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.