Ontario AIDS Network

ABSTRACT Cognitive impairment is an important comorbidity for people aging with HIV, and group therapy may ameliorate the associated anxiety and stress. Combination psychosocial interventions may have better outcomes than single technique approaches. A pilot, parallel design, two-arm trial randomized people aging with HIV-Associated Neurocognitive Disorder (HAND) to Cognitive Remediation Group Therapy (Experimental; combination of brain training activities and mindfulness-based stress reduction) or Mutual Aid Group Therapy (Control). Outcomes were feasibility, acceptability, fidelity, and exploratory measures of anxiety, stress, coping, and use of mindfulness and brain training activities. Among 40 contacted participants, 15 replied, 12 recruited, and 10 completed. Assessors confirmed intervention delivery with satisfactory fidelity. The novel arm had statistically significant improvements in stress and mindfulness use compared to control, and brain training and mindfulness use sustained at 3-month follow-up. Requiring a HAND diagnosis made recruitment challenging. Further research should broaden eligibility to people aging with HIV and cognitive challenges.

This qualitative study examined the impact upon people living with HIV (PHAs), of being trained and utilized as educators of health professionals. PHAs participated in a training program to help them develop skills to facilitate learners in problem-based educational events. After training the PHAs participated in small group problem-based tutorials with separate groups of physiotherapy and occupational therapy students and family medicine residents. Content analyses of the PHAs' reflective journals and semistructured interviews conducted at completion of the project indicated there was a positive impact on their teaching skills, self-awareness, personal understanding of HIV, confidence in teaching, and everyday life. Learner feedback indicated that they valued their interactions with the PHAs. This model of education has the potential to positively benefit patients living with a variety of illnesses and disabilities.