HIV patient biopsychosocial complexity - Fixed or modifiable?

BackgroundBiopsychosocial comorbidities are common in chronic illnesses like HIV, often resulting in complex clinical presentations. The Clinical Complexity Rating Scale for HIV (CCRS-HIV) was developed to identify these factors. This study examined whether complexity, as measured by the CCRS-HIV, could change over time.MethodsPatients at The Albion Centre in Sydney were assessed at two time points (T₁ and T₂) using the CCRS-HIV. Changes in total and subscale scores were analysed, along with the odds of scoring in the complex range (40+ or 45+). The impact of age and time between assessments was also evaluated.ResultsResults showed a significant decrease in total complexity scores from T₁ to T₂, with improvements across four subscales-two psychological/behavioural, one social, and one biomedical. The proportion of complex cases declined, and participants were nearly twice as likely to be complex at T₁ compared to T₂. Longer intervals between assessments were linked to greater improvements, while age and sex had no effect.ConclusionsThese findings suggest that complexity in people living with HIV (PLHIV) is modifiable and support the CCRS-HIV as a valuable tool for screening and tracking changes in clinical complexity.