© Kamla-Raj 2013 J Hum Ecol, 42(2): 135-140 (2013) HIV and AIDS: Its Implication for Physiotherapy Practice and Exercise Prescription Ushotanefe Useh School of Research and Postgraduate Studies, Faculty of Agriculture Science and Technology, North West University, Mafikeng Campus, South Africa E-mail: ushotanefe.useh@nwu.ac.za KEYWORDS Cardiopulmonary Physiotherapy. CD4 Count. Evidence based-Physiotherapy. Rehabilitation. Physiotherapy Curriculum ABSTRACT This paper was a narrative review of evidence-based physiotherapy and its implication for practice. This review reveals that there is a dearth of evidence of the efficacy of physiotherapy in the management of persons living with HIV and AIDS. Exercise prescription in cardiopulmonary therapy was found to be seldom utilised in the care of people with HIV and AIDS in out-patient physiotherapy. The emphasis of care was found to be more on routine chest physiotherapy which included (occasional) suctioning, counseling and health education. Evidence of the efficacy of physiotherapy in the management of people with HIV and AIDS is therefore not conclusive. Physiotherapy for people living with AIDS should be based on evidences which should include medical, physical and psychosocial benefits. It is recommended that the efficacy of physiotherapy intervention be qualitatively and quantitatively evaluated and inclusion of physiotherapy- specific AIDS care was also suggested in the under graduate curriculum. INTRODUCTION HIV poses serious risk to the health of millions around the globe. Despite the decades of research, no cure or vaccine has been found to prevent this disease and the resultant morbidity and mortality. Exercise has been shown to improve strength, car- diovascular function, and physiological status in general population. Safe exercise might improve outcome of adults living with HIV (Bopp et al. 2003; O’Brien et al. 2004; O’ Brien et al. 2009). HIV de- stroys the immune system cells and the body be- comes unable to resist other infections by even low-grade pathogens, giving rise to opportunistic infections. Due to weakened defence mechanisms, symptoms appear alone or severally. According to Loewenson and Whiteside (1997), these include chronic fatigue or weakness, diarrhoea, minor skin infections, respiratory problems, sustained weight loss, persistent swelling of the lymph nodes, dete- rioration of the central nervous system (CNS) which constitutes the cluster of the conditions known as AIDS related complex (ARC). As the weakening of the immune system continues, more severe dis- eases manifest themselves. This invariably degen- erates into serious bouts of illness, which signifi- cantly interfere with work and social life. Once the disease starts interfering with the patient’s func- tions, return to sustained normal health never oc- curs (Loewenson and Whiteside 1997). Some of the complications associated with AIDS require physiotherapy intervention (Dike 1993). Projections from the World Health Organi- sation (WHO) in early 1992 on the expanded dimensions of HIV/AIDS indicated that in the sub-Saharan Africa, more than six million adults would be affected with HIV, while the popula- tion of paediatric cases continue to rise rapidly (Webb 1997). With such alarming projections, the physiotherapists should anticipate that a greater proportion of their workload would be HIV/AIDS related. Pneumocystis carinii pneumo- nia (PCP), previously rare type of pneumonia is the most common respiratory complication of HIV in- fection (McClure 1993; Hills 1998). PCP is a major life threatening illness in patients with AIDS which causes progressive severe hypoxemia and breath- lessness. Dike (1993) reported that respiratory care for person with HIV and AIDS was the area of the greatest perceived risk within the physiotherapy profession due to high prevalence of respiratory complications. Despite the recognition of AIDS about two decades ago, the roles of physiother- apists was not apparent until the early 1990s (McClure 1993). According to McClure, many still perceive the physiotherapist’s role to lie pri- marily in the treatment of respiratory disorders; this multi-system disorder affects patients who may require physiotherapy for a wide range of problems due to respiratory, neurological, mus- culoskeletal and pain syndromes as well as gen- eral decline in fitness and functions. Physiother- apists living or working in areas with a low prev-