Assessment of HIV Related Disabilities among People Living with HIV Who Are on ART. A Cross Sectional Survey in Blantyre Urban, Malawi

Abstract

Background Despite improvements in survival, persons living with HIV experience a range of physical, cognitive, mental and social health-related challenges. Among adult persons living with HIV in Malawi, the prevalence of disability and associated risk factors are not known. This study was designed to assess the prevalence of impairments, activity limitations and associated risk factors among adults living with HIV in Blantyre urban, Malawi. MethodsWe conducted a quantitative cross-sectional study among adult persons aged 18 years and older living with HIV and on ART receiving their care at five government run health facilities in Blantyre urban. We used the WHO’s International Classification of Functioning, Disability and Health (ICF) for data collection. The ICF provides a unified, standard language and framework for the description of health and health-related states. The College of Medicine Research Ethics Committee (COMREC) approved the study and written informed consent was obtained from study participants. Descriptive statistics were used to summarize the data. Univariable and multivariable logistic regression were used to assess association between presence of disability and selected factors. Odds ratios (OR) and their 95% confidence intervals were calculated.Results Of the 277 participants enrolled, 225 (81%) were female and 52 (19%) were male. The mean age of participants was 37 years (std. dev 9.5). Impairments in mental functions (43%) and sensory functions and pain (40%) were the most prevalent among the study participants. Energy and drive (18%), memory (14%) and sleep (13%) were the most affected mental functions. Socio-demographic characteristics were not significantly associated with occurrence of the mental function impairments. Conclusions Our study highlights the level of impairments among person living with HIV especially mental health impairments, sensory functions and pain. Integrated health services including mental health screening and care, physical rehabilitation into all HIV testing and treatment settings are very critical to improve service delivery but also general access to rehabilitation by persons living with HIV.

Lived experience of people living with HIV in Blantyre, Malawi: An exploratory qualitative study

“…Common physical impairments reported by PLHIV include shortness of breath, muscle weakness, and joint discomfort 17 . Manyozo et al (2020) evaluated the WHO ICF in PLHIV in Malawi and reported that mental function deficits were the most affected domains, but they did not specify how these impairments influenced HIV-positive individuals' participation restrictions and activity limitations 18 . It is important to understand the connections between these challenges because individuals living with HIV are viewed holistically as such and may present with body functioning impairments associated with participation restrictions and activity limitations.…”