Advancing Research and Practice in HIV And Rehabilitation

Abstract and Introduction

Abstract

Background HIV increasingly is experienced as a complex chronic illness where individuals are living longer with a range of physical, cognitive, mental and social health-related challenges associated with HIV, comorbidities and aging, a concept that may be termed 'disability'. Rehabilitation such as physical therapy and occupational therapy can help address disability and has the potential to improve quality of life in people living with HIV. Hence, the role for rehabilitation in the context of HIV, aging and comorbidities is emerging. Our aim was to establish a framework of research priorities in HIV, disability and rehabilitation.

Methods We convened people living with HIV, clinicians, researchers, service providers, representatives from community-based organizations and policy and funding stakeholders to participate in the first International Forum on HIV and Rehabilitation Research. We conducted a multi-stakeholder consultation to identify current and emerging issues in HIV, disability and rehabilitation. Data were collated and analyzed using content analytical techniques.

Results Ninety-two participants attended the Forum from Canada, United Kingdom (UK), Ireland and the United States. Situated within three overarching themes (episodic health and disability across the life course; rehabilitation; and methodological advances), the Framework of Research Priorities in HIV, Disability and Rehabilitation includes six research priorities: 1) episodic health and disability; 2) aging with HIV across the life course; 3) concurrent health conditions; 4) access to rehabilitation and models of rehabilitation service provision; 5) effectiveness of rehabilitation interventions; and 6) enhancing outcome measurement in HIV and rehabilitation research. The Framework includes methodological considerations and environmental and personal contextual factors (or lenses) through which to approach research in the field. Knowledge translation should be implemented throughout the development and application of research knowledge to inform HIV clinical practice, programming and policy.

Conclusions These priorities highlight the emerging priorities of living long-term with HIV and outline a plan for HIV and rehabilitation research in resource-rich countries such as the UK and Canada.

Authors and Disclosures

Kelly K O'Brien^1,2,3*†, Francisco Ibáñez-Carrasco^4†, Patricia Solomon³, Richard Harding⁵, Jessica Cattaneo⁶, William Chegwidden^7,8, Jacqueline Gahagan⁹, Larry Baxter¹⁰, Catherine Worthington¹¹, Patriic Gayle¹², Brenda Merritt¹³, Rosalind Baltzer-Turje¹⁴, Nkem Iku¹ and Elisse Zack¹⁰

¹Department of Physical Therapy, University of Toronto, 500 University Avenue, Room 160, Toronto, ON, Canada. ²Institute of Health Policy, Management and Evaluation, University of Toronto, 4th Floor, 155 College Street, Toronto, ON, Canada. ³School of Rehabilitation Science, McMaster University, 1400 Main Street West, Room 403, Hamilton, ON, Canada. ⁴Ontario HIV Treatment Network, 1300 Yonge Street, Suite 600, Toronto, ON, Canada. ⁵Cicely Saunders Institute, School of Medicine, King's College London, Bessemer Road, London, United Kingdom. ⁶AIDS Committee of Toronto, 399 Church Street, 4th Floor, Toronto, ON, Canada. ⁷Barts and the London NHS Trust, London, United Kingdom. ⁸University College Hospitals NHS Foundation Trust, London, United Kingdom. ⁹School of Health and Human Performance, Dalhousie University, Stairs House, 6230 South Street, Halifax, NS, Canada. ¹⁰Canadian Working Group on HIV and Rehabilitation, 600 Bay Street, Suite 600, Toronto, ON, Canada. ¹¹School of Public Health and Social Policy, University of Victoria, Human and Social Development Building, 3800 Finnerty Road, Victoria, BC, Canada. ¹²Three Flying Piglets, London, United Kingdom. ¹³School of Occupational Therapy, Dalhousie University, Forrest Building, Room 215, 5869 University Avenue, Halifax, NS, Canada. ¹⁴Dr. Peter AIDS Foundation, 1110 Comox Street, Vancouver, BC, Canada

^†Equal contributors

Competing interests
The authors declare that they have no competing interests.

Authors' contributions
KKO and FIC led the conceptualization, planning and implementation of the Forum. KKO and JC led the analysis and established a preliminary Framework which was refined by PS, JC, RH, NI, LB and WC. PG filmed and edited the Forum sessions for translation on the Canadian Working Group on HIV and Rehabilitation (CWGHR) Knowledge and Translation (KTE) Library. KKO drafted the original manuscript. EZ was the principle knowledge user and advised on the overall translation of the research priorities via the Canadian Working Group on HIV and Rehabilitation. All authors are members of the Canada-UK HIV and Rehabilitation Research Collaborative (CUHRRC) involved in the Forum planning and implementation. All authors read and approved the final manuscript.