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Using a sample of 122 PLWH (People Living With HIV) and 95 HIV negatives, ages 35-65, the study created a composite score that assessed trauma, economic hardship (food insecurity and low socioeconomic status), and a stress composite variable (TES). Study participants also completed a comprehensive neuropsychological battery and an assessment of activities of daily living (ADLs). The PLWH group had more traumatic events, more food insecurity, lower socioeconomic status, and higher perceived stress when compared to the uninfected group (p<0.0001). Higher TES scores were associated with reduced executive functioning, worse learning, decreased working memory, and greater declines in ADL (p<0.0001). These group differences persisted even after controlling for relevant demographic, mental health, substance use, and HIV disease variables.
In this study the traumatic and adverse experiences sustained by the HIV positive group impacted neurocognitive and daily functioning (ADLs). These deficits are reported to occur with high frequency in PLWH, especially in older adults with HIV (50+). The study illustrates how HIV variables do not necessarily directly impact neurocognitive function. Rather, other endemic characteristics of PLWH that are independent of HIV infection and its treatment can have significant effects on neurocognitive function likely manifested in reduced daily function (reduced ADLs).
Older adults with HIV more often perceive HIV as the underlying cause of the multiple comorbid conditions they are experiencing as they age. Yet other life experiences, not HIV infection, underlie the physical and psychological challenges and deficits they encounter.