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Objective: This study describes trajectories of cognitive aging among American Indian/Alaskan Native (AI/AN) adults with and without HIV and the role of immunosenescence longitudinally., Method: We characterized trajectories of cognitive aging in a sample of 333 AI/AN and 309 non-Hispanic White (NHW) adults who were followed longitudinally for up to 20 years by the HIV Neurobehavioral Research Program (HNRP) across six U.S. research sites. We used growth curve modeling with autoregressive Lag-1 structures and heterogeneous residual variances to assess the role of ethnoracial identity and HIV grouping upon decline in trajectories of cognitive aging., Results: HIV- AI/AN adults demonstrated earlier and steeper decline in normative trajectories of cognitive aging on tasks of processing speed, timed tasks of attention/working memory, executive function, and psychomotor speed in comparison to HIV- NHW adults. Accentuated trajectories of cognitive aging were evident in both HIV+ and HIV+ immunosuppressed groups in comparison to HIV- peers and were primarily driven by the role of immunosenescence., Conclusions: AI/AN disparities in trajectories of cognitive aging are evident and are likely explained by the interplay of biopsychosociocultural factors, including immunosenescence. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: This cross-sectional study investigates the independent and interactive effects of depression and socioeconomic status (SES) on neurocognition in a diverse sample of people with HIV (PWH)., Method: The sample of 119 PWH (71% Latinx, 27% female) completed comprehensive neurocognitive and psychosocial evaluations and were separated into two groups: those with a history of depression diagnosis ( n = 47) and those without ( n = 72)., Results: The results of regression analyses indicated that lifetime depression was not associated with lower SES nor with worse neurocognitive performance on any neurocognitive outcome. However, a significant main effect of SES was observed on the Hopkins Verbal Learning Test (total), indicating that higher SES was associated with better verbal learning performance ( B = .11, SE  = .05, p < .02). Lastly, the results revealed an interactive effect of lifetime depression and SES, such that individuals with depression and higher SES performed better on tests of attention/working memory (i.e., WAIS-III Letter-Number Sequencing, B = .08, SE  = .04, p < .02; Paced Auditory Serial Addition Test, B = .39, SE  = .16, p < .02)., Conclusions: Depression and SES appear to play an important role in the neurocognitive performance of PWH. Specifically, higher SES appears to have a protective effect on attention/working memory among PWH only if they have co-morbid history of lifetime depression.

Abstract: Research suggests that health locus of control (HLOC) is related to important health and neurocognitive outcomes in people living with HIV. However, the role of ethnicity in these relationships remains poorly understood. This study explored the role of HLOC on neurocognition in a diverse sample of 134 people living with HIV (Latinx: n = 96; non-Latinx White: n = 38) who completed comprehensive neurocognitive evaluations and the Multidimensional HLOC Scale-Form C. Results indicate no ethnocultural differences in HLOC beliefs (ps > .05). External HLOC (i.e., chance and powerful others) related to worse neurocognition in the Latinx group and contributed to significant variance in global neurocognition and learning, memory, and verbal fluency, underscoring the role of external HLOC beliefs on neurocognition, particularly for Latinx individuals. Additional research is needed to better characterize the mechanistic relationship between HLOC beliefs and neurocognitive function and to further explore this relationship among other underrepresented populations also disproportionately affected by HIV., (Copyright © 2021 Association of Nurses in AIDS Care.)

People living with HIV (PLWH) report higher rates of cannabis use than the general population, a trend likely to continue in light of recent policy changes and the reported therapeutic benefits of cannabis for PLWH. Therefore, it is important to better understand cannabis-associated effects on neurocognition, especially as PLWH are at heightened risk for neurocognitive impairment. This study aimed to elucidate the effects of a past cannabis use disorder on current neurocognition in a diverse sample of PLWH. This cross-sectional study included 138 PLWH (age M(SD) = 47.28(8.06); education M(SD) = 12.64(2.73); 73% Male; 71% Latinx) who underwent neuropsychological, DSM-diagnostic, and urine toxicology evaluations. One-way ANCOVAs were conducted to examine effects of a past cannabis use disorder (CUD+) on tests of attention/working memory, processing speed, executive functioning, verbal fluency, learning, memory, and motor ability. Compared to the past CUD- group, the past CUD+ group performed significantly better on tests of processing speed, visual learning and memory, and motor ability ( p 's   < .05). Findings suggest PLWH with past cannabis use have similar or better neurocognition across domains compared to PLWH without past use.

