Healthcare Workers’ Perspectives on the Utilization of the International HIV Dementia Scale for the Screening HIV-Associated Neurocognitive Disorders: A Qualitative Study at TASO Centres in Central and Southwestern Uganda

Abstract

Jane Kasozi Namagga,1 Godfrey Zari Rukundo,2 Vincent Batwala,3 Vallence Niyonzima,1 Hanifah Nantongo,1 Grace Nambozi1 1Department of Nursing, Mbarara University of Science and Technology, Mbarara, Uganda; 2Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda; 3Department of Community Health, Mbarara University of Science and Technology, Mbarara, UgandaCorrespondence: Jane Kasozi Namagga, Department of Nursing, Mbarara University of Science and Technology, Mbarara, Uganda, Tel [phone], Email [email protected]: HIV-associated neurocognitive disorders (HAND) are becoming a significant public health concern in the continuum of human immune virus (HIV) treatment. These disorders range from subtle cognitive impairments to severe dementia. Despite many early-stage HAND cases being asymptomatic, healthcare workers (HCWs) rarely perform routine neurocognitive assessments. This leads to a high number of unrecognized cases and increases the risk of HAND among people living with HIV (PLWH).Material and Methods: We aimed to explore HCWs’ perspectives on integrating the International HIV Dementia Scale (IHDS) into routine care for screening HAND at The AIDS Support Organization (TASO) centres in central and southwestern Uganda.Results: We conducted five focus group discussions with 37 HCWs from five TASO centres. Thematic analysis revealed eight key theme: 1) Impaired brain function, 2) Changes in activities of daily living, 3) Promotion of quality care perspectives, 4) Tool applicable and user-friendly, 5) Client increased self-awareness and self-confidence, 6) Integration of IHDS into routine HIV care, 7) Uncertainty about IHDS use, and 8) Continuous training for HCWs.Conclusion: As PLWH enjoy longer and healthier lives, their risk for HAND increases, potentially affecting their quality of life. The use of the IHDS has raised awareness among HCWs and improved decision-making through cognitive assessments, emphasizing it value in PLWH. We recommend a prospective study to assess the long-term outcomes and efficacy of increased HAND screening. Furthermore, integrating a HAND screening module into the consolidated HIV guidelines is recommended to enhance its relevance.Keywords: healthcare workers, HIV associated neurocognitive disorders, international HIV dementia scale, screening

Keywords

• healthcare workers
• hiv associated neurocognitive disorders
• international hiv dementia scale
• screening