Over the past decade, large-scale HIV antiretroviral therapy (ART) programs have proven hugely successful in improving the life expectancy of people living with HIV. However, the extent to which treatment allows patients to maintain a productive work life remains an open question. We applied an instrumental variable method based on individual CD4 counts and exogenously changing treatment guidelines to identify the causal effect of ART on health-related absenteeism rates among workers living with HIV. We used monthly data from the occupational health program of one of the world's largest mining companies in South Africa (128,052 observations among 1,924 workers, from 2009 to 2017). Eighteen months after ART initiation, the treatment significantly reduced absenteeism by 1.033 days per worker and month. Using publicly available wage and treatment cost data, we find that the cost savings due to the absenteeism effect of ART alone outweigh treatment costs in the mining sector in several sub-Saharan African countries.

在过去十年中，大规模的 HIV 抗逆转录病毒治疗 (ART) 计划已证明在提高 HIV 感染者的预期寿命方面取得了巨大成功。然而，治疗在多大程度上让患者保持富有成效的工作生活仍然是一个悬而未决的问题。我们应用了基于个体 CD4 计数和外源性改变治疗指南的工具变量方法来确定 ART 对 HIV 感染者的健康相关缺勤率的因果影响。我们使用了南非世界上最大的矿业公司之一的职业健康计划的月度数据（从 2009 年到 2017 年，对 1,924 名工人进行了 128,052 次观察）。ART 开始 18 个月后，治疗显着减少了每个工人每月的缺勤 1.033 天。