Disability and Health Outcomes – From A Cohort of People On Long Term ART - Disability and Health Outcomes – From A Cohort of People On Long Term ART - Open Access Pub

HIV and AIDS remains a major health problem in South Africa even after two decades since the introduction of antiretroviral therapy. Long term survival with HIV is associated with new health related issues and a risk of functional limitation/disability. The aim of this study was to assess the impact and predictors of functional limitation associated with HIV/AIDS among people living with HIV (PLHIV) in South Africa. This study is a cross-sectional survey using a cohort in an urban area in Gauteng province South Africa. Questionnaires that were interview administered were used to collect information on demographics, disability, mental and physical health state, adherence and livelihood. A total of 1044 participants with an average age of 42±12 years, were included in the study and 51.9% of the participants reported functional limitation (WHODAS ≥ 2). These were reported mainly in the participation (40.2%) and mobility domains (38.7%). In addition, adherence to ARV, physical health symptoms and depression were strongly associated with functional limitations/disability. HIV as a chronic disease is associated with functional limitations that are not addressed and pose a risk of long term disability and negative adherence outcomes. Therefore, wellness for people living with HIV/AIDS (PLHIV) needs to include interventions that can prevent and manage disability. DOI 10.14302/issn.2324-7339.jcrhap-17-1430 Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) remain key priority health areas in HIV-endemic countries in spite of its thirty year trajectory 1. An estimated 7,000,000 people were living with HIV in South Africa in the year 2015 2. Due to life saving antiretroviral treatment (ART) more people survive. As a result, the focus of HIV management has shifted in recent years from that of a deadly disease towards managing a chronic condition 3. Managing chronicity requires a move towards a more integrated approach of treatment, care and support that includes rehabilitation in the continuum of care 3, 4, 5. There is similarity in this approach with the systems thinking proposed by Valdiserri in his call for improved focus on demographic and epidemiological data in order to develop high quality systems of care 1. There is very little understanding of the long term health outcomes of living with chronic HIV in Africa and the related services needed to manage associated health needs after long periods on ART 3, 4, 6. Co morbidities such as TB, cancer and depression have already received some attention 7, 8, 9. We have even less