Functional Limitations and Disability in Persons Living with HIV in South Africa and United States: Similarities and Differences

Kietrys, David M.; Myezwa, Hellen; Galantino, Mary Lou; Parrott, J. Scott; Davis, Tracy; Levin, Todd P; O’Brien, Kelly K; Hanass-Hancock, Jill

doi:10.1177/2325958219850558

Cited by 24 publications

(27 citation statements)

References 41 publications

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“…There is an increasing body of literature showing that chronic HIV infection remains associated with various impairments and functional limitations despite the tremendous progress made in the treatment of HIV/AIDS over the last several decades [ [6] , [7] , [8] ]. According to available studies, between one-quarter and one-half of the people living with HIV and treated with antiretroviral therapy (ART) experience some form of activity limitation [ 6 , [9] , [10] , [11] , [12] , [13] , [14] ]. On the other hand, people with disability can be at increased risk of acquiring HIV infection.…”

Section: Introductionmentioning

confidence: 99%

The multidimensional vulnerability of people with disability to HIV infection: Results from the handiSSR study in Bujumbura, Burundi

et al. 2020

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Background In resource-limited contexts, available data indicate that people with disability are disproportionally affected by the HIV epidemic. While disability resulting from chronic HIV infection has received some attention, few epidemiologic studies have examined the vulnerability of people with disability to HIV acquisition. The aims of the study were as follows: to estimate and compare HIV prevalence among people with and without disability living in Bujumbura, Burundi; to examine how the interaction among disability, gender and socioeconomic environment shapes vulnerability to HIV; and to identify potential pathways to higher HIV risk. Methods In this cross-sectional population-based study, 623 persons with disability (302 with disability onset ≤10 years [“early disability”]) and 609 persons without disability matched for age, sex and location were randomly selected to be tested for HIV and to participate in an interview about their life history, their social environment and their knowledge of sexual health. Findings A total of 68% of men and 75% of women with disability were affected by multidimensional poverty compared to 54% and 46% of their peers without disability ( p <0.0001). Higher HIV prevalence was observed among women with disability (12.1% [8.2–16]) than among those without (3.8% [1.7–6], OR a 3.8, p <0.0001), while it was similar among men with disability and those without ( p = 0·8). Women with disability were also at higher risk of sexual violence than were those without (OR a 2.7, p <0.0001). The vulnerability of women with early disability to HIV was higher among those who were socially isolated (HIV prevalence in this group: 19% [12–27]). In addition, education level and sexual violence mediated 53% of the association between early disability and HIV ( p = 0.001). Interpretation This study highlights how the intersection of disability, gender and social environment shapes vulnerability to HIV. It also shows that the vulnerability to HIV of women who grew up with a disability is mediated by sexual violence. Funding This research was funded by the Netherlands Organization for Scientific Research (Grant W08.560.005) and the Initiative HIV-TB-Malaria (new name of the organisation)

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Section: Introductionmentioning

confidence: 99%

The multidimensional vulnerability of people with disability to HIV infection: Results from the handiSSR study in Bujumbura, Burundi

et al. 2020

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“…Despite this, South Africa's HIV policies and guidelines do not speak to HIV-related disabilities, as premature mortality remains a key national health indicator [66]. However, political will to address non-fatal health loss is rising [67] as an increasing body of literature signals the need to address HIV-related disability [68][69][70]. Increased investment in health resources to enhance the quality of life and functioning in people with HIV will require concerted effort.…”

Section: Discussionmentioning

confidence: 99%

“…Increased investment in health resources to enhance the quality of life and functioning in people with HIV will require concerted effort. Access to adequate rehabilitation has the potential to optimize functioning, employability and could even enhance HAART adherence in people living with HIV [70].…”

Section: Discussionmentioning

confidence: 99%

Physical Rehabilitation Needs in the BRICS Nations from 1990 to 2017: Cross-National Analyses Using Data from the Global Burden of Disease Study

Jesus

Landry

Hoenig

et al. 2020

IJERPH

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Background: This study analyzes the current and evolving physical rehabilitation needs of BRICS nations (Brazil, Russian Federation, India, China, South Africa), a coalition of large emergent economies increasingly important for global health. Methods: Secondary, cross-national analyses of data on Years Lived with Disability (YLDs) were extracted from the Global Burden of Disease Study 2017. Total physical rehabilitation needs, and those stratified per major condition groups are analyzed for the year 2017 (current needs), and for every year since 1990 (evolution over time). ANOVAs are used to detect significant yearly changes. Results: Total physical rehabilitation needs have increased significantly from 1990 to 2017 in each of the BRICS nations, in every metric analyzed (YLD Counts, YLDs per 100,000 people, and percentage of YLDs relevant to physical rehabilitation; all p < 0.01). Musculoskeletal & pain conditions were leading cause of physical rehabilitation needs across the BRICS nations but to varying degrees: from 36% in South Africa to 60% in Brazil. Country-specific trends include: 25% of South African needs were from HIV-related conditions (no other BRICS nation had more than 1%); India had both absolute and relative growths of pediatric rehabilitation needs (p < 0.01); China had an exponential growth in the per-capita needs from neurological and neoplastic conditions (p < 0.01; r2 = 0.97); Brazil had a both absolute and relative growth of needs coming from musculoskeletal & pain conditions (p < 0.01); and the Russian Federation had the highest neurological rehabilitation needs per capita in 2017 (over than three times those of India, South Africa or Brazil). Conclusions: total physical rehabilitation needs have been increasing in each of the BRICS nations, both in absolute and relative values. Apart from the common growing trend, each of the BRICS nations had own patterns for the amount, typology, and evolution of their physical rehabilitation needs, which must be taken into account while planning for health and physical rehabilitation programs, policies and resources.

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“…The larger minimum sample size required based on both these methods was taken as the sample size for the study. Based on 90% study power, a precision estimate of 0.05, an estimated disability prevalence of 50%, [10] the sample size of 259 was required.…”

Section: Study Population and Sample Size Estimationmentioning

confidence: 99%

“…Using the international classi cation of function disability and health, reports from South Africa, Brazil and India highlight the high level of disablement among adults living with HIV, and that up to 65% live with some form of body impairments [8], [9]. A study conducted in 2014 and 2015 compared levels of functioning and disability among PLHIV in South Africa and the United States reported that disability was present at 51% in South Africa compared to 86.6% in the United States [10]. In Nigeria, a study conducted among 360 adults showed that two out every three PLHIV, although rated mild, it affected the participants quality of life signi cantly [11].…”

Section: Introductionmentioning

confidence: 99%

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

Manyozo¹,

Nesto²,

Kawalazira³

et al. 2020

Preprint

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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.

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Functional Limitations and Disability in Persons Living with HIV in South Africa and United States: Similarities and Differences

Cited by 24 publications

References 41 publications

The multidimensional vulnerability of people with disability to HIV infection: Results from the handiSSR study in Bujumbura, Burundi

The multidimensional vulnerability of people with disability to HIV infection: Results from the handiSSR study in Bujumbura, Burundi

Physical Rehabilitation Needs in the BRICS Nations from 1990 to 2017: Cross-National Analyses Using Data from the Global Burden of Disease Study

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

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