Cognitive Executive Functioning in Relation to HIV Medication Adherence among Gay, Bisexual, and Other Men who Have Sex with Men

Background: A year-long longitudinal study of 300 HIV-positive gay, bisexual or other MSM was undertaken to consider patterns relating to HIV medication adherence. The purpose of our analyses was to consider the rate of adherence in relation to both age and cognitive abilities; specifically, executive functioning as assessed by the Trail Making Test A and B. Methods: Adherence data were captured every two months, (bi-monthly), for the protease inhibitor in the participants' regimen using both self-report and MEMS. The Trails Making Test was administered at baseline and month 10 to asses executive functioning. Results: In our analytic sample, which consisted of 213 men who remained on the same protease inhibitor throughout the duration of the study, adherence rates were relatively high with more than 50% of the sample maintaining a 95%+ adherence rate at both baseline and month 10. Analyses at baseline indicated that both executive functioning and age were significantly related to rate of adherence. Analyses at month 10 indicated no significant relations. Conclusion: These results support previous research and suggest that the status of cognitive functioning (specifically executive/frontal functioning) be given consideration when working with HIV-positive individuals. As the average age of HIV infected persons continues to climb, addressing issues of neurocognitive compromise in relation to medication adherence and other activities of daily living will continue to be of paramount importance to patients, primary care providers and the HIV community as a whole.