HIV in

Physical
Therapy

By: Sierra Moore

Pre-Test
Learning Objectives

1. The learners will be able to know why stage 1 and stage 2 of HIV is when the disease is most
frequently contracted to others.
2. The learners will be able to define/know the term AIDS.
3. The learners will be able to list at least 2 long-term side effects of HIV medications.
4. The learners will be able to successfully treat and come up with a plan of care for a patient
with HIV.
5. The learners will be able to recognize the indications for physical therapy.
6. The learners will be able to recognize reasons why HIV patients may develop a mental
illness.
7. The learners will recognize the importance that physical therapists play in managing those
with HIV/AIDS.
Before we begin…

– Please jot down on a scrap piece of paper what the

first thing that comes to mind when you hear the
word HIV/AIDS
What is HIV?

– HIV stands for Human Immunodeficiency Virus

– HIV is a virus that attacks the immune system
• The virus destroys a type of white blood cell—the T-helper cells
• The virus goes inside the T-helper cells, destroys the healthy cell
and duplicates itself
Course of the disease

– The immune system of an infected person with HIV, eventually

breaks down
– If HIV is left untreated, it may take up to 10-15 years for the
immune system to become so severely damaged that it will not be
able to defend itself at all
– The progression of HIV varies from person to person
• Age, background, and health
Treatment

– There is currently no cure for HIV

– The sooner an infected person is treated, the healthier they are
long-term
– Anti-retroviral treatment
• Keeps the level of HIV low
• Allows the immune system recovery time
• Helps to prevent the disease from being passed on to another
person
Then…What is AIDS?

– AIDS stands for Acquired Immune Deficiency Syndrome

– AIDS is not a virus, but refers to the symptoms caused by HIV
– This is considered the last stage of HIV
– Immune system is severely damaged
The 3 Stages of HIV

– Stage 1: feels like the flu (does not always occur)

– Stage 2: may last for 10 years without symptoms
– Stage 3: when the immune system is so severely damaged it can
no longer fight off infections
– Implications
Symptoms of HIV

– Stage 1:
• Fever • Headache
• Body rash • Stomach ache
• Sore throat • Joint aches and pains
• Swollen glands • Muscle soreness
Symptoms of HIV

– Stage 2:
• Asymptomatic

– Stage 3:
• Weight loss • Persistent cough
• Chronic diarrhea • Mouth and skin issues
• Night Sweats • Regular infections
• Fever • Serious illnesses or diseases
Opportunistic Infections

– Infections that take the opportunity while the immune system is weakened
– Common opportunistic infections:
• Cryptococcal meningitis
• Toxoplasmosis
• Pneumonia
• Esophageal candidiasis
• Certain cancers
Managing other health
conditions
– Mental health
• Depression and anxiety is common
– Preventing STIs
– Exercising
– Eating a healthy diet
– Avoiding drugs, alcohol, tobacco
Statistics

– More than 1.1 million people in the U.S. are infected

with HIV
– 1 in 7 people are unaware that they are infected
– An estimated 37,600 Americans became newly infected
with HIV in 2014
What does HIV have to do with
physical therapy?
– PTs play a role in managing and preventing any disease or
condition that consists of low levels of activity, including HIV
– PTs can help people living with HIV to promote and maintain their
level of daily activity
– Exercise can be very beneficial to those with HIV
– PTs can work in a team with other health professionals to provide
care for patients with HIV
What does HIV have to do with
physical therapy?
– HIV effects every system in the body—PTs are educated
on all systems and need to consider the effect that the
physiology may have on therapy
In the World of Physical Therapy

– HIV is still taboo to speak about

– More physical therapists need to be open for discussion about HIV
in physical therapy
– It is necessary to educate ourselves on what we can do as a
profession to help those living with HIV
HIV related problems that can
be treated with PT
– Chronic pain – Dizziness/Fatigue
– Abnormal sensations (burning, – Sport, work, recreational
numbness, tingling) performance
– Muscle spasms/cramps – Walking/managing stairs
– Muscle weakness – Myalgia
– Muscle or joint stiffness – Peripheral neuropathy
– Balance
HIV and exercise

– Aerobic exercise or aerobic exercise/resistance training for at least

20 minutes 3x/week for at least 5 weeks has been proven
beneficial
– Participation in exercise is safe
– Helps to diminish the effects of medications and health
consequences of HIV
– Shown to improve fitness level, well-being, and body image
Rehabilitation

