| Publication Abstract Display | | Type: Published Abstract | | Title: Neurocognitive Impairment and Antiretroviral Nonadherence among HIV-1 Persons with Co-Occurring Bipolar Disorder. | | Authors: Blackstone K, Moore D, Gouaux B, Ellis R, Atkinson J, Grant I, and the HNRP Group | | Year: 2011 | | Publication: Archives of Clinical Neuropsychology | | Volume: 26 Issue: 6 Pages: 485 | | Abstract:Objective: Neuropsychological (NP) impairment and bipolar disorder (BD) are risk factors for antiretroviral (ARV) nonadherence in HIV; we examined the differential contribution of these risk factors for ARV nonadherence in HIV + /BD+ participants when compared with HIV participants without BD (HIV + /BD2). Method: Neurocognitive and adherence abilities were assessed in 43 HIV + /BD+ and 33 HIV + /BD2 individuals. DSM-IV BD diagnoses were determined by the SCID.
ARV adherence was measured as the proportion of correct bottle openings over a 30-day period using the Medication Event Monitoring System with nonadherence defined as <90% adherent. NP functioning was assessed with a seven-domain
comprehensive battery. Results: Participants were comparable across all demographic and disease variables (i.e., age, education, gender, CD4 count, and plasma viral load; p’s > 0.05); however, lifetime methamphetamine and hallucinogen
abuse/dependence diagnoses were more common in the HIV/BD+ group (p’s < 0.04) and were subsequently entered in all models to account for possible contributions to nonadherence. When group membership was not included in the model,
NP-impairment accounted for a small, but significant, proportion of ARV nonadherence (R squared = .04; p = 0.04). When group
membership (HIV + /BD+ v. HIV + /BD2) was included, NP impairment was no longer significant, and group membership
was the only significant predictor of ARV adherence (R squared = .19; p < 0.001), with HIV + /BD+ more nonadherent than HIV + /BD2 participants. Conclusions: Although NP impairment is associated with ARV nonadherence, BD diagnosis predicts nonadherence beyond impairment. These findings demonstrate that although NP impairment may be used as an indicator of ARV nonadherence, there are processes specific to BD that may influence adherence behaviors in the context of HIV. |
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