Skip to main content

Advertisement

SpringerLink
Log in

Cognitive Executive Functioning in Relation to HIV Medication Adherence Among Gay, Bisexual, and other Men who have Sex with Men

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

A longitudinal study of 300 HIV-positive gay, bisexual or non-gay-identified men-who-have-sex-with-men 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 executive functioning as assessed by the Trail Making Test A and B. Executive functioning was assessed at baseline and month 10. Our analytic sample consisted of 213 men who remained on the same protease inhibitor throughout the assessment timeframe. 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 executive functioning and age were related to rate of adherence. Analyses at month 10 indicated no significant relations. Findings support previous research and suggest that the status of executive functioning as well as age be given consideration when working with HIV-positive individuals.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Albert, S. M., Todak, G., Elkin, E., Marder, K., Dooneief, G., & Stern Y. (1994). Time allocation and disability in HIV infection: A correlational study. Journal of Occupational Science, 1, 21–30.

    Google Scholar 

  • Albert, S. M., Marder, K., Dooneief, G., Bell, K., Sano, M., & Todak, G. et al. (1995). Neuropsychologic impairment in early HIV infection. A risk factor for work disability. Archives of Neurology, 52(5), 525–530.

    CAS  Google Scholar 

  • Ammassari, A., Antinori, A., Aloisi, M. S., Trotta, M. P., Murri, R., & Bartoli, L. et al. (2004). Depressive symptoms, neurocognitive impairment, and adherence to highly active antiretroviral therapy among HIV-infected persons. Psychosomatics, 45(5), 394–402.

    Article  PubMed  Google Scholar 

  • Ammassari, A. A., Starace, F., Aloisi, M. S., Trotta, M. P., Murri, R., & D’Arminio Monforte, A. et al. (2003). Medication adherence among HIV+ adults: Effects of cognitive dysfunction and regimen complexity. Neurology, 61(5), 723–4; author reply 724.

    Google Scholar 

  • Arbuthnott, K., & Frank, J. (2000). Trail making test, part B as a measure of executive control: Validation using a set-switching paradigm. Journal of Clinical and Experimental Neuropsychology: Official Journal of the International Neuropsychological Society, 22(4), 518–528.

    CAS  Google Scholar 

  • Army Individual Test Battery (1944). Manuel of directions and scoring. Washington, DC: War Department, Adjutant General’s Office.

    Google Scholar 

  • Avants, S. K., Margolin, A., Warburton, L. A., Hawkins, K. A., & Shi, J. (2001). Predictors of nonadherence to HIV-related medication regimens during methadone stabilization. The American Journal on Addictions/American Academy of Psychiatrists in Alcoholism and Addictions, 10(1), 69–78.

    CAS  PubMed  Google Scholar 

  • Baldewicz, T. T., Leserman, J., Silva, S. G., Petitto, J. M., Golden, R. N., & Perkins, D. O. et al. (2004). Changes in neuropsychological functioning with progression of HIV-1 infection: Results of an 8-year longitudinal investigation. AIDS and Behavior, 8(3), 345–355.

    Article  PubMed  Google Scholar 

  • Bondi, M. W., Drake, A. I., & Grant, I. (1998). Verbal learning and memory in alcohol abusers and polysubstance abusers with concurrent alcohol abuse. Journal of the International Neuropsychological Society: JINS, 4(4), 319–328.

    CAS  PubMed  Google Scholar 

  • Bornstein, R. A., Nasrallah, H. A., Para, M. F., Whitacre, C. C., Rosenberger, P., & Fass, R. J. et al. (1992). Neuropsychological performance in asymptomatic HIV infection. The Journal of Neuropsychiatry and Clinical Neurosciences, 4(4), 386–394.

    CAS  PubMed  Google Scholar 

  • Bybee, J. A., & Zigler, E. (1991). Self-image and guilt: A further test of the cognitive-developmental formulation. Journal of Personality, 59(4), 733–745.

