E-Module (SSA) - Section 3.2

3.2 – What are the rehabilitation interventions that can address the activity limitations and participation restrictions common among people living with HIV?

The impairments described in Section 3.1 may result in a variety of activity limitations and restrictions to an individual’s participation in education, vocational, family and social pursuits.

A broader and more holistic rehabilitation approach should take into account the activity limitations and participation restrictions faced by people living with HIV. Rehabilitation providers have important roles to play in addressing these challenges at multiple levels. For example:

Clinical interventions
Education to family and community
Advocacy efforts to address the circumstances that create these challenges

It is vital that rehabilitation providers see that they have a role across the spectrum of the disease process from acute hospital care to long-term follow-up in the community. When rehabilitation providers are working with people living with HIV, they should consider both the individual’s personal characteristics (e.g., age, gender, economic status), as well as the environment in which they live, socialise and work.

Rehabilitation providers should also, where possible, be involved in advocacy efforts to ensure the efficient and effective provision of rehabilitation services to people living with HIV, particularly those from marginalized groups (e.g., unemployed, people with disabilities). Advocacy efforts can be strengthened by active involvement in community-based research initiatives focusing on rehabilitation for people living with HIV.

This section is organized according to the categories of activity and participation in the World Health Organization’s International Classification of Functioning, Disability and Health (see Section 1.3). Potential causes of these impairments and rehabilitation interventions are shown in the table below.

Table 3.2: Rehabilitation Interventions for Activity Limitations and Participation Restrictions

Activity Limitations and Participation Restrictions	Rehabilitation interventions⁹ (for details, see Section 3.3)
Learning and applying knowledge	Adult-based education programmes Assistive devices Environmental adaptation Provision of visual education materials
General tasks and demands	Energy conservation and pacing Environmental adaptation Exercise prescription – aerobic Exercise prescription – strength Home-based rehabilitation Return to work strategies
Communication	Adaptation of communication environment Articulation, fluency, resonance, language advice and exercises Education on managing conversations and communication Environmental adaptation Psychosocial rehabilitation
Mobility	Assistive devices Community-based rehabilitation Energy conservation and pacing Environmental adaptation Ergonomic interventions Exercise prescription – aerobic Exercise prescription – strength Exercise prescription – stretching and passive movement Home-based rehabilitation
Self-care	Advice on personal hygiene Advice and exercises related to transfers Assistive devices Energy conservation and pacing Environmental adaptation Ergonomic interventions Home-based rehabilitation
Domestic life	Advice on meal preparation and nutrition Assistive devices Energy conservation and pacing Environmental adaptation Home-based rehabilitation
Interpersonal interactions and relationships	Couple counseling Family support groups and parenting programmes Involvement and education of family and friends Psychosocial rehabilitation
Major life areas including work and employment	Education and advice on social grants/employment legislation Energy conservation and pacing Environmental adaptation Ergonomic interventions Extramural education and activities for learners Involvement and education of employers, colleagues and educators Psychosocial rehabilitation School education programmes School feeding programmes
Community, social and civic life	Community-based rehabilitation Education and advice on human rights Energy conservation and pacing Involvement and education of spiritual, political and community leaders

How Rehabilitation Can Help People Living with HIV in sub-Saharan Africa:

An Evidence-Informed Tool for Rehab ProvidersE-Module SSA

3.2 – What are the rehabilitation interventions that can address the activity limitations and participation restrictions common among people living with HIV?

Table 3.2: Rehabilitation Interventions for Activity Limitations and Participation Restrictions