HIV-Associated Neurocognitive Disorder (HAND)

Older people living with HIV can experience neurocognitive decline sooner than those living without HIV.

Neurocognitive decline means that a person no longer has the cognitive abilities they once had related to thinking and memory.

Neurocognitive decline may be linked to increased risk of Alzheimer’s disease and dementia.

It is often associated with a reduced ability to meet the demands of daily life.

For people who have received long-term ART treatments neurocognitive decline can also present as HIV-Associated Neurocognitive Disorder (HAND).

HAND is an umbrella term to describe neurodegenerative disease experienced by people living with HIV. It may affect up to 30% of people living with HIV.[1]

Signs of neurocognitive impairment can include:

  • Memory problems
  • Slowness
  • Difficulties multitasking, planning and concentrating
  • Changes in behaviour
  • Decreased motor skills (such as unsteady walking)

A person with neurocognitive decline may experience confusion and agitation. They may experience memory loss.

They may manage complexity by trying to reduce the number of things they have to deal with.

These things can make it harder for them to manage self-care, remember appointments, or to take different medications.

Changes in behaviour, memory problems and reducing function are all important signs of possible frailty and neurocognitive impairment that Peer Navigators can help to look out for.


More Information

See the Positive Life NSW resources:
the HAND booklet and
the HAND booklet for partners, family, friends and carers


More Information

See the free ASHM online short course HIV in ageing: For aged care and community nurses online learning module for a deeper dive into recognising and responding to age-related comorbidities among older people living with HIV.

[1] ASHM (2019). HIV-associated neurocognitive disorder.

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