3.1 – What are the rehabilitation interventions that address impairments common among people living with HIV?
3.1.6: Genitourinary and reproductive functions
People living with HIV can experience impairments of genitourinary and reproductive functions. These impairments are related to urination functions and sexual functions and may be directly caused by the viral pathogen or secondary bacterial and fungal infection. Side effects of medications also have an effect on urinary and sexual functions. Sexual impairments can also result from psychosocial etiologies.
Rehabilitation interventions include psychosocial rehabilitation, electrotherapy modalities and exercise. Potential causes of these impairments and rehabilitation interventions are shown in the table below.
Table 3.1.6: Clinical Aspects of Genitourinary and Reproductive Impairments
| Impairments | Possible Etiologies | Rehabilitation Interventions7 (for details, see Section 3.3) |
|---|---|---|
Urination dysfunction |
Urinary tract infection Viral pathogen affecting the nervous system Side effects of medication Opportunistic infections Other fungal or bacterial infections |
|
Sexual impairments including loss of libido, pain during sex and male erectile problems
|
Viral pathogen Emotional issues (e.g., anxiety, stress, grief and depression) Smoking Side effect of medication Alcohol use Recreational drug use Hormone dysfunction (e.g., testosterone deficiency and thyroid dysfunction in men and women, early menopause in women with HIV) Autonomic and/or peripheral neuropathy Sexually transmitted infections |
|
7Choice of rehabilitation interventions will depend on patient assessment and available resources.
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