PHYSICAL CHALLENGES IN ADOLESCENTS WITH PERINATAL HIV: A CROSS-SECTIONAL STUDY

N. Comley-White¹, J. Potterton¹, V. Ntsiea¹

¹University of the Witwatersrand, Physiotherapy, Johannesburg, South Africa

Background: Human Immunodeficiency Virus (HIV) continues to be a global health challenge across the age spectrum. As access to antiretroviral therapy improves so the cohort of adolescents with perinatally acquired HIV grows. Research is starting to show how this vulnerable population face unique challenges in terms of motor development, mental health issues and neurocognitive delay. This is a growing area of research with many gaps still needing to be addressed.

Purpose: The aim of this study was to determine the physical challenges that adolescents with perinatally acquired HIV have.

Methods: Using a cross-sectional study design, two groups of adolescents were assessed: adolescents with perinatally acquired HIV (APH); and age-matched adolescents who were HIV negative (controls). The study was at an urban HIV research and services clinic in Johannesburg, South Africa. Participants were assessed for body mass index (BMI), endurance (outcome measure: shuttle run test), muscle power (outcome measure: broad standing jump) and motor impairment (outcome measure: Movement Assessment Battery for Children 2^nd edition [MABC] consisting of a subsections for manual dexterity, aim and catching, balance). Data was skewed and thus medians and interquartile ranges were analysed. The Mann-Whitney U test was used to determine the differences between the groups.

Results: The sample size comprised of 147 APH and 102 controls, of which 116 (46.5%; n=249) were female and the median age was 11 years (min=10; max=16; IQR=3). The APH had lower anthropometric values compared to the controls: weight (p<0.001), height (p<0.001) and BMI (p=0.007). The APH also performed poorer on all outcome measures (except the shuttle run test) with the most notable differences between the groups for the MABC manual dexterity subsection (p=0.034) and MABC balance subsection (p=0.042).

Conclusions: Despite access to antiretroviral therapy adolescents with perinatally acquired HIV present with lower weight, height and BMI than their HIV negative counterparts and they face greater physical challenges and motor performance deficits (specifically manual dexterity and balance).

Implications: This study highlights the role of healthcare workers, especially physiotherapists, in the holistic long-term management of APH. Early intervention plays a key role in ensuring that this vulnerable population has access to the best possible health outcomes despite living with a chronic health condition.

Funding acknowledgements: University of the Witwatersrand; South African Society of Physiotherapy

Keywords:
HIV
Adolescence
Physical

Topics:
Disability & rehabilitation
Paediatrics
Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? Yes

Institution: University of the Witwatersrand

Committee: Human Research Ethics Committee (Medical)

Ethics number: M180226