Abstract

BackgroundRecent 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.AimThis study aimed to explore physiotherapists’ awareness of falls risk and accelerated bone demineralisation in PLWH and their perceptions of current falls prevention strategies in the care of PLWH in selected regions of sub-Saharan Africa.MethodAn exploratory descriptive qualitative research method 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.ResultsThe 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.ConclusionPhysiotherapists 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.

Highlights

  • Falls among people living with Human immunedeficiency virus (HIV) (PLWH) is an emerging concern

  • Physiotherapists may need to be more aware of the potential risk of falls and bone demineralisation in people living with HIV (PLWH) and routinely assess for these phenomena in both older and younger PLWH

  • Physiotherapists need to be aware of their scope of practice in primary HIV care, falls and fracture prevention, before they can promote it among other health professionals and the community at large [6]

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Summary

Introduction

Falls among people living with HIV (PLWH) is an emerging concern. The first study was published recently, in 2012 [1]. Scant evidence exists for physiotherapy interventions that reduce falls [10] or promote bone health [11, 12] in PLWH and the role of physiotherapy for HIV at primary care is not clearly understood by the interdisciplinary team [6]. This may result in inappropriate, delayed or non-referral of PLWH who may have benefited from physiotherapy; as well as physiotherapists being sidelined from HIV care policy-making dialogues [13]. Aim: This study aimed to explore physiotherapists’ awareness of falls risk and accelerated bone demineralisation in PLWH and their perceptions of current falls prevention strategies in the care of PLWH in selected regions of subSaharan Africa

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