World AIDS Day: Physiotherapy's Evolving Role

On World AIDS Day, it's worth reflecting on how dramatically the landscape of HIV care has changed. When I began my career, HIV was often a terminal diagnosis. Today, thanks to antiretroviral therapy, people living with HIV can expect a near-normal life expectancy. This remarkable progress has fundamentally changed what physiotherapists like myself can offer: we're no longer managing end-stage complications but supporting long, active lives.

However, longevity brings new challenges. People living with HIV now face similar age-related conditions as the general population, but often earlier and with additional complexities. The evidence shows increased rates of osteoporosis, cardiovascular disease, peripheral neuropathy, and musculoskeletal pain in this population. This is where physiotherapy becomes increasingly relevant.

Bone health requires attention 

Both HIV itself and some antiretroviral medications can affect bone density. Weight-bearing exercise and resistance training are proven interventions for maintaining bone health and reducing fracture risk. We design programmes that are safe, progressive, and sustainable for the long term.

Peripheral neuropathy is common 

HIV-associated neuropathy affects up to 50% of people living with HIV, causing pain, numbness, and balance problems. Physiotherapy can help manage symptoms through specific exercises, gait training, and falls prevention strategies. We also advise on appropriate footwear and home safety modifications.

Cardiovascular fitness matters more than ever 

With HIV no longer limiting life expectancy, cardiovascular disease has become a leading cause of mortality in this population. Regular aerobic exercise reduces cardiovascular risk factors and improves overall health outcomes. The key is finding activities that people enjoy and will maintain.

Chronic pain needs addressing

Research indicates that chronic pain is significantly more prevalent in people living with HIV than in the general population. As physiotherapists, we take a holistic approach—combining manual therapy, exercise, pain education, and self-management strategies to improve function and quality of life.

Strength and function preservation is crucial

Some people living with HIV experience accelerated muscle loss and frailty. Resistance training, even at modest intensities, can preserve muscle mass, improve functional capacity, and maintain independence.

What's become clear through the evidence and my clinical experience is that people living with HIV benefit from the same physiotherapy interventions as anyone else—but they may need them sooner and require more careful monitoring. There's nothing inherently different about treating someone with HIV; universal precautions protect everyone, and the therapeutic relationship is built on the same foundations of trust, respect, and collaboration.

On World AIDS Day, I want people living with HIV to know that physiotherapy has much to offer in maintaining your health, function, and independence throughout a long life. Musculoskeletal problems, pain, or reduced fitness aren't inevitable and certainly aren't something to simply endure.

Can Physiotherapy Help You?

To find out how we can help with physiotherapy or treatment for neurological conditions such as Parkinson's or stroke, In-clinic or with home visit physiotherapy, contact the team now to arrange your first appointment.