioeconomic burden. Our objective was to investigate the relations between HIV disease and employment status. Design: We used data from the ANRS-EN12-VESPA survey. Methods: Analyses were restricted to the 2750 working-aged (<60years) participants. Individuals' health characteristics were compared according to employment status and to plans of access/return to work, using logistic regression models to account for sociodemographic/occupational and health characteristics. Results: Employment rate reached 56.5%: 44.9% of the participants had remained employed since diagnosis and 11.6% had accessed employment after diagnosis. Compared with those unemployed, participants who had maintained employment were less likely to be of fair/poor health status (adjusted odds-ratio 0.40, 95% confidence interval [0.26-0.62]) and have a history of AIDS (0.65 [0.48-0.89]) and HCV coinfection (0.53 [0.36-0.79]); participants who had accessed employment were more likely to have been diagnosed HIV-infected from 1996 onwards (1.95 [1.20-3.15]) and less likely to be of fair/poor health status (0.48 [0.28-0.92]) and to have a history of HIV-related hospitalization (0.68 [0.47-0.97]) and a CD4 cell count≤200/mm3 (0.56 [0.31-1.01]). Among employed participants, 70.1% had not disclosed their HIV status at the workplace and 8.5% reported HIV-related adjustments in their working conditions. Among those unemployed, 64.5% reported plans of access/return to work and 58.2% of these had actually attempted to do so. Motivations for access/return to work were mainly of a social, psychological and financial nature.
