Recommendations for rehab for adults living with HIV
As adults age with HIV, more individuals are living with the physical, social and psychological consequences of the disease, long-term treatment and comorbidities associated with ageing. Since the introduction of anti-retroviral drugs (in the 1990’s in Europe and US, in 2000’s in Africa and India) HIV is now experienced as a chronic illness with specific challenges such as premature onset of cardiovascular disease (CVD), diabetes, bone and joint disorders, neurocognitive disorders and non-AIDS-defining cancers.
Rehabilitation has become an increasingly important strategy to address disability in patients, but few professionals work specifically with people living with HIV (PLHIV) highlighting a gap in service provision and need for further HIV knowledge, training and clinical guidance. No guidelines specific to HIV rehabilitation exist; and high level evidence is absent. This article aims to fill that gap.
The authors established 8 overarching and 52 specific evidence-informed recommendations from a combination of the research. PLHIV and rehab clinicians were integral in developing the recommendations.
Synaps of recommendations (see article for full list):
- education of health care professionals in HIV and ageing is paramount
- individual and multidisciplinary rehab plans with a focus on neurocognitive and mental health impairments are necessary
- rehab is recommended across the continuum of care (acute, recovery and community-based care)
- contextual factors such as stigma and social support should be addressed in the programme.
- intrinsic factors such as self-management and spirituality play a major role in outcome success
- cognitive rehabilitation interventions (cognitive training, stimulation, rehabilitation) may be recommended for adults with mild cognitive impairment and stroke.
- a combination of aerobic and resistive exercise may be recommended for older adults living with HIV who are medically stable and living with comorbidities.
These evidence-informed recommendations provide a guide for rehabilitation with older adults living with HIV.
> From: O'Brien et al., BMJ Open 4 (2015) e004692(Epub ahead of print). All rights reserved to The Author(s). Click here for the Pubmed summary.