Depressive symptoms mediate the association between loneliness and cognitive performance in women living with HIV: findings from the Women’s Interagency HIV Study
Year: 2026
Type: article
Abstract: Loneliness is a risk factor for cognitive impairment, yet, its role in domain-specific cognitive performance and underlying mechanisms remain understudied in women living with HIV (WLWH). To assess whether depressive symptoms mediate associations between loneliness and global and domain-specific cognition, data were analyzed from 1621 WLWH participating in the Women's Interagency HIV Study, a multicenter, observational cohort conducted in the United States. Mediation analysis using linear mixed-effects models estimated average direct and indirect effects and proportion mediated, adjusting for covariates. Median age was 49 years, 75% were Black, and 25% were lonely at initial visit. Lonely WLWH had higher depressive symptoms, greater housing instability, lower employment, and higher substance use than non-lonely WLWH. In adjusted models, higher loneliness was associated with poorer global cognition, executive function, processing speed, learning, memory, and verbal fluency. Significant indirect associations through depressive symptoms were observed for global cognition, executive function, processing speed, and learning. Direct associations were attenuated after accounting for depressive symptoms, except for executive function. Interventions addressing loneliness and depression may support cognitive performance in WLWH. Findings underscore the need for additional longitudinal research to clarify the long-term cognitive consequences of loneliness in WLWH.
Source: AIDS Care
Institutions: Northeastern University, Johns Hopkins University, University of North Carolina at Chapel Hill, University of Alabama at Birmingham, University of California, San Francisco, Albert Einstein College of Medicine, University of Miami, Hektoen Institute, Case Western Reserve University, Georgetown University, Georgetown University Medical Center, SUNY Downstate Health Sciences University
Language: English
Topic: HIV Research and Treatment
Subfield: Virology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: hybrid
Funders: Northwestern University, Georgia Clinical and Translational Science Alliance, National Institutes of Health, University of California, San Francisco, Center for AIDS Research, University of Alabama at Birmingham, National Institute on Alcohol Abuse and Alcoholism, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Mental Health, National Institute on Drug Abuse, National Cancer Institute, National Institute on Deafness and Other Communication Disorders, National Institute of Nursing Research, National Institute of Allergy and Infectious Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Neurological Disorders and Stroke, National Institute of Dental and Craniofacial Research, National Institute on Minority Health and Health Disparities, Center for AIDS Research, University of North Carolina at Chapel Hill, Clinical and Translational Science Institute, University of California, Los Angeles
Awards: G1034546755, G1296759572, Translational Biomedical Science Training Grant, G1913134163, G1972383081, Georgetown-Howard Universities Center for Clinical and Translational Science (GHUCCTS), G2008237588, G2435036225, G2542587862, G2840405583, G3102910958, G311558797, G3869857964, G4044828089, G409006598, G4584981698, G4844376359, G4953964255, G5147848267, G562934659, G5660189159, G5699974340, G5817808917, G5863844756, Clinical and Translational Science Institute, G5900455136, G5933640408, G6349975595, G6384504179, G6396423216, G6509896931, University of Miami Developmental HIV/AIDS Mental Health Research Center (D-ARC), G6745172908, G6759032351, G6809319421, G6990385686, G7001360886, G7152846654, G7454986501, Institutional Career Development Core, G7627181020, G775892330, G7760075911, G7807729167, Johns Hopkins Institute for Clinical and Translational Research, G9000034708, G9000080293, G9000082816, G9000258633, G9000310595, University of Pittsburgh MACS/WIHS CCS, MACS/WIHS -CCS, A Mixed-methods Approach to Understand the Interplays of Social and Physical Environments, Loneliness, and Cognition among Older People with HIV, ERC Einstein-Rockefeller-CUNY Center for AIDS research, SF Bay Area MACS/WIHS Combined Cohort Study, UNC MACS/WIHS Combined Cohort Study Clinical Research Site, Surviving the HIV Epidemic (S/HE) in metropolitan Washington DC - Advancing knowledge through cohort studies, Center for AIDS Research at Emory University, JHU Center for the Advancement of HIV Neurotherapeutics (JHU CAHN), Northwestern CORE Clinical Research Site: Trans-omics for HIV/AIDS Research, Los Angeles CRS for the MACS/WIHS Combined Cohort Study, Data Analysis and Coordination Center for the MACS-WIHS Combined Cohort Study, Social connections, risk for COVID-era psychiatric and substance use disorders, and HIV control, MACS/WIHS Combined Cohort Study: Cook County Clinical Research Site (CC_CRS), The University of North Carolina Center for AIDS Research, MACS/WIHS Combined Cohort Study: Brooklyn Clinical Research Site (Bklyn CRS), Clinical Research Sites for the MACS/WIHS Combined Cohort Study (MACS/WIHS-CCS) - Baltimore/Wash DC Center, Atlanta MACS/WIHS Combined Cohort Study Clinical Research Site, UAB-MISS MACS/WIHS Combined Cohort Study, Miami Center for AIDS Research, UCLA Clinical and Translational Science Institute, Clinical Research Sites for the MACS/WIHS Combined Cohort Study (MACS/WIHS-CCS), UAB Center for AIDS Research (CFAR), G929137571
OpenAlex ID: W7213974904