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Ranuschio B, Bell S, Flatt JD, Barnes L, Puno T, Ribeiro A, Sheik-Yosef N, Villalobos E, Wackens J, Liboro RM. A Focus on Aging, HIV/AIDS, and Neurocognitive Challenges: Examining Southern Nevada HIV Sector Providers' Awareness and Prospective Roles. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6876. [PMID: 37835146 PMCID: PMC10572135 DOI: 10.3390/ijerph20196876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 09/24/2023] [Accepted: 09/30/2023] [Indexed: 10/15/2023]
Abstract
Although abundant research has been carried out to investigate the underlying mechanisms that may cause neurocognitive challenges among middle-aged and older people living with HIV/AIDS (PLWH), to monitor the prevalence rates of HIV-related neurocognitive deficits, and to identify factors related to the improvement of diagnostic screening tools, classification and nosology, and clinical and rehabilitative treatment of HIV-Associated Neurocognitive Disorder (HAND); to date, there have been only a few studies that have explored and examined the awareness and work experiences HIV sector healthcare and service providers have related to HAND. To address this research gap, we conducted a qualitative, community-based participatory research study and interviewed 12 HIV sector providers in Southern Nevada, USA, from January to April 2022. After performing a thematic analysis of our interviews, we were able to identify two major themes and several sub-themes. Under our first major theme, provider awareness and knowledge, we identified four sub-themes: (1) prior knowledge and current awareness; (2) lived experiences of patients and clients with neurocognitive challenges; (3) lack of knowledge as a barrier to providing needed care; and (4) continuing education and professional development. Under our second major theme, prospective provider roles, we identified three sub-themes: (1) early detection; (2) direct and practical support; and (3) appropriate and timely referrals. In this article, we discuss our findings and lessons learned from our study, as well as their implications for the future work of researchers and providers in the HIV sector related to improving care and support for people aging with HIV/AIDS and experiencing neurocognitive challenges.
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Affiliation(s)
- Brandon Ranuschio
- Department of Psychology, College of Liberal Arts, University of Nevada, Las Vegas, NV 89154, USA; (B.R.); (S.B.); (L.B.); (T.P.); (A.R.); (N.S.-Y.); (E.V.); (J.W.)
| | - Sherry Bell
- Department of Psychology, College of Liberal Arts, University of Nevada, Las Vegas, NV 89154, USA; (B.R.); (S.B.); (L.B.); (T.P.); (A.R.); (N.S.-Y.); (E.V.); (J.W.)
| | - Jason D. Flatt
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89154, USA;
| | - Lianne Barnes
- Department of Psychology, College of Liberal Arts, University of Nevada, Las Vegas, NV 89154, USA; (B.R.); (S.B.); (L.B.); (T.P.); (A.R.); (N.S.-Y.); (E.V.); (J.W.)
| | - Trinity Puno
- Department of Psychology, College of Liberal Arts, University of Nevada, Las Vegas, NV 89154, USA; (B.R.); (S.B.); (L.B.); (T.P.); (A.R.); (N.S.-Y.); (E.V.); (J.W.)
| | - Alexander Ribeiro
- Department of Psychology, College of Liberal Arts, University of Nevada, Las Vegas, NV 89154, USA; (B.R.); (S.B.); (L.B.); (T.P.); (A.R.); (N.S.-Y.); (E.V.); (J.W.)
| | - Nadia Sheik-Yosef
- Department of Psychology, College of Liberal Arts, University of Nevada, Las Vegas, NV 89154, USA; (B.R.); (S.B.); (L.B.); (T.P.); (A.R.); (N.S.-Y.); (E.V.); (J.W.)
| | - Esmeralda Villalobos
- Department of Psychology, College of Liberal Arts, University of Nevada, Las Vegas, NV 89154, USA; (B.R.); (S.B.); (L.B.); (T.P.); (A.R.); (N.S.-Y.); (E.V.); (J.W.)
| | - Janelle Wackens
- Department of Psychology, College of Liberal Arts, University of Nevada, Las Vegas, NV 89154, USA; (B.R.); (S.B.); (L.B.); (T.P.); (A.R.); (N.S.-Y.); (E.V.); (J.W.)
| | - Renato M. Liboro
- Department of Psychology, College of Liberal Arts, University of Nevada, Las Vegas, NV 89154, USA; (B.R.); (S.B.); (L.B.); (T.P.); (A.R.); (N.S.-Y.); (E.V.); (J.W.)