– People with HIV are living longer

– Side effects of treatment and the progression of the disease cause
activity restrictions and limitations
– Patients need to maintain ADLs and functional activities for as long
as possible
– Important for patients to hold on to their independence
Rehabilitation

– PTs can create exercise plans to help keeping these patients active
for as long as possible
– Physical therapy can help patients stay in the workforce in order to
provide for their families
– Rehab needs of these patients can be very complex
Long-term Effects of Medications

– Myalgia – Osteoporosis
– Hypertension – Heart disease
– Hyperglycemia – Insomnia
– Peripheral neuropathy – Suicidal thoughts
– Liver damage – Depression
– Diabetes or insulin resistance
– Hyperlipidemia
Mental Health

– Often overlooked
– Having a very serious illness is a major source of stress
– Patients can develop mental health problems from
• Dealing with the stigma of living with HIV
• Losing relationships due to the disease
• Loss of social support, feelings of isolation
Mental Health

• Having to tell others about HIV-positive result

• Changes of appearance/abilities
• Facing discrimination
• Losing one’s job or dealing with stress of not being able to work
eventually
• Managing medications, not being able to get treatment
Mental Health

– Depression is the most common

– It is important to recognize the signs of depression and suicide
– Educate yourself and have resources available and ready to provide a patient
• SAMSHA’s Suicide Prevention Lifeline (800) 273-TALK (8255)
• Support groups
– Call 911 if you think that a person is will harm him/herself
Persons with Disabilities

– At risk for HIV due to

– HIV risk behaviors (drug injections, unprotected sex, etc.)
– Sexual violence
– Access to HIV education, information, and prevention services
Video Break

– https://www.youtube.com/watch?v=1OmEvsm_yDI
Global Perspective
World AIDS Day

– December 1st
– Raises awareness of HIV/AIDS in communities
around the world
– One of the most highly recognized health days
– #WorldAidsDay
Questions? Comments? Concerns?
Discussion

– What is one thing that you learned that you found interesting
or that you didn’t know before?
Post-Test
References

1. About HIV & AIDS. AVERT. https://www.avert.org/about-hiv-aids. Published March 31, 2017. Accessed
July 31, 2017.
2. Content source: HIV.gov adapted this content from CDC's HIV Basics and CDC's NCHHSTP NewsroomDate
last updated: 6/19/2017. U.S. Statistics. HIV.gov. https://www.hiv.gov/hiv-basics/overview/data-and-
trends/statistics. Accessed July 31, 2017.
3. Physical therapy, HIV and AIDS - resources and links. Physical therapy, HIV and AIDS - resources and links
| World Confederation for Physical Therapy. http://www.wcpt.org/node/33479#hiv. Accessed July 31,
2017.
4. O'Brien K, Nixon S, Tynan A-M, Glazier R. Aerobic exercise interventions for adults living with HIV/AIDS.
Cochrane Database of Systematic Reviews 2010, Issue 8. Art. No.: CD001796. DOI:
10.1002/14651858.CD001796.pub3
References

5. UNAIDS. (April 2009). Policy Brief on Disability and HIV. July 31, 2017.
6. Physical therapy, HIV and AIDS - resources and links. Physical therapy, HIV and AIDS - resources and links
| World Confederation for Physical Therapy. http://www.wcpt.org/node/33479#hiv. Accessed July 31,
2017.
7. HIV Disease and AIDS. American Physical Therapy Association.
http://www.moveforwardpt.com/symptomsconditionsdetail.aspx?cid=931ce05b-4b22-4952-9b18-
34af9e201f8d. Published November 1, 2016. Accessed July 31, 2017.
8. Content source: HIV.govDate last updated: 5/15/2017. Mental Health. HIV.gov.
https://www.hiv.gov/hiv-basics/staying-in-hiv-care/other-related-health-issues/mental-health.
Accessed July 31, 2017.
9. HIV Medicines and Side Effects Understanding HIV/AIDS. National Institutes of Health.
https://aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/22/63/hiv-medicines-and-side-effects.
Published January 17, 2017. Accessed August 1, 2017.
10. Global HIV/AIDS Overview. HIV.gov. https://www.hiv.gov/federal-response/pepfar-global-
aids/global-hiv-aids-overview. Accessed August 1, 2017.