Title

Assessing Risk of HIV Associated Neurocognitive Disorder

Document Type

Article

Publication details

Cummins, D, Waters, D, Aggar, C & O'Connor CC, In press, 'Assessing risk of HIV associated neurocognitive disorder, Nursing Research.


Abstract

BACKGROUND: People with HIV (PLHIV) are aging and 20% are at risk of developing a neurological complication known as HIV associated neurocognitive disorder (HAND). Signs and symptoms of HAND may be subtle, however treatment can improve clinical outcomes.

OBJECTIVE: To identify and agree on a risk assessment and monitoring process for the regular review of patients at risk of HIV associated neurocognitive disorder.

METHODS: Between March and September 2017, 25 experts from 4 community health care services participated in 3 rounds of a modified Delphi study to reach consensus on the items, monitoring period and format of assessment tools to identify risk of HAND in people living with HIV in the community.

RESULTS: More than 80% consensus was reached at all three Delphi rounds. A flow chart, initial assessment and annual monitoring tool were developed for ongoing assessment of risk of developing HAND.

CONCLUSION: Twenty per cent (20%) of PLHIV may develop HAND, a treatable condition. The use of a modified Delphi method led to the successful development of two risk assessment tools to identify those at risk of HAND. The initial assessment tool may be used as a precursor to formal assessment by medical and nursing staff, while the annual monitoring tool may assist community-based health professionals in their ongoing assessment of risk of HAND in PLHIV, facilitating early formal medical review for this condition.

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