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Antiretroviral therapy (ART) has dramatically increased survival for HIV patients. However, little is known about the economic effects of ART on patients, their households, and communities in settings with slack labor markets, common in areas with the highest HIV burden. Using clinical and economic data from a large population-based surveillance system in rural South Africa, this paper assesses the extent to which labor supply of HIV patients recovers on treatment. Employment and labor force participation largely recover, but lag behind health gains. Barriers to employment for HIV patients include low labor demand and location of job opportunities. For households of HIV patients, ART provides substantial protection against asset loss due to HIV illness and death. Finally, I find suggestive evidence that ART rollout has positive spillover effects on employment of HIV negatives at the community level.