Usefulness of lumbar puncture educational videos for older people with HIV

Video-based education offers opportunities to enhance patients' medical literacy and to reduce anxiety and hesitation for patients undergoing diagnostic procedures such as lumbar puncture (LP). Multiple studies centered on LP education have demonstrated that video-based education can reduce anxiety regarding possible adverse events, while increasing literacy regarding the procedure itself for clinical purposes. Our study sought to assess the impact of video-based education on knowledge of and willingness to undergo an LP among older people with HIV (PWH). We enrolled PWH age ≥ 50 years who regularly attend our Infectious Diseases clinic between March 3 and November 16, 2023. Participants watched a patient-centered educational video explaining the LP procedure and completed a questionnaire both pre- and post-video assessing demographics, general awareness and prior experience with an LP, specific knowledge, attitudes and perceptions toward an LP and willingness to undergo an LP. Our study included 99 PWH with mean (standard deviation, SD) age of 58.8 (5.7) years, one-third females and 60% African American/Black race. After watching the video, participants were significantly more likely to correctly identify technical details of the procedure (excluding those who had previously had an LP, 83.7% pre-video vs. 95.9% post-video) and common complications of an LP; agree that LPs can result in back pain (p < 0.001) and headaches (p < 0.001). There was no significant difference in participants' willingness to undergo an LP for diagnostic or research purposes. Only 5% said that they would never have an LP under any circumstance after watching the video. Other educational interventions, such as in-person demonstrations or models, may help mitigate fears of LP. Our study provides important insight into the knowledge and perceptions of PWH when asked to undergo an LP and demonstrates that video-based education may not be sufficient to mitigate fears surrounding LP procedures, or a lack of interest or time for participating in an LP.