Can patients and their caregivers boost identification of HIV associated neurocognitive disorder (HAND)?
HIV associated neurocognitive disorder (HAND) may be difficult to identify as signs and symptoms (S&S) are nonspecific. Objective To ascertain whether people living with HIV and their caregivers using a self reflective tool could identify S&S of HAND. Design This study was a nurse led prospective observational multi-site study using a quantitative design. Setting Participants were recruited from three sites in Sydney, New South Wales (NSW), Australia: an inner metropolitan HIV clinic, an inner metropolitan sexual health clinic and a suburban hospital HIV clinic. Subjects 121 patients and 44 caregivers who attended ambulatory clinics providing HIV care. Main Outcome Measures Observing usual standard of care to follow patients who had formal neuropsychological testing and diagnosis of HAND. Results Sixty one percent of participants and 57% of caregivers identified more than four symptoms. Sixteen had neuropsychological exams; five were diagnosed with HAND. After changes to their medication regime all of those five showed an improvement in cognition. Of the remaining 11, four results were inconclusive, with some deficits noted. Conclusion Patients and caregivers stated the booklet helped them to reflect on behavior changes which they could subsequently discuss with their doctor. The booklet was considered useful to identify S&S which could indicate HAND.