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1. An Integrated Approach to HIV Disclosure for HIV-Affected Families in Thailand.

Author

Jantarapakde J, Pancharoen C, Teeratakulpisarn S, Mathajittiphan P, Kriengsinyot R, Channgam T, Pengnonyang S, Plodgratok P, Lakhonphon S, Luesomboon W, Jadwattanakul T, Avihingsanon A, Ananworanich J, Ungaro P, and Phanuphak P

Subjects
Adolescent, Adult, Child, Female, Humans, Male, Parents, Surveys and Questionnaires, Thailand epidemiology, Family psychology, HIV Infections epidemiology, HIV Seropositivity psychology, Truth Disclosure
Abstract

Disclosure of HIV status to family members could improve communication, relationship, and cohesion. We evaluated the impact of a family-centered program designed to increase the readiness/willingness of parents to disclose HIV status to their children. People living with HIV (PLWH) with children ≥8 years were surveyed regarding HIV knowledge, family relationship, attitudes, willingness/readiness to disclose, and they were then invited to participate in group education and family camps. Of 367 PLWH surveyed, 0.8% had disclosed, 14.7% had not yet disclosed but were willing/ready to disclose, 50.4% were willing but not ready, and 33.2% did not wish to disclose. The educational sessions and camps led to significant improvements of HIV knowledge and disclosure techniques, and readiness/willingness to disclose. Given the benefits of group education and family camps in supporting PLWH to improve their communication with their families and disclose their HIV status, these supporting activities should be included in HIV programs.

Published
2019
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2. HIV-associated cognitive performance and psychomotor impairment in a Thai cohort on long-term cART.

Author

Do TC, Kerr SJ, Avihingsanon A, Suksawek S, Klungkang S, Channgam T, Odermatt CC, Maek-A-Nantawat W, Ruxtungtham K, Ananworanich J, Valcour V, Reiss P, and Wit FW

Abstract

Objectives: To assess cognitive performance and psychomotor impairment in an HIV-positive cohort, well-suppressed on combination antiretroviral therapy (cART), in an Asian resource-limited setting., Methods: Cross-sectional sociodemographic and cognitive data were collected in 329 HIV-positive and 510 HIV-negative participants. Cognitive performance was assessed using the International HIV Dementia Scale (IHDS), Montreal Cognitive Assessment (MoCA), WAIS-III Digit Symbol, Trail Making A, and Grooved Pegboard (both hands). Psychomotor test scores in the HIV-positive participants were converted to Z-scores using scores of the HIV-negative participants as normative data. Psychomotor impairment was defined as performance on two tests more than 1 standard deviation (SD) from controls or more than 2 SD on one test. Multivariate linear and logistic regression analyses were used to investigate associations between HIV and non-HIV-related covariates and poorer cognitive performance and psychomotor impairment., Results: HIV-positive participants, mean age 45 (SD 7.69) years received cART for a median of 12.1 years (interquartile range [IQR] 9.1-14.4). Median CD4 cell count was 563 cells/mm 3 (IQR 435-725), and 92.77% had plasma HIV RNA <40 copies/mL. The adjusted mean differences between HIV-positive versus HIV-negative cohorts indicated significantly inferior cognitive performance (tests all P <0.001) with increasing age and lower income, independently associated. Psychomotor impairment was found ( P <0.02) in all tests except the Grooved Pegboard non-dominant hand ( P =0.48). Psychomotor impairment prevalence was 43% in the HIV-positive cohort, associated with male gender and lower income., Conclusions: In this study, in individuals with viral suppression rates >90% on long-term cART, we found that inferior cognitive performance and psychomotor impairment were primarily associated with non-HIV-related factors.

Published
2018

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