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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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2.3 What is the impact of HIV on body systems and why does this matter for rehabilitation providers?

HIV is a complex and multi-system disease that causes a range of conditions that can affect almost every single body system. However, antiretroviral therapy has contributed to HIV-positive people living longer and having better quality of life.

Despite these improvements, Van As et al.1 found that physical impairments, activity limitations and participation restrictions have had a negative effect on people living with HIV. They highlighted the need for rehabilitation providers to have detailed knowledge of the effects of HIV on the patient so that appropriate interventions can be made. They recommend the International Classification of Functioning, Disability and Health (ICF),2 developed by the World Health Organization, as a useful framework for evaluating impairments and life-related challenges resulting from HIV and HIV-related conditions (visit Section 3 to learn more about HIV-related disability).

Figure 2.3: Examples of diagnoses affecting different body systems in people living with HIV

Examples of  diagnoses affecting different body systems in people living with HIV. Read description below.

Figure 2.3 Examples of diagnoses affecting different body systems in people living with HIV – Description.

This diagram illustrates the different body systems that are affected by HIV.  These include:

  • The immune system (e.g., primary HIV infection)
  • The visual (eyes) system (e.g., HIV retinopathy, CMV retinitis)
  • Skin (e.g. Kaposi’s sarcoma)
  • The central nervous system (e.g., Toxoplamosis, Lymphoma, HIV/AIDS Neurocognitive Disorder (HAND), Spinal lesions
  • The respiratory system (e.g., pneumocystic carinii pneumonia (PCP), tuberculosis
  • The cardiovascular system (e.g., hypertension, stroke)
  • The gastrointestinal system (e.g., esophagitis, tumours)
  • The endocrine system (e.g., lipodystropy, diabetes)
  • The musculoskeletal system (e.g., osteoporosis/osteopenia, myopathy)
  • The reproductive system (e.g., vaginal yeast infections (in women), testitis (in men)
  • The peripheral nervous system (e.g., peripheral neuropathy).

1 Van As M, Myezwa H, Stewart A, Maleka D, Musenge E. The International Classification of Function Disability and Health (ICF) in adults visiting the HIV outpatient clinic at a regional hospital in Johannesburg, South Africa. AIDS Care. 2009;21(1):50-8. PubMed PMID: 19085220.

2 World Health Organization. International Classification of Functioning Disability and Health (ICF) – Geneva. 2011.

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