While transgender and gender non-binary (trans/nb) individuals are disproportionately affected by HIV, pre-exposure prophylaxis (PrEP) uptake remains low in this underserved population. We conducted four focus groups with 37 trans/nb individuals in San Diego and Los Angeles to assess barriers and facilitators of PrEP usage. Transcripts were coded for qualitative themes. Although overall PrEP awareness was high, participants reported limited knowledge and misinformation about PrEP. Barriers to PrEP use included: structural access (e.g., discrimination from health care providers, lack of trans-inclusive services, financial barriers), mental health struggles limiting ability to access PrEP, and concerns about potential side effects, drug-drug interactions with hormone therapy, and lack of other STI protection. Facilitators of PrEP usage included: increased PrEP availability, prior experience taking daily medications, and motivation to have active and healthy lives without fear of contracting HIV. Addressing both structural and psychosocial/behavioral factors in trans-affirming health care environments is crucial to designing inclusive, effective PrEP interventions.

Antiretroviral therapy (ART) adherence is vital for optimal HIV treatment. However, there is limited ART adherence research on the US Latinx population, who are at increased risk for HIV infection and worse HIV health outcomes. This study examined electronically measured ART adherence (Medication Event Monitoring System) and its association with demographic, clinical, neurocognitive, and sociocultural variables in Latinx and non-Latinx white (NLW) persons living with HIV [PLWH ( N  = 128)]. Latinx participants demonstrated worse adherence than NLW participants ( p  = 0.04). Linear regressions revealed different predictors of adherence. Among Latinx participants, recent cocaine use, stress, and, unexpectedly, higher US acculturation predicted worse adherence ( p s < 0.05). Among NLW participants, recent cocaine use predicted worse adherence ( p  < 0.05). Intergroup comparisons within the Latinx group were not conducted due to subsample size. Thus, ethnicity, sociocultural variables, and cocaine use are important considerations for ART adherence, and poor ART adherence may be one pathway explaining worse outcomes in Latinx PLWH. Culturally tailored adherence interventions incorporating substance use treatment, acculturation, and stress management are warranted to improve health outcomes.

Background: This secondary analysis aims to describe, over time, the relationship between HIV disease progression and intention to quit cigarette smoking among current monocigarette users with and without a lifetime history of polytobacco use., Methods: Participants completed a baseline assessment at the time of HIV care initiation and four follow-up assessments (3, 6, 9, and 12-months). Assessments included biochemically verified smoking status and audio computer-assisted self-interviews assessing psychosocial, substance use, and clinical variables known to influence smoking behaviors. Using linear and generalized linear fixed-effects models, we modeled the covariance structure for the repeated outcome measures (intention to quit and 7-day point prevalence smoking abstinence) across the study time points and included a three-way interaction term to examine the effects of disease stage and tobacco product use., Results: Participants (N = 357) were 73.1% male, 67.3% black/African American, and had a mean (SD) age of 38.7 (10.6) years. At baseline, lifetime polytobacco users reported significantly worse HIV-related symptoms and burdens, illness perception, social support, and nicotine dependence. Intention to quit, but not smoking abstinence, was predicted by a three-way interaction between time from HIV care initiation, disease progression, and tobacco product use (p = .04). Overall, progressive HIV was associated with greater intention to quit smoking cigarettes. However, the relationship differed over time between the two tobacco product groups., Conclusion: Future studies should consider tailoring the timing of cessation interventions upon disease stage and lifetime history of polytobacco use., (Copyright © 2018. Published by Elsevier B.V.)

Introduction: Tobacco use among persons living with HIV represents an important risk factor for poor treatment outcomes, morbidity, and mortality. Thus, efforts designed to inform the development of appropriate smoking cessation programs for this population remains a public health priority. To address this need, a study was conducted to longitudinally assess the relationship between intention to quit smoking and cessation over the 12-month period following initiation of HIV care., Methods: Patients initiating HIV care at a large inner city safety net clinic were enrolled (n = 378) in a 12-month prospective study. Audio computer-assisted self-interviews were conducted at baseline, and at 3, 6, 9, and 12 months post-enrollment, and HIV-related clinical data were collected from participants' electronic medical records. Variables of interest included intention to quit smoking, 7-day point prevalence smoking abstinence (biochemically verified), and stage of HIV. Data were collected in Houston, Texas from 2009 to 2015., Results: The sample was 75% male and 62% Black. Findings indicated that intention to quit smoking increased between baseline and 3 months, and subsequently trended downward from 3 to 12 months. Results from linear and generalized linear mixed models indicated that participants with advanced HIV disease (vs. not advanced) reported significantly (p < .05) higher intention to quit smoking at 3, 6, and 12 months post-study enrollment. A similar though nonsignificant pattern was observed in the smoking abstinence outcome., Conclusions: HIV treatment initiation appears to be associated with increases in intention to quit smoking thus serves as a potential teachable moment for smoking cessation intervention., Implications: This study documents significant increases in intention to quit smoking in the 3-month period following HIV care initiation. Moreover, quit intention trended downward following the 3-month follow-up until the 12-month follow-up. In addition, a marked effect for HIV disease stage was observed, whereby participants with advanced HIV disease (vs. those without) experienced a greater increase in intention to quit. HIV treatment initiation appears to be associated with increases in intention to quit smoking, thus serves as a crucial teachable moment for smoking cessation intervention for people living with HIV.