HIV-Related Disability in HIV Hyper-Endemic Countries: A Scoping Review

Abstract

Background: In the era of enhanced access to ART, many people live longer lives but with episodes of disability resulting from HIV, HIV-related conditions, and/or as side-effects of ART. It is crucial to understand the extent of disability among people living with HIV in high-prevalence settings to inform choices regarding care, policy and research. This article presents the results of the first scoping review to examine the extent, nature and range of disability among people living with HIV in HIV hyper-endemic countries. Methods: This scoping review used the World Health Organization's International Classification of Functioning, Disability and Health (ICF) to conceptualize "disability". A systematic search of electronic databases was conducted using specific keyword and subject heading combinations. Identified publications were screened and reviewed according to inclusion/exclusion criteria. Data were systematically extracted and reviewed for quality. Extracted data were reviewed for patterns related to methods or results. Results were aligned with the corresponding ICF code. Results: Forty-one articles were included, reporting data from 38 unique studies. Most (78%) of the studies were conducted in South Africa; five in Botswana, one in Zimbabwe and Lesotho, and none in Swaziland. Almost all studies recruited more females than males. All studies except two were in adults. The studies indicate that people living with HIV experience a variety of disabilities. Impairments in body structure/function comprise the majority of data, with particular focus on mental function. Data on activity limitations and participations restriction were limited, however, they were recorded. They indicate severe impact on people's life and possible adherence. Conclusions: We argue that the time has come to elevate the focus holistically on health and life-related consequences of living with HIV and to integrate disability into the discussions and approaches to HIV care.

Physiotherapy rehabilitation in the context of HIV and disability in KwaZulu-Natal, South Africa

“…These statistics indicate that there will be more and more people living with, rather than dying of, HIV in South Africa and more specifically in the province of KwaZulu-Natal. This is, of course, a positive development, but this increased longevity has been mirrored by an increase in the prevalence and impact of disability experienced by this population [3,4].…”

“…A significant challenge to physiotherapists is the frequent presence of cognitive deficits and mental health conditions related to HIV [4]. These deficits may include loss of concentration, poor memory and social withdrawal [28].…”

“…Depending on the source, between 12% and 24% of the South African population is considered to have a disability which is above the world average and one of the highest in Africa [6]. A recent scoping review [4] indicates that the disabling effects of HIV, its opportunistic infections and the treatment of both affects a large number of people PLHIV including those on long-term treatment. The review, which focuses on hyper-endemic countries, summarises a wide range of research papers including a number of health conditions (e.g.…”

Disability and Health Outcomes – From a Cohort of People on long term ART

“…Recent evidence has suggested that people living with HIV including those on ART experience a diverse set of disabilities (5,(10)(11)(12)(13). The United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD) has been instrumental in many policy debates including HIV/AIDS.…”

“…Understanding the scope, types of disabling effects as well as its impact on health outcomes and treatment adherence is crucial to inform management of HIV as a chronic condition (3,6). Existing literature used the international classification of function (ICF) as a lens to understand the relationship between HIV and disability (5,6,10,11,(13)(14)(15). The ICF is a classification system of health components of function and disability.…”