Physiotherapy and HIV (FS-14)

PHYSIOTHERAPY AND HIV: RECENT ADVANCES, FUTURE DIRECTIONS

Nixon S1, Brown D2, Galantino ML3, Munalula Nkandu E4, Myezwa H5
1University of Toronto, Physical Therapy, Toronto, Canada, 2Chelsea and Westminster Hospital NHS Foundation Trust, Therapies Department, London, United Kingdom, 3Stockton University, School of Health Sciences, Galloway, United States, 4University of Zambia, Physiotherapy, Lusaka, Zambia, 5University of Witwatersrand, Physiotherapy, Johannesburg, South Africa

Learning objectives

  1. To present cutting-edge physical therapy related research, clinical practice and innovations in the response to the global HIV pandemic
  2. To describe the place of PT research and clinical practice within recent global declarations on HIV and the United Nations Sustainable Development Goals
  3. To discuss directions for future PT research and advocacy to promote function, social participation, inclusion and equity in the HIV response

Description

AIDS-related deaths have fallen 42% since the peak in 2004; yet, more women, men, girls and boys are becoming HIV-infected each day (UNAIDS, 2014). The result is a growing population of people (young and old) living with HIV as a chronic illness, and the expectation that this number will continue to grow over the decades to come.

HIV affects every body system, and so experiences of HIV-related disability vary dramatically - from impairments linked to neurological, orthopedic or respiratory conditions, to activity limitations, to participation restriction that limit opportunities for living meaningful, engaged lives. Furthermore, the concept of “episodic disability” describes the unpredictable but ongoing fluctuations in wellness and illness that characterize life for many people living with HIV. The uncertainty that results from HIV-related episodic disability over the course of the day, week, month or year has itself been shown to be disabling.

Within this context, physiotherapy has a crucial role to play in working with people living with HIV and their communities, health and social care providers, educational institutions, and policy drivers to focus on function, ability and inclusion. Whereas ART is bringing years to life, so PT (and rehabilitation more broadly) is bringing life to years.

However, provision of PT in the context of HIV remains highly equitable and undervalued across all WCPT regions, with huge variations in access to PT services for people living with HIV. There are shining examples of success from around the world, as the panelists will highlight. In general, however, rehabilitation is not yet viewed as a mainstream part of the HIV care continuum. The paradigm shift toward a rehabilitation focus for good health and well-being pf people living with HIV, as a chronic and episodic illness, has yet to occur worldwide.

This symposium will present the best and latest evidence demonstrating the disability experienced by people living with HIV, the effectiveness of PT interventions across a range of practice settings including hospitals, clinics and community, and the value of physiotherapy in the public health response to improving health, well-being and quality of life for people living with HIV These contributions will be located within the broader HIV movement. We will look to the future, proposing directions for research, advocacy and clinical innovation that are best positioned to improve the health and well being of adults and children living with HIV around the world. 

Implications / Conclusions

This symposium will highlight global perspectives on HIV-related rehabilitation, reflecting on existing research to guide future research strategic aims. We will provide a context for participants to consider practical implications, relevant outcome measures and evidence-based interventions for physiotherapy practice and advocacy across a range of clinical and community settings.

Keywords

  1. HIV
  2. episodic disability
  3. rehabilitaiton interventions

Funding acknowledgements

Stephanie Nixon is supported by a Canadian Institutes of Health Research New Investigator Award.

Relevance to physical therapy globally

Widespread access to life-saving antiretroviral therapy (ART) is transitioning HIV into a chronic illness for many of the 35 million people living with HIV worldwide, including 25 million in Sub-Saharan Africa. Physical therapy has a crucial role to play in improving function and social participation among adults and children living with HIV. Moreover, rehabilitation offers a much-needed corrective to the overly narrow biomedical focus on HIV testing and ART in the current HIV response.

Target audience

Clinicians, researchers, policy-makers and advocates who are concerned with improving opportunities for people growing up and growing older with HIV.

 

Programme subject to change

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