title: HIV/AIDS: use of the ICF in Brazil and South Africa--comparative data from four cross-sectional studies.
abstract: BACKGROUND
  Human immunodeficiency virus (HIV) is a serious disease which can be associated with various activity limitations and participation restrictions. The aim of this paper was to describe how HIV affects the functioning and health of people within different environmental contexts, particularly with regard to access to medication.
  
  
  METHODS
  Four cross-sectional studies, three in South Africa and one in Brazil, had applied the International Classification of Functioning, Disability and Health (ICF) as a classification instrument to participants living with HIV. Each group was at a different stage of the disease. Only two groups had had continuing access to antiretroviral therapy. The existence of these descriptive sets enabled comparison of the disability experienced by people living with HIV at different stages of the disease and with differing access to antiretroviral therapy.
  
  
  RESULTS
  Common problems experienced in all groups related to weight maintenance, with two-thirds of the sample reporting problems in this area. Mental functions presented the most problems in all groups, with sleep (50%, 92/185), energy and drive (45%, 83/185), and emotional functions (49%, 90/185) being the most affected. In those on long-term therapy, body image affected 93% (39/42) and was a major problem. The other groups reported pain as a problem, and those with limited access to treatment also reported mobility problems. Cardiopulmonary functions were affected in all groups.
  
  
  CONCLUSIONS
  Functional problems occurred in the areas of impairment and activity limitation in people at advanced stages of HIV, and more limitations occurred in the area of participation for those on antiretroviral treatment. The ICF provided a useful framework within which to describe the functioning of those with HIV and the impact of the environment. Given the wide spectrum of problems found, consideration could be given to a number of ICF core sets that are relevant to the different stages of HIV disease.
authors.affiliation: Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Park Town 2093, Johannesburg, South Africa. hellen.myezwa@wits.ac.za
authors.forename: H
authors.initials: H
authors.lastname: Myezwa
authors.forename: C M
authors.initials: CM
authors.lastname: Buchalla
authors.forename: J
authors.initials: J
authors.lastname: Jelsma
authors.forename: A
authors.initials: A
authors.lastname: Stewart
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000523:psychology; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D026761:Physical Therapy Specialty / Q000379:methods*; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology
chemical_list: D044966:Anti-Retroviral Agents