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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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4.8: HIV, Sex and Gender

Gender has been generally defined as shared expectations and norms held by society about appropriate male and female behavior, characteristics and roles.1 Gender differs from the concept of sex in that it refers to socially prescribed gender-specific roles and expectations, whereas sex refers to biological sex differences.1 Gender inequality refers to differential social opportunity and power, based on gender. Those with less social opportunity are more likely to have their needs overlooked or marginalized, have less access to social and health care systems and be at higher risk of contracting communicable diseases, including HIV.1

While HIV affects women and men, a number of socio-economic factors, in addition to physiologic differences, place women at increased susceptibility to infection. Issues such as poverty, marginalization, gender power inequalities and violence increase the vulnerability of women to HIV infection.2 In Canada, there are rising rates of infection among women, with racialized and Indigenous women comprising most of the new female HIV cases annually. Consultations with Canadian women living with HIV have identified three central characteristics of supportive women-centred HIV care, including: (i) coordinated and integrated services that address both HIV and women’s health care priorities, and protect against exclusion from care due to HIV-related stigma, (ii) care that recognizes and responds to structural barriers that limit women’s access to care, such as violence, poverty, motherhood, HIV-related stigma, and challenges to safe disclosure, and, (iii) care the fosters peer support and peer leadership in its design and delivery to honor the diversity of women’s experiences, overcome women’s isolation, and prioritize women’s ownership over the decisions that affect their lives.3

The needs of transgendered individuals living with HIV have also been explored. Factors associated with lower engagement in care included: depressive and post-traumatic stress disorder symptoms, barriers in access to care, transphobia, HIV-related stigma and housing insecurity.4

1 Gahagan J, Ricci C. HIV/AIDS Prevention for Women in Canada: A meta-ethnographic synthesis (PDF). 2011 .

2 Gatali M, Archibald CP. Women’s Health Surveillance Report: A Multi-dimensional Look at the Health of Canadian Women. Canadian Institute for Health Information, 2003 (PDF).

3 O’Brien N, Greene S, Carter A, Lewis J, Nicholson V, et al. Envisioning Women-Centered HIV Care: Perspectives from Women Living with HIV in Canada. Women’s Health Issues. 2017 Nov-Dec;27(6):721-730. doi: 10.1016/j.whi.2017.08.001. Epub 2017 Sep 6. PMID: 28887140.

4 Lacombe-Duncan A, Bauer GR, Logie CH, Newman PA, Shokoohi M, Kay ES, Persad Y, O’Brien N, Kaida A, de Pokomandy A, Loutfy M. The HIV Care Cascade Among Transgender Women with HIV in Canada: A Mixed-Methods Study. AIDS Patient Care STDS. 2019 Jul;33(7):308-322. doi: 10.1089/apc.2019.0013. Epub 2019 Jun 12. PMID: 31260342.

Additional information regarding HIV in specific populations can be found at this link: Specific Populations

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