Prospective Memory in HIV-Associated Neurocognitive Disorder: A Systematic Review and Meta-Analysis

Prospective memory (PM) is the ability to remember and execute intended actions in the future. It Involves encoding, retention, and retrieval of information at a specific time (Time-based prospective memory) or based on a specific cue (Event-based prospective memory). Deficits in prospective memory are prevalent among people with HIV Associated Neurocognitive Disorder (HAND), with direct implications for medication adherence and everyday functional independence. This systematic review and meta-analysis were conducted in accordance with PRISMA guidelines and included searches of PubMed, ScienceDirect, ProQuest, PsycINFO, and Google Scholar for quantitative studies, specifically controlled studies comparing PM performance in HAND with that of seronegative or HIV-positive comparison groups. Five independent studies (total N = 677; 244 HAND, 433 comparison) yielded 9 independent effect sizes; 9 were pooled using robust variance estimation to account for within-study dependency, with the remaining 2 retained for qualitative synthesis. A random-effects meta-analysis showed a significant, moderate pooled effect (Hedges' g = 0.53, 95% CI [0.27, 0.68], p < .001; τ² = 0.02), indicating worse overall PM performance in HAND relative to comparison groups. Subtype analysis across three studies reporting both time-based and event-based types showed a larger deficit for time-based PM (g=-0.72) than for event-based PM (g=-0.35), a difference that was significant after cluster-robust correction (p = 0.043). However, these findings are based on only three studies and should therefore be interpreted cautiously. These findings provide quantitative confirmation that PM deficits in HAND are moderate in magnitude and disproportionately concentrated in time-based PM, supporting a PM-targeted, strategy-based intervention as part of rehabilitation and medication-adherence-focused medical care for people living with HAND.