A longitudinal analysis of neurocognitive profiles in South African women with HIV.

Abstract

HIV and the consequences of HIV-associated neurocognitive disorders (HAND) disproportionally affect South African women. Longitudinal neurocognitive data on women with HIV are limited. We tracked longitudinal neurocognitive profiles of South African women with HIV (baseline n = 140) compared to women without HIV (baseline n = 156). We determined if lifetime and childhood trauma were significantly correlated with global deficit scores (GDS). We assessed neurocognitive performance at baseline, 1-year, and 5-years. We used mixed linear models to determine between-group differences and neurocognitive profiles over time. We used Pearson's correlations to assess correlations with GDS. There were no significant between-group differences in GDS. Both groups showed a significant decline in GDS (i.e., improved cognition) between baseline and 1-year follow-up (p < 0.01). There were significant group differences in learning (p = 0.02) and attention/working memory (p = 0.01) at baseline, with HIV + status associated with higher deficit scores. Childhood neglect was correlated with baseline GDS among women with HIV. Our results support the use of antiretroviral treatment to improve and/or maintain neurocognition in women with HIV. Future research should focus on the specific types of trauma exposure, specifically neglect and its association with HAND.