Do HIV+ Drug Users Differ from HIV+ Non-Users on Neurocognitive Functioning?

Substance use disorders often co-occur with HIV and may have adverse consequences on neurocognitive deficits as well as HIV outcomes. An ongoing debate exists as to whether HIV infection and substance use disorders (SUDs) act in a synergistic fashion on neurocognitive functioning. Prior research has shown mixed results with some studies finding a relationship between HIV associated neurocognitive disorders (HAND) and SUDs, whereas other studies have demonstrated limited or weak associations. However, these prior studies all contained design flawsand lacked proper controls for confounding factors. This two group comparison study assessed the neurocognitive functioning of 30HIV+ participants without a history of SUDs to 30 HIV+ participants with a history of multiple SUDs including at least one severe SUD using the Computerized Neurocognitive Battery (CNB). The sample was predominately African American (83%), 63% were male and the average age was 44 years. The majority of participants in the drug user group had cocaine (87%) and alcohol (73%) substance use disorders. After controlling for literacy, compared to non-drug users, the drug users demonstrated poorer efficiency scores on the social cognition, executive functioning and sensorimotor domains of the CNB. The HIV+ nonusers were also more similar to a normative sample of healthy controls. These findings are significant since even mild cognitive impairment can lead to problems with medication adherence and engagement in risky behaviors resulting in the need for innovative treatments for HIV+ drug users, especially those with cocaine use disorders. NIMH Support: PMHARC (P30MH097488).