142nd APHA Annual Meeting and Exposition

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Impaired executive function, drug and sex risk, and HIV infection in African American men

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014

Joy Scheidell, MPH , Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL
Maria Khan, PhD, MPH , Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL
Larry Keen II, Ph.D. , Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
Eugene Dunne, MA , Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
William Latimer, PhD, MPH , Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
BACKGROUND: African American men experience disproportionate HIV infection in the US. Impaired planning ability, an executive function measured by the Tower of London (TOL) neuropsychological test, is a modifiable risk factor that may contribute to drug and sex risk, and, in turn, HIV infection in this population.

METHODS: Using baseline data of the Neuro-HIV Intervention Study (N=244), we estimated adjusted prevalence ratios (APRs) and 95% confidence intervals (CIs) for associations between impaired planning ability (TOL standardized total excess moves score < 10th percentile) and outcomes including risky injection practices (ever having shared needles, cookers, cotton, or rinse water and ever backloaded), casual sex (sex with a partner for less than three months), buying sex, and biologically-confirmed HIV infection.

RESULTS: Approximately 18% were HIV-infected. In analyses adjusting for age and education, impairment on TOL was associated with HIV infection (APR: 1.81, 95% CI: 1.09, 3.01) and with some but not all potential mediating factors including needle sharing (APR: 1.69, 95% CI: 1.03, 2.73) and buying sex (APR: 2.50, 95% CI: 1.66, 3.78). When adjusting for needle sharing and buying sex, factors that may mediate the association between impaired planning and HIV infection, the APR for the association between TOL and HIV strengthened to 1.91 (95% CI: 1.10, 3.33), suggesting other factors likely mediate the relationship.

CONCLUSIONS: Interventions that seek to improve planning may reduce HIV infection among African American men. Additional research is needed to identify the behavioral determinants of HIV infection that are most strongly influenced by impaired executive function.

Learning Areas:

Epidemiology

Learning Objectives:
Describe the effect of impaired planning ability on drug and sexual risk behaviors and HIV infection in African American men.

Keyword(s): African American, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctoral student in epidemiology and my research focuses on STI/HIV and related risk behaviors. I have been working with this data for over a year and have presented findings related to executive function and infectious disease in the sample previously.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5057.0: Substance Use and HIV/AIDS