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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 width="36%"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)


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.