Interaksi antara Persepsi, Kognisi, dan Kesejahteraan pada Orang dengan HIV: Tinjauan Cakupan

Abstract

Despite viral suppression, people living with HIV continue to experience significant declines in quality of life (QoL) and cognitive function. Current literature suggests a complex interplay between biological mechanisms and psychological perceptions; however, the pathways linking these factors to well-being remain fragmented. This scoping review aims to map the interplay between illness perception, cognitive function, and well-being in people living with HIV, with a focus on identifying underlying neurobiological and psychological mediators. A scoping review was conducted following the Arksey and O'Malley framework and PRISMA-ScR guidelines. A systematic search across EBSCOHost, SCOPUS, and ScienceDirect was limited to articles published between 2020 and 2025. A total of 17 studies met the inclusion criteria. Thematic analysis identified three interconnected domains: 1) Neurobiological Drivers, where chronic immune activation (e.g., T-cell exhaustion, monocyte activation) and reduced neurotrophic support (BDNF) were associated with cortical atrophy and cognitive decline; 2) Psychological Mediators, where sleep disturbances and maladaptive illness perceptions (e.g., rumination) exacerbated cognitive deficits; and 3) Functional Impact, where cognitive impairment was a stronger predictor of disability and reduced QoL than viral load alone. Well-being in people living with HIV is shaped by a self-reinforcing interaction between neurobiological vulnerability and maladaptive psychological processes. Integrating routine cognitive screening, sleep management, and behavioral-based interventions into HIV care is essential to improve functional outcomes and overall quality of life.