Barriers to addressing HIV-Associated neurocognitive disorder (HAND): Community-based service provider perspectives

About 50% of people living with HIV will develop HIV-associated neurocognitive disorder (HAND) during their lifetime, and we know that cognitive issues are a concern for people living with HIV. However, limited information exists regarding how HAND is managed and coped with, or how cognitive issues are discussed with others, including health care professionals. Following a community-based research approach, we conducted 25 interviews in 2016 aimed to (1) build the capacity of people living with HIV, (2) facilitate participant recruitment and data collection, (3) increase the validity and reliability of our data analysis results, and (4) facilitate knowledge transfer and exchange regarding HAND. After thorough training, we engaged a number of peer researchers living with HAND in the analysis and knowledge transfer and exchange (KTE) phases of the study. This engagement prompted a number of tensions between the clinicians and the peers that we learned to navigate and make productive. We conclude that it is possible to engage patients and providers only if careful attention, time and human resources are provided to navigating the emerging tensions. The outcomes of our study suggest that engaging an interdisciplinary team across multiple sites with PRAs is a valuable method for comprehensively exploring the lived experience of a complex chronic condition such as HAND.

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Can Individualized-Targeted Computerized Cognitive Training Benefit Adults with HIV-Associated Neurocognitive Disorder? The Training on Purpose Study (TOPS)

AIDS and Behavior ◽

10.1007/s10461-021-03230-y ◽

2021 ◽

Author(s):

David E. Vance ◽

Pariya L. Fazeli ◽

Andres Azuero ◽

Virginia G. Wadley ◽

James L. Raper ◽

...

Keyword(s):

Cognitive Training ◽

Neurocognitive Disorder ◽

Computerized Cognitive Training ◽

Hiv Associated Neurocognitive Disorder

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Scaling Up Information Sharing on HIV-Associated Neurocognitive Disorder: Raising Awareness and Knowledge Among Key Stakeholders

SAGE Open ◽

10.1177/21582440211016898 ◽

2021 ◽

Vol 11 (2) ◽

pp. 215824402110168

Author(s):

Renato M. Liboro ◽

Paul A. Shuper ◽

Lori E. Ross

Keyword(s):

Health Care ◽

Information Sharing ◽

Service Providers ◽

Scale Up ◽

People Living With Hiv ◽

Neurocognitive Disorder ◽

Public Health Informatics ◽

Raising Awareness ◽

Hiv Associated Neurocognitive Disorder ◽

Hiv Aids

Although the majority of specialists and researchers in the field of HIV/AIDS are aware and knowledgeable about HIV-associated neurocognitive disorder (HAND) as a condition that affects as much as 50% of people living with HIV/AIDS (PLWH), research has documented that many health care and service providers who work directly with PLWH are either unaware of HAND or believe they do not know enough information about HAND to effectively support their clients experiencing neurocognitive challenges. Based on the findings of a qualitative study that interviewed 33 health care and service providers in HIV/AIDS services to identify and examine their awareness and knowledge on HAND, this article argues for utilizing a combination of Public Health Informatics principles; communication techniques, propagation strategies, and recognized approaches from Implementation and Dissemination Science; and social media and online discussion platforms, in addition to traditional Knowledge Mobilization strategies, to scale up information sharing on HAND among all relevant stakeholders. Increasing information sharing among stakeholders would be an important step to raising awareness and knowledge on HAND, and consequently, improving care, services, and support for PLWH and neurocognitive issues.

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Genetic variation of matrix metalloproteinase enzyme in HIV-associated neurocognitive disorder

Gene ◽

10.1016/j.gene.2019.02.057 ◽

2019 ◽

Vol 698 ◽

pp. 41-49 ◽

Cited By ~ 1

Author(s):

HariOm Singh ◽

Sumitra Nain ◽

Asha Krishnaraj ◽

Sonam Lata ◽

T.N. Dhole

Keyword(s):

Genetic Variation ◽

Matrix Metalloproteinase ◽

Neurocognitive Disorder ◽

Hiv Associated Neurocognitive Disorder

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A qualitative systematic review of service user and service provider perspectives on the acceptability, relative benefits, and potential harms of art therapy for people with non-psychotic mental health disorders

Psychology and Psychotherapy Theory Research and Practice ◽

10.1111/papt.12093 ◽

2016 ◽

Vol 90 (1) ◽

pp. 25-43 ◽

Cited By ~ 8

Author(s):

Alison Scope ◽

Lesley Uttley ◽

Anthea Sutton

Keyword(s):

Mental Health ◽

Systematic Review ◽

Art Therapy ◽

Service Provider ◽

Service User ◽

Mental Health Disorders ◽

Provider Perspectives ◽

Qualitative Systematic Review ◽

Health Disorders

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Effects of a 12-week aerobic exercise programme on HIV-associated neurocognitive disorder in Nigeria: A protocol for randomized controlled trial (Preprint)

10.2196/preprints.29230 ◽

2021 ◽

Author(s):

Martins Nweke ◽

Nombeko Mshunqane ◽

Nalini Govender ◽

Aderonke Akineplu ◽

Adesola Oginniyi

Keyword(s):

Aerobic Exercise ◽

Repeated Measures ◽

Controlled Trial ◽

Exercise Programme ◽

Moderate Intensity ◽

Behavioural Intervention ◽

Neurocognitive Disorder ◽

Neurocognitive Performance ◽

Southeastern Nigeria ◽

Hiv Associated Neurocognitive Disorder

BACKGROUND The introduction of antiretroviral therapy (ART) has led to a drastic fall in the incidence of HIV-associated dementia. However, less severe but limiting forms of HIV-associated neurocognitive disorder (HAND) continues to be prevalent even with the use of ART. Aerobic exercise, a behavioural intervention may be a beneficial and effective complement to ART in the management of HAND. In HIV-negative individuals, aerobic exercise mitigates pathogenic changes similar to those of HAND. OBJECTIVE This protocol describes a randomized clinical trial designed to determine the effect of a 12-week aerobic exercise programme on HAND in Southeastern Nigeria. METHODS A minimum of seventy-six patients diagnosed with HAND will be randomized into aerobic exercise and control groups. Aerobic exercise will be carried out on a stationary bicycle ergometer at moderate intensity, three times a week for 12-weeks. Primary outcomes are neurocognitive performance, CD4-count and viral load. Evaluation of post-exercise neurocognitive performance will be undertaken using reliable neuropsychological tests relevant to PLWHIV, in line with Frascati criteria. Secondary outcomes such as quality of life, and activity limitation and social participation will be assessed using the WHOQOL-Bref, and the Oxford Participation and Activities questionnaire respectively. Data will be subjected to exploratory statistics to test for normality and homogeneity. The effect of the exercise programme on HAND will be analysed using two-way repeated-measures ANOVA, with Bonferroni’s correction. Within-group comparison will be undertaken using paired sampled t-test. RESULTS Enrollment began on 18th January 2021. Recruitment has been completed. The trial is ongoing and will be completed in July 2021 CONCLUSIONS The study will provide valuable information about the effect of aerobic exercise on HAND thus verifying the suitability of aerobic exercise as a complementary therapy for mitigating neurocognitive disorder among PLWHIV. Data from the study will be useful in pursuit of debate on the necessity of a sponsored rehabilitation arm in ART clinics. CLINICALTRIAL The study was registered with the PAN African Trial Registry (PACTR) on the 1stth September 2020. The registration ID is PACTR202009483415745.

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