Cocaine Use May Moderate the Associations of HIV and Female Sex with Neurocognitive Impairment in a Predominantly African American Population Disproportionately Impacted by HIV and Substance Use
Year: 2023
Type: article
Study design: Observational Study
Abstract: HIV-associated neurocognitive disorders (HAND) remain a major challenge for people with HIV in the antiretroviral therapy era. Cocaine use may trigger/exacerbate HAND among African American (AA) adults, especially women. Between 2018 and 2019, 922 adults, predominantly AAs, with/without HIV and with/without cocaine use in Baltimore, Maryland, were enrolled in a study investigating the association of HIV and cocaine use with neurocognitive impairment (NCI). Neurocognitive performance was assessed with the NIH Toolbox Cognition Battery (NIHTB-CB). NCI was considered to be present if the fully adjusted standard score for at least two cognitive domains was 1.0 standard deviation below the mean. Although the overall analysis showed HIV and female sex were associated with NCI, the associations were dependent on cocaine use. Neither HIV [adj prevalence ratio (PR): 1.12, confidence interval (95% CI): 0.77-1.64] nor female sex (adj PR: 1.07, 95% CI: 0.71-1.61) was associated with NCI among cocaine nonusers, while both HIV (adj PR: 1.39, 95% CI: 1.06-1.81) and female sex (adj PR: 1.53, 95% CI: 1.18-1.98) were associated with NCI in cocaine users. HIV was associated with two NIHTB-CB measures overall. In addition, HIV was associated with a lower dimensional change card sort score (an executive function measure) in cocaine users and not in nonusers. Cognitive performance was poorer in female than in male cocaine users. The adverse effect of HIV on cognitive performance predominantly affected cocaine users. However, cocaine use may moderate the impact of HIV and female sex on cognitive performance, highlighting the importance of reducing cocaine use in NCI prevention among the AA population.
Source: AIDS Patient Care and STDs
Authors: Hong Lai, David D. Celentano, Glenn Treisman, Jag Khalsa, Gary Gerstenblith, Bryan Page, Raul N. Mandler, Yihong Yang, Betty Salmeron, Sandeepan Bhatia, Shaoguang Chen, Shenghan Lai, Karl Goodkin, Man Charurat
Language: English
Topic: HIV Research and Treatment
Subfield: Virology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: green
Awards: Changes in Coronary Noncalcified Volume in Relation to Changes in Cocaine Use, The Impact of Cocaine Abstinence or Reduced Use on Radiomic Features of Noncalcified Coronary Plaques in HIV-Infected Cocaine Users with Silent Coronary Artery Disease, Effects of HIV, Cocaine, and Prolonged ART Use on Subclinical Cardiovascular Disease, Subclinical Atherosclerosis in HIV plus Black Cocaine Users, HIV Infection, Cocaine Use and Coronary Artery Disease in HIV+ African Americans, HIV, Cocaine & Regional Left Ventricular Dysfunction
OpenAlex ID: W37083446