AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #218 - Differences in neuropsychological functioning by HIV status and sexual risk profiles
Authors: Presenting Author: Dr. Sarit Golub - Hunter College of the City University of New York
Additional Authors: Dr. Julia Tomassilli, Mr. William Kowalczyk, Dr. Jeffrey Parsons,
Aim: In neuropsychological research, a link has been made between substance dependence and deficits in frontal system (i.e. executive) functioning, including problems with decision-making, working memory, and impulse control. In behavioral research, a link has been made between self-reported executive function deficits (e.g. impulsivity, sensation seeking, myopia) and HIV risk behavior. A better understanding of how neurocognitive factors influence HIV risk-behavior is critical to prevention efforts, as these factors may be working against specific intervention strategies or moderating intervention effectiveness. However, the majority of research focuses exclusively on high-risk individuals, without examining the neuropsychological profiles of individuals who are able to sustain HIV prevention behavior. In addition, little research compares the role of neuropsychological deficits among HIV-positive and HIV-negative individuals, to examine differential interactions between functioning, HIV-status, and risk. The present study was designed to investigate differences in neuropsychological functioning between HIV-positive and HIV-negative MSM who varied systematically in their risk behavior profiles.
Method / Issue: Substance Dependent MSM (n = 155) were recruited for a cross-sectional study. Eligible participants were stimulant using (i.e. reported 3 or more instances of cocaine, methamphetamine use in the past 90 days), sexually active MSM (i.e. reported at least two occasions of anal sex in the past 90 days) between the ages of 25 and 50. Participants were stratified by HIV-status. In addition, participants were stratified by recent risk behavior. Participants were classified as “high-risk” if they reported 2 or more instances of unprotected sex in the past 90 days, and were classified as “low-risk” if they reported condom use during 100% of anal sex acts in the past 90 days. Participants completed a neuropsychological assessment battery including the Iowa Gambling Task (IGT), IGT variant (IGTv), Wisconsin Card Sort (WCS), the Counting Span (CS), and a Go-Nogo task (GnG). Factorial ANOVA was used to compare neuropsychological functioning and deficits by HIV-status and risk behavior.
Results / Comments: Consistent with past research, HIV+ participants demonstrated deficits on four out of five tasks, compared to HIV-negative participants. However, on two of the tasks, significant interactions were found. Low-risk participants demonstrated hypersensivitiy to punishment (i.e. lower IGTv scores) compared to high-risk participants; however, this relationship was strongest among HIV+ low risk individuals, who demonstrated the lowest IGTv scores of any group. An interaction was also found on working memory (i.e. CS scores). Although HIV+ participants scored lower than HIV- participants on working memory overall, HIV-negative high-risk participants demonstrated greater deficits in working memory compared to their low-risk counterparts.
Discussion: Certain neuropsychological factors may increase vulnerability to risk taking, and/or may enhance individuals’ ability to sustain HIV prevention behavior. These findings suggest that neuropsychological factors may operate differently for HIV-positive and HIV-negative MSM. Further research is needed describing HIV-positive and HIV-negative men who sustain low-risk behavior, in order to identify factors that might promote resilience in this critical population.
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