| Publication Abstract Display | | Type: Published Abstract | | Title: Delayed recall impairment among HIV+ methamphetamine users is associated with medication nonadherence. | | Authors: Moore DJ, Blackstone K, Gouaux B, Atkinson JH, Grant I, and the HNRC Group | | Year: 2011 | | Publication: International Neuropsychological Society 39th Annual Meeting, Boston, Mass | | Volume: Issue: Pages: | | Abstract:Introduction: Previous studies have indicated that significant neurocognitive impairments, including deficits among attention/working memory, learning, delayed recall and motor skills, are consistently reported among HIV+ methamphetamine (HIV+/METH) users (e.g., Rippeth et al., 2004). Although substance use is a consistently a strong predictor of ART medication nonadherence among HIV+ individuals, few studies have examined cognition as a predictor of medication adherence in HIV+/METH; our aim is to investigate the role of cognitive impairment in predicting ART adherence in HIV+/METH.
Method: We examined HIV+ persons with a lifetime history of DSM-IV-diagnosed METH abuse or dependence (HIV+/METH; n=150); subanalyses focused on a subset of currently METH using individuals (n=51) as determined by self report of METH use in the past 30 days or a positive urine toxicology for METH at the time of their visit. Neuropsychological functioning was assessed with a comprehensive NP battery, covering seven neuropsychological domains. Medication adherence was evaluated with the ACTG 4-day adherence questionnaire and nonadherence was identified as report of any skipped dose in the last 4 days.
Results: No association was found between global neuropsychological functioning and nonadherence among HIV+/METH+ users; however, we did observe an association between the presence of delayed recall impairment and ART nonadherence (Likelihood ratio = 6.0; p=0.01) such that 16% (17/104) of the persons with unimpaired delayed recall scores were nonadherent whereas 35% (16/46) of those with impaired delayed recall were nonadherent. Among those participants who evidenced current METH use, a similar, but non-significant, pattern emerged: 4% (5/24) of unimpaired as compared to 36% (4/11) impaired reported nonadherence.
Discussion: Results suggest that the presence of impaired delayed recall performance among HIV+/METH users can relate to nonadherence to ART medications. Future studies are needed to develop interventions (e.g., real-time reminders) to circumvent the observed difficulties that HIV+/METH users may have in remembering to take their ART medications. |
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