Rehabilitation: A crucial component in the future of HIV care and support

Abstract

Provision of antiretroviral therapy (ART) is not an end in itself but a means to achieving improved wellness for people living with HIV. Rehabilitation, broadly defined, is another key contributor to wellness within this context. Understanding the potential for rehabilitation requires that one is able to consider HIV not only within a biomedical model that focuses on body systems, diagnoses and symptoms, but also within a rehabilitation framework that focuses on how these diagnoses and symptoms affect people’s lives more broadly. Furthermore, rehabilitation is a human rights imperative, which deserves the energetic attention enjoyed by other aspects of HIV treatment and care. In particular, the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) is shining a long-overdue spotlight on the human rights imperatives associated with disability. For South Africa and other countries, proactively and meaningfully engaging rehabilitation in the HIV response will require major shifts on several fronts, including practice, education, policy and research. We argue that in settings where ART delivery is now widespread, HIV should be understood not only as a medical issue, but as a rehabilitation and disability concern. Whereas medicine adds years to life, it is rehabilitation that aims to add life to years.

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

“…It is crucial to understand the extent of disability among people living with HIV in high-prevalence settings in order to inform choices regarding care, policy and research. These findings add to the growing body of literature that calls for attention to disability in high HIV-prevalence settings [4][5][6][7]16,[56][57][58][59]. In particular, this scoping review demonstrates that much is already known about impairments, activity limitations and participation restrictions experienced by people living with HIV in hyper-endemic countries, but that key gaps in understanding remain.…”

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

“…While physiotherapists are not involved in prescribing or dispensing medication, they should be aware of the potential side effects of HAART medication, which can raise further issues of stigma and negatively affect adherence [7]. Physiotherapists can also play a key role, as members of the wider multi-disciplinary team, in reinforcing and encouraging PLHIV to adhere to taking their tablets on time every day.…”

“…Physiotherapy, as a profession, can play a key role in assisting PLHIV to prevent and manage disability and therefore enable holistic participation in the occupational, social and recreational aspects of life [7,8]. The profession of physiotherapy is concerned with the assessment and treatment of people challenged with a wide array of neurological, musculoskeletal and respiratory conditions.…”

“…PLHIV are prone to opportunistic infections that have the potential to damage one or all of the above physiological systems [9]. Physiotherapists are therefore involved in the rehabilitation of these patients [7].…”

Disability, Health and Human Development

“…It is sometimes adopted in public health curricula and endorsed by clinical associations as a conceptual framework (e.g., APTA 2008). In medicine, it is most often used in rehabilitation settings (Nixon et al 2011), but has also been used in other fields such as oncology (e.g. Bornbaum et al 2013).…”