Physiotherapists’ Awareness of Risk of Bone Demineralisation and Falls in People Living with HIV and their Perceptions about Fall Risk Management: A Qualitative Study

Abstract

Background: Recent research has indicated a seemingly increased propensity for both falls and accelerated bone loss in people living with HIV (PLWH). Physiotherapists play a crucial role in optimising function and quality of life of PLWH through prevention of falls and reducing the harm that results. Aim: This study aimed to explore physiotherapists’ awareness of falls risk and accelerated bone demineralisation in PLWH and their perceptions about current falls prevention in the care of PLWH in selected regions of sub-Saharan Africa. Method: An interpretative exploratory qualitative research method with a phenomenological approach was employed to explore physiotherapists’ perceptions and experiences regarding bone health and falls in PLWH. In-depth semi-structured telephonic interviews were used to collect data from 21 physiotherapists working in primary HIV care. Transcribed interview data were coded in Atlas.ti.8 ® and analysed using inductive thematic analysis. Results: The primary study revealed a lack of awareness by physiotherapists of falls risk and bone demineralisation in PLWH. As such, physiotherapists did not link falls or fractures to HIV or antiretroviral therapy (ART) when they did observe such events during their general patient assessments. However, in retrospect, some physiotherapists were able to recognise risk factors linked to falls in those with HIV. Current services for falls prevention, as perceived by the physiotherapists, were sub-optimal. Conclusion: Physiotherapists may need to be more aware of the potential risk of falls and bone demineralisation in PLWH and routinely assess for these phenomena in both older and younger PLWH. Key words: Accidental falls, Bone mineral density, HIV, physiotherapists, sub-Saharan Africa