@article{85adbf22f1214be69dddb460bace941c,
title = "Perceived and posttraumatic stress is associated with decreased learning, memory, and fluency in HIV-infected women",
abstract = "Objective: Psychological risk factors (PRFs) are associated with impaired learning and memory in HIV-infected (HIV+) women. We determined the dynamic nature of the effects of PRFs and HIV serostatus on learning and memory over time. Design: Multicenter, prospective cohort study. Methods: Every 2 years between 2009 and 2013 (three times), 646 HIV+ and 300 demographically similar HIV-uninfected (HIV-) women from the Women's Interagency HIV Study completed neuropsychological testing and questionnaires measuring PRFs [perceived stress, posttraumatic stress disorder (PTSD) symptoms, depressive symptoms]. Using mixed-effects regressions, we examined separate and interactive associations between HIV-serostatus and PRFs on performance over time. Results: HIV+ and HIV- women had similar rates of PRFs. Fluency was the only domain in which performance over time depended on the combined influence of HIV-serostatus and stress or PTSD (P<0.05), not depression. In HIV, higher stress and PTSD were associated with a greater cognitive decline in performance (P<0.05) vs. lower stress and PTSD. Irrespective of time, performance on learning and memory depended on the combined influence of HIV-serostatus and stress or PTSD (P≤0.05). In the context of HIV, stress and PTSD were negatively associated with performance. Effects were pronounced on learning among HIV+ women without effective treatment or viral suppression. Regardless of time or HIV-serostatus, all PRFs were associated with lower speed, global neuropsychological, and executive function. Conclusion: More than depression, perceived stress and PTSD symptoms are treatment targets to potentially improve fluency, learning, and memory in women living with HIV particularly when HIV treatment is not optimal.",
keywords = "HIV, cognition, learning, memory, stress, women",
author = "Rubin, {Leah H.} and Cook, {Judith A.} and Gayle Springer and Weber, {Kathleen M.} and Cohen, {Mardge H.} and Martin, {Eileen M.} and Valcour, {Victor G.} and Lorie Benning and Christine Alden and Joel Milam and Kathryn Anastos and Young, {Mary A.} and Gustafson, {Deborah R.} and Sundermann, {Erin E.} and Maki, {Pauline M.}",
note = "Funding Information: L.H.R.{\textquoteright}s effort was supported by Grant Number 1K01MH098798-01 and V.G.V.{\textquoteright}s by K24MH098759, each from the National Institute of Mental Health (NIMH). Data in this article were collected by the Women{\textquoteright}s Interagency HIV Study (WIHS). The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH). WIHS (Principal Investigators): UAB-MS WIHS (Michael Saag, Mirjam-Colette Kempf, and Deborah Konkle-Parker), U01-AI-103401; Atlanta WIHS (Ighovwerha Ofotokun and Gina Wingood), U01-AI-103408; Bronx WIHS (Kathryn Anastos), U01-AI-035004; Brooklyn WIHS (Howard Minkoff and Deborah Gustafson), U01-AI-031834; Chicago WIHS (Mardge Cohen and Audrey French), U01-AI-034993; Metropolitan Washington WIHS (Seble Kassaye), U01-AI-034994; Miami WIHS (Margaret Fischl and Lisa Metsch), U01-AI-103397; UNC WIHS (Adaora Adimora), U01-AI-103390; Connie Wofsy Women{\textquoteright}s HIV Study, Northern California (Ruth Greenblatt, Bradley Aouizerat, and Phyllis Tien), U01-AI-034989; WIHS Data Management and Analysis Center (Stephen Gange and Elizabeth Golub), U01-AI-042590; Southern California WIHS (Joel Milam), U01-HD-032632 (WIHS I–WIHS IV). The WIHS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional cofunding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute on Mental Health (NIMH). Targeted supplemental funding for specific projects is also provided by the National Institute of Dental and Craniofacial Research (NIDCR), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Deafness and other Communication Disorders (NIDCD), and the NIH Office of Research on Women{\textquoteright}s Health. WIHS data collection is also supported by UL1-TR000004 (UCSF CTSA) and UL1-TR000454 (Atlanta CTSA). Publisher Copyright: {\textcopyright} 2017 Wolters Kluwer Health, Inc. All rights reserved.",
year = "2017",
month = nov,
day = "13",
doi = "10.1097/QAD.0000000000001625",
language = "English (US)",
volume = "31",
pages = "2393--2401",
journal = "AIDS",
issn = "0269-9370",
publisher = "Lippincott Williams and Wilkins",
number = "17",
}
