Use of screening assessments in identifying the need for occupational therapy in HIV-associated neurocognitive disorders

People living with HIV (PLWHIV) present with an increased risk of cognitive dysfunction and dependence in daily activities. In South Africa, PLWHIV attending a neuropsychiatric clinic are screened using the International HIV Dementia Scale (IHDS) to determine the presence of HIV-associated neurocognitive disorder (HAND). It is unknown how effectively this screening identifies the need for rehabilitation in occupational therapy. This study determined the cognitive and daily living dysfunction in PLWHIV who scored <11 on the IHDS (Indicating the presence of HAND), using the Montreal Cognitive Assessment (MoCA) and the World Health Organisation Disability Assessment Schedule 2.0 (WHODAS 2.0). A sample of 55 participants had a median score of 7 on the IHDS. The median score of 20 on the MoCA and 23.51% for daily living on the WHODAS 2.0 indicated mild dysfunction. The IHDS scores were moderately associated with the MoCA scores but not the WHODAS 2.0 scores. An IHDS score of 9 was associated with mild cognitive dysfunction, while an IHDS score of 7 or less was associated with moderate cognitive dysfunction and mild to moderate disability in daily living. It is suggested that PLWHIV with a score of ≤7 should be prioritised for referral for occupational therapy intervention.