Rehabilitation and Quality of Life for Aging People Living With HIV: Addressing Multimorbidity and Stigma

With the advent and regular use of Highly Active Antiretroviral Therapy (HAART), Human Immunodeficiency Virus (HIV) has transitioned from a terminal illness to a chronic disease, leading to an aging population of people with HIV (PWH). By 2030, it is estimated that 70% of PWH will be over the age of 50, presenting new challenges related to frailty, neurocognitive impairment, musculoskeletal conditions, and functional decline.¹ Despite medical advancements, HIV-related stigma remains a major barrier to healthcare, particularly in rehabilitation services. This article explores the historical evolution of HIV rehabilitation, the impact of chronic HIV on physical and cognitive function, the role of stigma, and the latest evidence-based rehabilitation interventions. Additionally, it highlights HIV-related pathologies relevant to physiatry, including neuromuscular complications, musculoskeletal disorders, HAND (HIV-associated neurocognitive disorder), stroke, and neurorehabilitation strategies. As the clinical trajectory of HIV increasingly mirrors that of other chronic, disabling conditions, the integration of HIV-specific rehabilitation into physiatric practice, education, and research is not only appropriate, but essential to advancing equitable, comprehensive care.