Fall history and associated factors among adults living with HIV-1 in the Cape Winelands, South Africa : an exploratory investigation
Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
Oxford University Press
Abstract
Background. People with HIV-1 (PWH) exhibit a high fall incidence and increased fracture risk. As little is known about fall
frequency and associated factors in PWH residing in lower-middle-income countries (LMIC), we investigated fall frequency, bone
quality, and factors associated with fall history in a South African cohort.
Methods. Fifty PWH without obvious predisposing factors for mobility impairments attending 2 public primary care clinics in
the Western Cape region participated. Demographic, clinical, and physical performance data were collected. Falls were assessed retrospectively
over 12 months. Mobility and balance were evaluated using a physical performance battery. Bone mineral density was
screened using quantitative ultrasound (QUS). Associations between variables and falls grouping were analyzed using chi-square
tests, t tests, and Mann-Whitney U tests, and effect sizes (ES) were calculated.
Results. Thirty-four percent of PWH (median age, 36.6 years) reported falling during the past year, and 41.2% of fallers reported
multiple falls. Fallers had more mobility problems (P = .013), higher fear of falling (P = .007), higher fracture history (P = .003),
worse balance performance (P < .001), higher proportions of detectable viral loads (P = .021), and poorer bone quality (P = .040).
Differences were of medium to large ES.
Conclusions. This exploratory study is the first to show that relatively young South African PWH without obvious predisposing
factors for gait and balance impairments experience falls. The observed fall-associated factors warrant further research using larger
samples and longitudinal designs to ascertain fall predictors within this population.
Description
CITATION: Berner, K., et al. 2019. Fall history and associated factors among adults living with HIV-1 in the Cape Winelands, South Africa : an exploratory investigation. Open Forum Infectious Diseases, 6(10):ofz401, doi:10.1093/ofid/ofz401.
The original publication is available at https://academic.oup.com/ofid
Publication of this article was funded by the Stellenbosch University Open Access Fund.
The original publication is available at https://academic.oup.com/ofid
Publication of this article was funded by the Stellenbosch University Open Access Fund.
Keywords
Bone quality, Falls (Accidents) -- Boland (South Africa), HIV-positive persons -- Boland (South Africa)
Citation
Berner, K., et al. 2019. Fall history and associated factors among adults living with HIV-1 in the Cape Winelands, South Africa : an exploratory investigation. Open Forum Infectious Diseases, 6(10):ofz401, doi:10.1093/ofid/ofz401