Neurocognitive disorders and HIV

Background and aim: Thanks to the development of effective treatment, HIV is now considered a chronic illness. People are now living longer on antiretroviral medication and living with HIV for decades. Although the prognosis has greatly improved for the health and life expectancy of people living with HIV, there continue to be complications, including HIV-associated neurocognitive disorder (HAND). This meta-synthesis aims to explore the experiences of people with HIV and cognitive difficulties and how they manage these conditions.

Method: A systematic literature search was conducted. 15 qualitative and mixed-method studies were included in the review, assessed for quality using the CASP criteria, and analysed using thematic analysis.

Results: The review resulted in five meta-themes and nineteen subthemes. These themes included details of people’s experiences with cognitive difficulties and HIV, seeking to understand these cognitive changes, and their emotional and psychological responses to these new difficulties. The themes also expand on how people manage living with cognitive challenges, including how they adjust their daily lives and their social support.

Conclusions: The findings provide an initial understanding of some experiences of PLWHIV experiencing cognitive difficulties, including cognitive challenges, emotional and social impacts, and ways of coping. Limitations included the overrepresentation of Western samples and lack of author reflexivity in a majority of the selected studies. Future research and clinical practice implications are discussed.