- Centre for Addiction and Mental Health, Toronto, ON M5S 2S1, Canada
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Alford K, Daley S, Banerjee S, Vera JH. Quality of life in people living with HIV-associated neurocognitive disorder: A scoping review study. PLoS One 2021; 16:e0251944. [PMID: 34010362 PMCID: PMC8133427 DOI: 10.1371/journal.pone.0251944] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/05/2021] [Indexed: 02/07/2023] Open
Abstract
Quality of life (QoL) is recognized as an essential end point in the disease management of chronic conditions such as HIV with calls to include good QoL as a ‘fourth 90’ in the 90-90-90 testing and treatment targets introduced by World Health Organization in 2016. Cognitive impairments impact a broad spectrum of experiences and are a common issue effecting people living with HIV (PLWH). Despite this, few studies have examined QoL in PLWH who also have a cognitive disorder. This study aimed to synthesize and describe what is known about QoL in those living with HIV-associated neurocognitive disorders (HAND). A scoping review of peer-reviewed literature was conducted to identify how QoL has been investigated and measured in PLWH with HAND, and how PLWH with HAND report and describe their QoL. We searched PsychInfo, Medline, Scopus, and Web of Science along with hand-searching reference lists from relevant studies found. Included studies were those published in English after 1st January 2003 which included PLWH with cognitive impairment not due to other pre-existing conditions. Fifteen articles met criteria for inclusion. Two studies measured QoL as a primary aim, with others including QoL assessment as part of a broader battery of outcomes. The MOS-HIV and SF-36 were the most commonly used measures of overall QoL, with findings generally suggestive of poorer overall QoL in PLWH with HAND, compared to PLWH without cognitive impairment. Studies which examined dimensions of QoL focused exclusively on functionality, level of independence, and psychological QoL domains. There is a considerable dearth of research examining QoL in PLWH with HAND. The initiatives which advocate for healthy aging and improved QoL in PLWH must be extended to include and understand the experiences those also living with cognitive impairment. Research is needed to understand the broad experiential impacts of living with these two complex, chronic conditions, to ensure interventions are meaningful to patients and potential benefits are not missed.
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Affiliation(s)
- Kate Alford
- Department of Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Falmer, East Sussex, United Kingdom
- * E-mail:
| | - Stephanie Daley
- Centre for Dementia Studies, University of Sussex, Falmer, East Sussex, United Kingdom
| | - Sube Banerjee
- Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Jaime H. Vera
- Department of Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Falmer, East Sussex, United Kingdom
- Department of Medicine, Brighton and Sussex Medical School, University of Sussex, Falmer, East Sussex, United Kingdom
- Brighton and Sussex University Hospitals NHS Trust, Brighton, East Sussex, United Kingdom
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Eaton AD, Walmsley SL, Craig SL, Rourke SB, Sota T, McCullagh JW, Fallon BA. Protocol for a pilot randomised controlled trial evaluating feasibility and acceptability of cognitive remediation group therapy compared with mutual aid group therapy for people ageing with HIV-associated neurocognitive disorder (HAND) in Toronto, Canada. BMJ Open 2019; 9:e033183. [PMID: 31676660 PMCID: PMC6830703 DOI: 10.1136/bmjopen-2019-033183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION HIV-associated neurocognitive disorder (HAND) may affect 30%-50% of people ageing with HIV. HAND may increase stress and anxiety, and impede coping. Psychosocial group therapy may ameliorate HAND's symptoms, yet the ideal intervention is unclear. This protocol outlines a pilot randomised controlled trial (RCT)-designed using community-based participatory research-to pilot cognitive remediation group therapy (CRGT) against an active comparator. METHODS AND ANALYSIS This is a pilot, parallel design, two-arm RCT that will recruit participants diagnosed with the mild neurocognitive disorder form of HAND from a neurobehavioural research unit at a tertiary care hospital in Toronto, Canada. Eligibility criteria include age ≥40 years, known HIV status for 5+ years, English fluency, able to consent and able to attend 8 weeks of group therapy. Eligible participants will be randomised to one of two treatment arms, each consisting of eight-session group interventions delivered once weekly at 3 hours per session. Arm 1 (novel) is CRGT, combining mindfulness-based stress reduction with brain training activities. Arm 2 (active control) is mutual aid group therapy. The primary outcomes are feasibility, measured by proportions of recruitment and completion, and acceptability, determined by a satisfaction questionnaire. The secondary outcome is intervention fidelity, where content analysis will be used to assess facilitator session reports. A between-group analysis will be conducted on exploratory outcomes of stress, anxiety, coping and use of intervention activities that will be collected at three time points. ETHICS AND DISSEMINATION Ethical approval was obtained from the Research Ethics Boards of St. Michael's Hospital and the University of Toronto. Findings will be disseminated through peer-reviewed publications, conference presentations and community reporting. This study could provide insight into design (eg, recruitment, measures) and intervention considerations (eg, structure, content) for a larger trial to lessen the burden of cognitive decline among people ageing with HIV. TRIAL REGISTRATION NUMBER NCT03483740; Pre-results.
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Affiliation(s)
- Andrew David Eaton
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Sharon L Walmsley
- Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Shelley L Craig
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Sean B Rourke
- Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Teresa Sota
- Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada
| | | | - Barbara A Fallon
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
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