Economic Consequences of HIV Status and Viral Load Level Among Households: Evidence from Twelve Sub-Saharan African Countries

Background: HIV/AIDS is the leading cause of death in sub-Saharan Africa. Families facing numerous challenges, often exacerbated by the pandemic, frequently turn to their communities and external economic support for assistance. Methods: The PHIA project data (2015-2022) from 12 sub-Saharan countries focused on both adolescents and adults aged > 15 years and above. This study examined income after work, with HIV status, viral load, and sociodemographic factors as predictors. Descriptive statistics and econometric modelling were used to analyze the determinants of working and receiving income. Results: Our analysis revealed a strong connection between health status and labor force engagement among individuals in Sub-Saharan Africa. Suppressed viral load in HIV-positive individuals significantly increased the odds of working and earning income by 2.1 times, underscoring the economic value of ART adherence. Behavioral factors such as alcohol use also played a role: those consuming alcohol frequently had 1.27 times higher odds of economic participation. Conversely, poor health outcomes and larger household sizes diminished employment prospects. Age, gender, and marital status influenced economic engagement, with older adults, females, and married individuals showing reduced odds. Higher education and wealth status substantially boosted labor participation. Rural residents were more economically active than urban dwellers. These findings emphasize the critical intersection between health and socioeconomic resilience Conclusions: Our study demonstrates that health status, particularly viral suppression among HIV-positive individuals, plays a pivotal role in enhancing income generation. Behavioral and demographic factors also shaped employment outcomes, with younger, educated, wealthier individuals showing higher odds. Poor health, female gender, older age, and urban residence reduced income opportunities. These findings highlight the vital link between clinical well-being and socioeconomic empowerment.