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HIV-Associated Neurocognitive Disorders Remain a Concern in Africa Despite HAART

Strategic Insights

— 2 min read

Research findings presented in a new study published in Comprehensive Psychiatry have revealed that HIV-associated neurocognitive disorders (HAND) remain a significant public health concern among people living with HIV (PWH) in Africa, even with the widespread implementation of highly active antiretroviral therapy (HAART). The study, conducted by researchers from the University of Gondar, Ethiopia, aimed to synthesize the current evidence on the effectiveness of HAART on neurocognitive outcomes among HIV-positive individuals in Africa. The meta-analysis included 62 primary studies with a combined sample of 19,831 individuals living with HIV, estimating a pooled prevalence of HAND at 47.18%.

Key Takeaways:

  • The pooled prevalence of HIV-associated neurocognitive disorders (HAND) among people living with HIV (PWH) in Africa was estimated at 47.18%, with the highest prevalence in Eastern Africa (50.85%) and the lowest in Central Africa (34.68%).
  • Despite the widespread implementation of HAART, milder forms of neurocognitive impairment continue to be observed among individuals receiving antiretroviral therapy, with a prevalence of 46.96%.
  • Advanced HIV disease stage, lower educational attainment, older age, being female, history of substance use, reduced CD4+ T-cell counts, and comorbid medical illness were identified as independent predictors of increased odds of HAND.
  • HIV-associated neurocognitive disorders affect nearly half of people living with HIV in Africa, highlighting a critical unmet need in HIV care.
  • Integrating regular cognitive assessments, timely interventions, and culturally appropriate rehabilitation into HIV care is vital for enhancing clinical outcomes and quality of life.

Statistics:

  • Pooled prevalence of HAND among PWH in Africa: 47.18% (95% CI: 39.94%-54.42%);
  • Prevalence of HAND in Eastern Africa: 50.85%;
  • Prevalence of HAND in Southern Africa: 48.12%;
  • Prevalence of HAND in Western Africa: 43.67%;
  • Prevalence of HAND in Central Africa: 34.68%;
  • Prevalence of HAND among individuals receiving antiretroviral therapy: 46.96%;
  • Prevalence of HAND among ART-naive participants: 50.22%;
  • Odds ratio (OR) for advanced HIV disease stage: 3.59 (95% CI: 2.81-4.59);
  • Odds ratio (OR) for lower educational attainment: 3.13 (95% CI: 2.19-4.48);
  • Odds ratio (OR) for older age: 2.05 (95% CI: 1.51-2.78);
  • Odds ratio (OR) for being female: 2.18 (95% CI: 1.79-2.64);
  • Odds ratio (OR) for history of substance use: 2.70 (95% CI: 2.65-2.75);
  • Odds ratio (OR) for reduced CD4+ T-cell counts: 2.49 (95% CI: 1.42-4.36);
  • Odds ratio (OR) for comorbid medical illness: 2.05 (95% CI: 1.57-2.67);

Sources:

  • The role of HAART in mitigating neurocognitive decline among HIV-positive Africans: Systematic review and meta-analysis. Comprehensive Psychiatry, 2025;143:152639.
  • HIV/AIDS Study Finds Gondar, Ethiopia. AIDS Weekly. October 20, 2025; p 146.

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