Functioning, disability and health in people living with HIV on antiretroviral therapy in Rwanda

Abstract

The study aimed to explore the need for and nature of care that PLWH living in Rwanda receive from their health care providers using a bio-psychosocial framework. A further aim was to determine if the Kinyawanda version of the World Health Organisation Disability Assessment Schedule 2.0 (WHODAS 2.0), which was used to gather the functional data, was valid within the Rwandan context. A mixed methods approach was used. A quantitative survey was used to determine the profile and the prevalence of disability among PLWH, by measuring impairment, activity limitation and participation restriction amongst PLWH who are also on antiretroviral treatment. In addition the relationship between functioning and medication was explored. A Kinyarwanda version of the ICF core set of questions and the WHODAS 2.0 outcome instrument was used. Face-to-face interviews were conducted among PLWH at 15 selected hospitals representing all provinces in the country. The final sample size included 502 PLWH. Participants‘ health status showed that the longer they had HIV and had been on antiretroviral treatment, the more likely they were to have impairments. Pain (69%) and fatigue (83%) were more prevalent than any other problems found in all domains measured under impairments. Problems with mobility function (57%) scored the highest prevalence under activity limitations, and problems in participation/social functions had the highest prevalence in comparison to the other domains. The mean score of the different domains were significantly different with participation scoring the highest (46%, with 100% the worst score rate)