Learning Objective #1: Understand the relation between injection drug use and CVI in persons with HIV/AIDS

Learning Objective #2: Examine ankle joint changes in HIV/AIDS persons dependent upon illicit drug use

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Injection drug use is associated with the development of human immunodeficiency virus (HIV)/acquired immunodeficiency disorder (AIDS) as well as other health problems, one of which is chronic venous insufficiency (CVI). CVI is a chronic and debilitating condition of the lower extremities. The purpose of this study was to examine ankle joint mobility and CVI in HIV/AIDS persons with and without a history of injection drug use. The significance to nursing is that for person with HIV/AIDS, CVI adds an additional complication that may go undiagnosed resulting in untreated mobility limitations and pain. The study was based on the physiological theoretical framework of the functional relationship between the muscle-joint unit activity and intact venous valves of the lower leg. A cross-sectional design with quota sampling was used. The sample, recruited from an infectious diseases clinic, included 36 men and 37 women, mean age 45.8 years (SD = 7.6); 93% were African American. There were 47 injection drug users and 26 non-injection drug users. The mean duration of HIV/AIDS was 9.55 years, SD = 4.40. The instruments included a goniometry for ankle joint measurements. Structured interviews were conducted individually followed by the leg and joint assessments. Findings: Those who used injected drugs had significantly higher CVI classifications, less inversion-eversion motion of the ankle joints, and less flexion-extension of the ankle joint than those who did not inject drugs. Neither the presence of peripheral neuropathies nor the years diagnosed with HIV/AIDS affected these findings. Conclusions: Injection drug use decreased motion of the ankle joint and increased the severity of CVI.