Perceptions, Challenges, and Operational Bottlenecks in Electronic Vaccine Intelligence Network Implementation: A Qualitative Study Among Immunization Stakeholders in Indore District, India.

People living with HIV (PLWH) are at a higher risk for falls at a younger age than those without HIV. In one study, 30% of PLWH between 45 and 65 years of age experienced at least one fall in the past year and over 18% had multiple falls (). This rate is comparable to older adults’ fall rate of 25% to 30% () and is associated with serious outcomes. Owing to reasons related to HIV infection, medications, and comorbid conditions (), PLWH experience health consequences common in older people at a younger age including frailty (), deficits in motor function (), and in cognition, which may drive fall risk whether or not a person is living with HIV (, ). Recurring falls are more likely in PLWH who are frail and more frequent among those with poor balance, gait, and endurance (). There are several factors that increase fall risk for PLWH. Heavy alcohol use is associated with a 1.3 times greater likelihood of a fall (). Other contributors include polypharmacy (), illicit drug use (), medical conditions (e.g., diabetes, neuropathy) (), and mental health conditions (e.g., depression) (). The focus of fall prevention for PLWH has been on addressing mediators of fall risk () with a lack of relevant occupational therapy (OT) literature on the topic. Exercise interventions improve aerobic capacity () and strength (), but data on the impact of exercise interventions on fall risk in PLWH is limited. It is not clear whether fall prevention interventions effective in geriatric populations without HIV are generalizable to PLWH. Also, interventions requiring specific equipment such as weight machines are often not accessible. It is also unknown how to address alcohol to prevent falls. Effective yet practical fall prevention interventions are needed for PLWH that are customized to their needs.