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

Abstract

HIV-Associated Neurocognitive Disorder (HAND) is an emergent public health issue in developed countries. Consequently, people living with HIV who experience HAND will increasingly require support from community-based HIV service providers. The objective of our qualitative study was to identify barriers service providers face in addressing HAND among people living with HIV. Thirty-three providers from 22 AIDS service organizations across Ontario, Canada, were interviewed. Using thematic analysis, three types of barriers were identified: (a) personal/ professional, (b) service access, and (c) systemic. This paper draws attention to HAND-related obstacles that service providers encounter in their work and presents options to overcome them.

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

“…This makes social media and online discussion platforms potentially ideal tools to be utilized for scaling up HAND information sharing in addition to traditional Knowledge Mobilization tools that have been conventionally used to provide unidirectional communication of specific messages from scholars and experts to knowledge users (Iribarren et al, 2018;Noble et al, 2017). Case in point, in our own research study, none of the 33 community-based health care and service providers we interviewed who were aware of and had some knowledge about HAND obtained their information from social media and online discussion platforms; their awareness and knowledge on HAND were exclusively gained from more traditional sources such as conference and community presentations, fact sheets and information brochures, and AIDS service organization websites (Liboro et al, 2017(Liboro et al, , 2018(Liboro et al, , 2019. Some studies have proposed that social media and online discussion platforms could be utilized as viable alternatives to traditional Knowledge Mobilization tools because unlike social media and online discussion platforms, traditional Knowledge Mobilization tools may not comprehensively cover current influential factors and trends present in the community by the time they disseminate information (Hannaford et al, 2018;Noble et al, 2017).…”

Strategies Employed by Community-Based Service Providers to Address HIV-Associated Neurocognitive Challenges: A Qualitative Study

“…The protocol utilized open-ended questions to (a) explore participants’ work experiences related to clients’ neurocognitive issues, (b) determine participants’ familiarity with HAND, (c) examine obstacles participants experienced as they addressed clients’ neurocognitive issues, and (d) identify strategies they employed to support these clients. In the subsequent discussion of the study’s findings and analysis, however, this article specifically focused on data related to strategies enacted by providers to address HIV-associated neurocognitive challenges experienced by their clients, as the other study findings have been analyzed and discussed in previous publications 24–26 (eg, providers’ work experiences; familiarity, education, and training related to HAND; barriers to addressing HAND).…”

“…Our research on the work and lived experiences and perspectives of community-based service providers in the HIV sector shows that there are distinctly identifiable strategies that service providers have been using to address HIV-associated neurocognitive challenges experienced by their clients; strategies that could potentially be tested and proven useful by further investigation, and later, incorporated in HIV sector service provision policy and practice. of the study's findings and analysis, however, this article specifically focused on data related to strategies enacted by providers to address HIV-associated neurocognitive challenges experienced by their clients, as the other study findings have been analyzed and discussed in previous publications [24][25][26] (eg, providers' work experiences; familiarity, education, and training related to HAND; barriers to addressing HAND).…”

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

“…With the earlier age of impairment and syndemic factors associated with HIV, HAND may be a condition in need of specific psychosocial intervention distinct from what is currently being tested in geriatric adults with dementia 12 14. Yet despite exploratory research on the unique challenges of HAND and a stated community need,11 12 15–17 HAND intervention research in the era of modern cART is limited and the optimal intervention is unclear 13 14…”