Cognitive impairment among HIV+ women of color

Background. Cognitive impairment is associated with aging and may be especially pronounced among the HIV+ population, in whom HIV infection has documented neurological effects. Objective. We explored the prevalence, correlates, and associations with health outcomes of cognitive impairment among HIV+ women of color (WOC). Methods. Fifty WOC consented to cognitive testing (CogState) and completed a brief psycho-social survey at UNC's Infectious Disease clinic (summer 2012). Following a 30-minute testing battery (resulting in 6 standardized scores), interviewers asked about depression and anxiety, substance use and documented learning disabilities or neurological deficits. Multilogit logistic models resulted in risk ratios and 95% confidence intervals for the 3-level impairment variable (none, mild or equivocal, moderate or severe). Results. Participants generally had low education (88% <=ighschool), were not married (78%) and had been living with HIV for over six years (87%). One-half the sample reported at least one bout of serious depression but most were not on depression / anxiety medication (70%). While most women reported historical substance use (54%), few reported currently using (6%). Only 28% of women had no cognitive impairment while 38% had moderate or severe impairment; 28% of women were between 40-49 and 36% were between 50-59 years of age. Only historic substance use was associated with cognitive impairment in this sample Conclusions. Cognitive impairment is prevalent among HIV+ women of color. As this population ages and the neurological effects of HIV become manifest, the cognitive health of the HIV+ population will become increasingly important for research, practice, and policy.