    Article  CAS  PubMed  Google Scholar 

  • Carrieri, P., Cailleton, V., Le Moing, V., Spire, B., Dellamonica, P., & Bouvet, E. et al. (2001). The dynamic of adherence to highly active antiretroviral therapy: Results from the french national APROCO cohort. Journal of Acquired Immune Deficiency Syndromes (1999), 28(3), 232–239.

    CAS  Google Scholar 

  • Cohen, R. A., Boland, R., Paul, R., Tashima, K. T., Schoenbaum, E. E., & Celentano, D. D. et al. (2001). Neurocognitive performance enhanced by highly active antiretroviral therapy in HIV-infected women. AIDS (London, England), 15(3), 341–345.

    CAS  Google Scholar 

  • d’Arminio Monforte, A., Lepri, A. C., Rezza, G., Pezzotti, P., Antinori, A., & Phillips, A. N. et al. (2000). Insights into the reasons for discontinuation of the first highly active antiretroviral therapy (HAART) regimen in a cohort of antiretroviral naive patients. I.CO.N.A. study group. Italian cohort of antiretroviral-naive patients. AIDS (London, England), 14(5), 499–507.

    CAS  Google Scholar 

  • Di Stefano, M., Monno, L., Fiore, J. R., Buccoliero, G., Appice, A., & Perulli, L. M. et al. (1998). Neurological disorders during HIV-1 infection correlate with viral load in cerebrospinal fluid but not with virus phenotype. AIDS (London, England), 12(7), 737–743.

    CAS  Google Scholar 

  • Ellis, R. J., Hsia, K., Spector, S. A., Nelson, J. A., Heaton, R. K., & Wallace, M. R. et al. (1997). Cerebrospinal fluid human immunodeficiency virus type 1 RNA levels are elevated in neurocognitively impaired individuals with acquired immunodeficiency syndrome. HIV neurobehavioral research center group. Annals of Neurology, 42(5), 679–688.

    Article  CAS  PubMed  Google Scholar 

  • Ferrando, S., van Gorp, W., McElhiney, M., Goggin, K., Sewell, M., & Rabkin, J. (1998). Highly active antiretroviral treatment in HIV infection: Benefits for neuropsychological function. AIDS (London, England), 12(8), F65–F70.

    CAS  Google Scholar 

  • Ferrando, S. J., Rabkin, J. G., van Gorp, W., Lin, S. H., & McElhiney, M. (2003). Longitudinal improvement in psychomotor processing speed is associated with potent combination antiretroviral therapy in HIV-1 infection. The Journal of Neuropsychiatry and Clinical Neurosciences, 15(2), 208–214.

    PubMed  Google Scholar 

  • Gass, C. S., & Daniel, S. K. (1990). Emotional impact on trail making test performance. Psychological Reports, 67(2), 435–438.

    Article  CAS  PubMed  Google Scholar 

  • Gaudino, E. A., Geisler, M. W., & Squires, N. K. (1995). Construct validity in the trail making test: What makes part B harder? Journal of Clinical and Experimental Neuropsychology: Official Journal of the International Neuropsychological Society, 17(4), 529–535.

    CAS  Google Scholar 

  • Goodkin, K., Wilkie, F. L., Concha, M., Hinkin, C. H., Symes, S., & Baldewicz, T. T. et al. (2001). Aging and neuro-AIDS conditions and the changing spectrum of HIV-1-associated morbidity and mortality. Journal of Clinical Epidemiology, 54(Suppl. 1), S35–S43.

    Article  PubMed  Google Scholar 

  • Gross, R., Bilker, W. B., Friedman, H. M., & Strom, B. L. (2001). Effect of adherence to newly initiated antiretroviral therapy on plasma viral load. AIDS (London, England), 15(16), 2109–2117.

    CAS  Google Scholar 

  • Halkitis, P. N., Kutnick, A. H., & Slater, S. (2005). The social realities of adherence to protease inhibitor regimens: Substance use, health care and psychological states. Journal of Health Psychology, 10(4), 545–558.

