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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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3.2 What are the rehabilitation interventions that can address the activity limitations and participation restrictions common among people living with HIV?

The impairments described in Section 3.1 may result in a variety of activity limitations and restrictions to an individual’s participation in education, vocational, family and social pursuits.

A broader and more holistic rehabilitation approach should take into account the activity limitations and participation restrictions faced by people living with HIV. Rehabilitation providers have important roles to play in addressing these challenges at multiple levels. For example:

  • Clinical interventions
  • Education to family and community
  • Advocacy efforts to address the circumstances that create these challenges

It is vital that rehabilitation providers see that they have a role across the spectrum of the disease process from acute hospital care to long-term follow-up in the community. When rehabilitation providers are working with people living with HIV, they should consider both the individual’s personal characteristics (e.g., age, gender, economic status), as well as the environment in which they live, socialise and work.

Rehabilitation providers should also, where possible, be involved in advocacy efforts to ensure the efficient and effective provision of rehabilitation services to people living with HIV, particularly those from marginalized groups (e.g., people who are experiencing financial instability, people from racialized communities, people with disabilities). Advocacy efforts can be strengthened by active involvement in community-based research initiatives focusing on rehabilitation for people living with HIV.

This section is organized according to the categories of activity and participation in the World Health Organization’s International Classification of Functioning, Disability and Health (see Section 1.3).

Potential causes of these impairments and rehabilitation interventions are shown in the table below.

Table 3.2: Rehabilitation Interventions for Activity Limitations and Participation Restrictions

Activity Limitations and Participation Restrictions Rehabilitation Interventions

Learning and applying knowledge

Adult-based education programs

Assistive devices

Environmental adaptation

Provision of visual or auditory education materials

General tasks and demands

Energy conservation and pacing

Environmental adaptation

Exercise prescription – aerobic

Exercise prescription – strength

Home-based rehabilitation

Assistive devices – scooters, jar openers, sock donners

Return to work/activity strategies

Communication

Adaptation of communication environment

Articulation, fluency, resonance, language advice and exercises

Augmentative communication devices e.g. text-to-voice output device

Education on managing conversations and communication

Environmental adaptation

Psychosocial rehabilitation

Mobility

Assistive devices

Community-based rehabilitation

Energy conservation and pacing

Environmental adaptation

Ergonomic interventions

Exercise prescription – aerobic

Exercise prescription – strength

Exercise prescription – balance/neuromotor skills

Exercise prescription – stretching and passive movement

Home-based rehabilitation

Self-care

Advice on personal hygiene

Advice/training and exercises related to transfers

Assistive devices (e.g. grab bars, raised toilet seat)

Energy conservation and pacing

Environmental adaptation

Ergonomic interventions

Home-based rehabilitation

Domestic life

Advice on meal preparation and nutrition

Assistive devices

Energy conservation and pacing

Environmental adaptation

Home-based rehabilitation

Interpersonal interactions and relationships

Couple counseling

Family support groups and parenting programs

Involvement and education of family and friends

Psychosocial rehabilitation

Major life areas including work and employment

Accessibility awareness and promotion

Education and advice on social grants/ employment/accessibility legislation

Energy conservation and pacing

Environmental adaptation

Ergonomic interventions

Extramural education and activities for learners

Involvement and education of employers, colleagues and educators

Psychosocial rehabilitation

School education programs

School feeding programs

Vocational rehabilitation

Community, social and civic life

Community-based rehabilitation

Education and advice on human rights

Energy conservation and pacing

Involvement and education of spiritual, political and community leaders

Advocacy group participation

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