title: HIV-related disabilities: an extra burden to HIV and AIDS healthcare workers?
abstract: BACKGROUND
  Healthcare workers have been at the forefront of dealing with the impact of HIV and AIDS at all stages of the pandemic. This brings new challenges to include disability into HIV care. However, the implications for healthcare workers in an already fragile health system along with HIV-related disabilities in persons living with HIV are little understood. This study examined the healthcare workers' perspective on disability in HIV care.
  
  
  METHODS
  This article describes a qualitative study using in-depth interviews with 10 healthcare workers in a semi-urban hospital setting in KwaZulu-Natal, South Africa. The study aimed to understand healthcare workers' experiences with disability in the context of HIV. The International Classification of Functioning Disability and Health (ICF) was used as a guiding framework to understand disability.
  
  
  RESULTS
  Healthcare workers described HIV-related disabilities on all three levels of disability, namely impairments/ body function, activity limitations and participation restrictions, as affecting the livelihood of their patients and household members. Issues also arose from disability and stigma that were perceived as affecting adherence to antiretroviral treatment. In addition, healthcare workers encounter challenges in dealing with the increased needs of care and support for those people living with HIV who experience HIV-related disabilities. They indicated a limited ability to cope and respond to these needs. Primarily they arrange additional referrals to manage complex or episodic disabilities. Participants also identified issues such as excessive work load, lack of resources and training and emotional challenges in dealing with disability.
  
  
  CONCLUSIONS
  Healthcare workers need support to respond to the increased needs of people living with HIV who have HIV-related disabilities. Responses need to reflect: 1) increase in rehabilitative staff including in community outreach programmes; 2) skills training in HIV-related disability; and 3) psychosocial support for healthcare workers.
authors.affiliation: a Health Economics and HIV/AIDS Research Division (HEARD) , University of KwaZulu-Natal , South Africa.|b VU University , Amsterdam , The Netherlands.
authors.forename: Leonie
authors.initials: L
authors.lastname: van Egeraat
authors.affiliation: b VU University , Amsterdam , The Netherlands.
authors.forename: Jill
authors.initials: J
authors.lastname: Hanass-Hancock
authors.affiliation: c University of the Witwatersrand , Johannesburg , South Africa.
authors.forename: Hellen
authors.initials: H
authors.lastname: Myezwa
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000523:psychology; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006233:Persons with Disabilities / Q000523:psychology*; D004644:Emotions; D005069:Evaluation Studies as Topic; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012944:Social Support; D013019:South Africa; D055815:Young Adult
keywords: ICF framework; disability; health care provider perspective