Faculty of Medicine, MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK.
Department of Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Brighton, UK.
HIV Med. 2023 Aug;24(8):946-952. doi: 10.1111/hiv.13494. Epub 2023 Apr 5.
The 2018 British HIV Association (BHIVA) Standards of Care state that people living with HIV should be questioned annually for symptoms of cognitive or memory decline. If symptoms are identified, screening should be considered and services offered if impairment is detected. We examined the availability of services, along with current practices related to the screening and management of cognitive impairment in people living with HIV, in UK HIV services.
A survey was distributed via email to all UK HIV services leads on the BHIVA audit mailing list. Questions related to screening practices, referral pathways, and the management of patients with suspected cognitive impairment. Descriptive analyses were conducted on all data returned.
In total, 190 surveys were distributed. Of the respondents, 39 (60.6%) stated that they undertook screening for cognitive impairment in their HIV service, and 30 (47.6%) reported not offering a specific service or referral pathway. Awareness of BHIVA screening guidelines was high (49 [84.48%]), yet 15 (30.6%) respondents stated that they were not followed in their service and 41 (71.9%) felt there was a need for training on screening, assessment, and management of cognitive impairment in patients with HIV within their department.
Despite no directive, a substantial number of HIV services surveyed are routinely screening patients for cognitive impairment without guidance on when to screen and which screening tools should be used. A UK consensus on screening, along with guidance and training for services, may help to resolve this gap in service provision.
2018 年英国艾滋病协会（BHIVA）护理标准规定，应每年询问艾滋病毒感染者是否有认知或记忆减退的症状。如果发现症状，应考虑进行筛查，并在发现功能障碍时提供服务。我们检查了英国艾滋病毒服务中与艾滋病毒感染者认知障碍的筛查和管理相关的服务提供情况和当前做法。
通过电子邮件向 BHIVA 审计邮件列表上的所有英国艾滋病毒服务负责人分发了一份调查。问题涉及筛查做法、转诊途径以及疑似认知障碍患者的管理。对所有返回的数据进行描述性分析。
共分发了 190 份调查。在答复者中，39 人（60.6%）表示他们在艾滋病毒服务中进行了认知障碍筛查，30 人（47.6%）报告未提供特定服务或转诊途径。对 BHIVA 筛查指南的认识度很高（49 [84.48%]），但 15 名（30.6%）答复者表示他们的服务中未遵循这些指南，41 名（71.9%）认为他们部门需要针对艾滋病毒感染者的认知障碍筛查、评估和管理进行培训。
尽管没有指示，但接受调查的大量艾滋病毒服务机构正在常规筛查患者的认知障碍，但没有关于何时进行筛查以及应使用哪些筛查工具的指导。英国在筛查方面的共识，以及对服务的指导和培训，可能有助于解决服务提供方面的这一差距。
