HIV/AIDS in Physiotherapy Education – Mainstreaming Using UN Principles

Abstract

HIV /AID S remains at epidemic levels in South Africa with onein ten people affected by the HI virus. The United Nations program for AID S(UNAID S) has defined five principles that can be used to mainstream HIV .The five key principles are: the development of a clearly defined entry point;use of existing policies, structures and frameworks; advocacy sensitizationand capacity building; distinguishing between the external (institutionalinterventions) and internal (staff risks and vulnerability) domain; and developingstrategic partnerships. A proposed HIV curriculum for physiotherapists wasbeen developed from a series of studies undertaken to understand the issues related to HIV using the principles ofmainstreaming.The purpose of this paper is to explore how each principle of mainstreaming can be applied in physiotherapyeducation and curricula.Each mainstreaming principle was considered and ways in which it could be mainstreamed into physiotherapytraining and practice, using data from the patients’, academics’ and clinicians’ experience were proposed.The five principles can be used in South African settings. In principle one the aetiology, approaches to treatment,management of conditions and symptoms are used to identify entry points for introducing HIV teaching. Relevantexamples of conditions associated with HIV include pain, stroke, specific muscle weakness patterns, fatigue andcardiopulmonary system problems (e.g. breathlessness). The role of physiotherapy in HIV management is also a goodentry point.For principle two, policies were considered. Pertinent areas such as antiretroviral use, frameworks such as theInternational Classification of Function (ICF), Worthington’s rehabilitation framework and CBR can also be integratedwith HIV physiotherapy curriculum and practice. Sensitised and aware staff as promoted in principle three,can advocate for affected patients and role model appropriate practice and attitudes in HIV management thuscontributing to reducing stigma and burnout. Integrating policies with the need to avoid risks and correct inappropriateattitudes of staff is promoted and promoting strategic partnerships and collaborative work will help provideappropriate services.Using the mainstreaming principles allows for the inclusion of HIV content in physiotherapy education and practice.Both physiotherapy curriculum and continuous professional development may use this information to respondappropriately.