Stephanie L Marhefka, PhD¹, Philip Alcabes, PhD², Elizabeth Frank, PhD³, Keith Krasinski, MD⁴, and Susan Abramowitz, PhD¹. (1) Pediatrics, New York University School of Medicine, 550 First Avenue, NBV 8W51, New York, NY 10016, 212-263-8226, stephanie@marhefka.net, (2) Program in Urban Public Health, Hunter College, 425 East 25th Street, New York, NY 10010, (3) Pediatrics, NYU School of Medicine, 550 First Avenue, Room NB-8W-50, New York, NY 10016, (4) Pediatrics and Environmental Medicine, New York University School of Medicine, NB 8-West 51, 550 First Avenue, New York, NY 10016

Background: Studies have not examined changes in cognitive functioning from childhood to adolescence among perinatally HIV-infected individuals. It is important to examine these changes within the context of changes in Ryan White funding and the widespread provision of HAART. Method: Full Scale IQ scores were available from Wechsler intelligent tests given as standard care. Time was categorized into three phases: 1985-1991 (Phase I; onset of epidemic), 1992-1996 (Phase II; large sums of care and research dollars—pre-HAART), and 1997-2003 (Phase III; HAART era). Results: 366 IQ scores were available for 91 children ages 3-21 (average of 4 scores per child). IQ scores ranged from 46 to 127 (M= 90.49; SD=14.98). Contrary to study hypothesis, IQ scores did not systematically increase from Phase I to Phase III; they remained similar. However, IQ scores varied based on age. Chi-square analysis showed that when children were under 13, their IQ scores were less likely to be in the Mentally Deficient Range than when children were over 13 (X2 = 10.55; p= .001). Conclusions: Perinatally-infected children may suffer from decreases in cognitive functioning during adolescence. Research is needed to determine factors that contribute to these cognitive declines, including poor adherence or response to HAART and residual effects of antiretroviral therapy. Clinicians should monitor cognitive functioning throughout adolescence and health care teams should work with schools to insure that their patients are receiving appropriate special services. Adolescents would benefit from Ryan White funding towards providing and managing these services.

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