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E-Module

An HIV and Rehab Resource

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  • About
    • 1 – What is this resource about and who is it for?
    • 2 – Why was this resource created?
    • 3 – How can this resource be used?
    • 4 – Can this resource be used for teaching?
    • 5 – How was this resource developed?
    • 6 – Who contributed to developing this adapted resource?
    • 7 – Who funded the development of this resource?
    • 8 – Disclaimer
  • Section 1
    • 1.1 How is “rehabilitation” defined in this resource?
    • 1.2 How can rehabilitation help people living with HIV?
    • 1.3 How can the World Health Organization’s “ICF” help us think about rehabilitation for people living with HIV?
    • 1.4 How can the Episodic Disability Model help us think about rehabilitation for people living with HIV?
    • 1.5 Who provides rehabilitation for people living with HIV?
    • 1.6 Do rehabilitation providers need special skills or training to care for people living with HIV? If so, what?
    • 1.7 What roles do rehabilitation providers have related to HIV?
    • 1.8 When is rehabilitation clinical intervention useful along the HIV care continuum?
  • Section 2
    • 2.1 What do rehabilitation professionals need to know about the stages of HIV infection?
    • 2.2 What do rehabilitation providers need to know about CD4 count and viral load?
    • 2.3 What is the impact of HIV on body systems and why does this matter for rehabilitation providers?
    • 2.4 Who might rehabilitation providers treat?
    • 2.5 What do rehabilitation providers need to know about antiretroviral therapies?
  • Section 3
    • 3.1 What are the rehabilitation interventions that address impairments common among people living with HIV?
    • 3.2 What are the rehabilitation interventions that can address the activity limitations and participation restrictions common among people living with HIV?
    • 3.3 More information on the rehabilitation interventions available for people living with HIV
    • 3.4 – What do rehabilitation providers need to know about their patients’ beliefs and use of traditional healers, spiritual leaders and alternative therapies outside the formal medical system?
  • Section 4
    • 4.1: Intersectionality Theory in the Context of Rehabilitation
    • 4.2: Children and Youth
    • 4.3: HIV and Aging
    • 4.4: Substance Use
    • 4.5: Trauma
    • 4.6: Racialized Populations
    • 4.7: Indigenous Populations
    • 4.8: HIV, Sex and Gender
    • 4.9: HIV and COVID-19
    • 4.10: Is HIV itself a disability?
  • Section 5
    • 5.1 What are outcome measures?
    • 5.2 Why is it important to use outcome measures during rehabilitation with people living with HIV?
    • 5.3 How do rehabilitation providers know if an outcome measure will be useful in practice?
    • 5.4 What are floor and ceiling effects in outcome measurement?
    • 5.5 What is the difference between generic and HIV-specific outcome measures?
    • 5.6 How should you decide which outcome measures to use?
    • 5.7 How do you access a copy of an outcome measure?
    • 5.8 What are rehabilitation-related outcome measures that can be useful for people living with HIV?
  • Case Studies
    • Case #1 – Acute Care, Cardiorespiratory and Neurological
    • Case #2 – Musculoskeletal – Knee Pain
    • Case #3 – Aging, Cognition, Community, Stroke
    • Case #4 – Complex Case – Musculoskeletal, Episodic, Cardiorespiratory
    • Case #5 – Diabetes, Neuropathy, Substance Use
    • Case #6 – Transition from Paediatric to Adult Care
    • Supplemental Case Studies without Leading Questions
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1.6 Do rehabilitation providers need special skills or training to care for people living with HIV? If so, what?

Most rehabilitation providers already have the clinical skills they need to help people living with HIV (e.g., rehabilitation assessment of patients and treatment techniques that are used for musculoskeletal, cardiorespiratory and neurological conditions).

Many diseases affect only one body system. However, HIV and its related conditions can affect every body system (e.g., neurological, musculoskeletal, cardiorespiratory). While the underlying HIV-related pathology may be new, the resulting impairments (e.g., muscle weakness, impaired memory), activity limitations (e.g., difficulty climbing stairs or getting dressed) and participation restrictions (e.g., being able to work, participating in a community group) tend to be the same as other conditions.

The rehabilitation assessment and treatment techniques for these challenges also tend to be the same.

Examples

A pneumonia may result from HIV, but the chest physiotherapy assessment and treatment techniques are the same as other pneumonias.

A stroke may result from HIV, but the rehabilitation assessment and treatment techniques are the same as other patients with stroke

Cognitive dysfunction may occur as a result of HIV, but the rehabilitation assessment and treatment techniques for assisting that individual to cope with daily tasks are the same as other patients with cognitive decline

However, there is some new information that rehabilitation providers need to know about HIV, including:

  • That HIV can simultaneously affect multiple body systems
  • The side effects of HIV treatments that may cause disability
  • The unique forms of HIV-related stigma that may disable people as much as the virus itself
  • The psychosocial aspects of living with HIV

Another concern is that rehabilitation providers may not feel skilled enough to care for people living with HIV.1-3 This is the primary purpose of this resource: to enhance knowledge among rehabilitation providers to help address the needs of people living with HIV.

1 Salbach NM, Solomon P, O’Brien KK, Worthington C, Baxter L, Blanchard G, Casey A, Chegwidden W, Dolan LA, Eby S, Gervais N. Design features of a guideline implementation tool designed to increase awareness of a clinical practice guide to HIV rehabilitation: A qualitative process evaluation. J Eval Clin Pract. 2019 Aug;25(4):648-655. doi: 10.1111/jep.13070. Epub 2018 Nov 26. PMID: 30479024.

2 Worthington C, O’Brien K, Myers T, Nixon S, Cockerill R. Expanding the lens of HIV services provision in Canada: results of a national survey of HIV health professionals. AIDS Care. 2009 Nov;21(11):1371-80. doi: 10.1080/09540120902883101. PMID: 20024713.

3 Worthington C, Myers T, O’Brien K, Nixon S, Cockerill R. Rehabilitation in HIV/AIDS: development of an expanded conceptual framework. AIDS Patient Care STDS. 2005 Apr;19(4):258-71. PubMed PMID: 15857198.

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