    Article  PubMed  Google Scholar 

  • Heaton, R. K., Grant, I., Butters, N., White, D. A., Kirson, D., & Atkinson, J. H. et al. (1995). The HNRC 500–Neuropsychology of HIV infection at different disease stages. HIV neurobehavioral research center. Journal of the International Neuropsychological Society: JINS, 1(3), 231–251.

    Article  CAS  PubMed  Google Scholar 

  • Heaton, R. K., Marcotte, T. D., Mindt, M. R., Sadek, J., Moore, D. J., & Bentley, H. et al. (2004). The impact of HIV-associated neuropsychological impairment on everyday functioning. Journal of the International Neuropsychological Society: JINS, 10(3), 317–331.

    Article  PubMed  Google Scholar 

  • Hill, Z., Kendall, C., & Fernandez, M. (2003). Patterns of adherence to antiretrovirals: Why adherence has no simple measure. AIDS Patient Care and STDs, 17(10), 519–525.

    Article  PubMed  Google Scholar 

  • Hinkin, C. H., Castellon, S. A., Durvasula, R. S., Hardy, D. J., Lam, M. N., & Mason, K. I. et al. (2002). Medication adherence among HIV+ adults: Effects of cognitive dysfunction and regimen complexity. Neurology, 59(12), 1944–1950.

    CAS  PubMed  Google Scholar 

  • Hinkin, C. H., Hardy, D. J., Mason, K. I., Castellon, S. A., Durvasula, R. S., & Lam, M. N. et al. (2004). Medication adherence in HIV-infected adults: Effect of patient age, cognitive status, and substance abuse. AIDS (London, England), 18(Suppl. 1), S19–S25.

    Google Scholar 

  • Hugen, P. W., Langebeek, N., Burger, D. M., Zomer, B., van Leusen, R., & Schuurman, R. et al. (2002). Assessment of adherence to HIV protease inhibitors: Comparison and combination of various methods, including MEMS (electronic monitoring), patient and nurse report, and therapeutic drug monitoring. Journal of Acquired Immune Deficiency Syndromes (1999), 30(3), 324–334.

    CAS  Google Scholar 

  • Kalichman, S. C., Difonzo, K., Austin, J., Luke, W., & Rompa, D. (2002). Prospective study of emotional reactions to changes in HIV viral load. AIDS Patient Care and STDs, 16(3), 113–120.

    Article  PubMed  Google Scholar 

  • Kimmerling, M., Wagner, G., & Ghosh-Dastidar, B. (2003). Factors associated with accurate self-reported adherence to HIV antiretrovirals. International Journal of STD and AIDS, 14(4), 281–284.

    Article  PubMed  Google Scholar 

  • Kortte, K. B., Horner, M. D., & Windham, W. K. (2002). The trail making test, part B: Cognitive flexibility or ability to maintain set? Applied Neuropsychology, 9(2), 106–109.

    Article  PubMed  Google Scholar 

  • Kruse, W., Rampmaier, J., Ullrich, G., & Weber, E. (1994). Patterns of drug compliance with medication to be taken once and twice daily assessed by continuous electronic monitoring in primary care. International Journal of Clinical Pharmacology Therapy, 32, 453–457.

    Google Scholar 

  • Lezak, M. D. (1995). Neuropsychological assessment (3rd ed.). New York: Oxford University Press.

    Google Scholar 

  • Liu, H., Golin, C. E., Miller, L. G., Hays, R. D., Beck, C. K., & Sanandaji, S. et al. (2001). A comparison study of multiple measures of adherence to HIV protease inhibitors. Annals of Internal Medicine, 134(10), 968–977.

    CAS  PubMed  Google Scholar 

  • Mannheimer, S., Friedland, G., Matts, J., Child, C., & Chesney, M. (2002). The consistency of adherence to antiretroviral therapy predicts biologic outcomes for human immunodeficiency virus-infected persons in clinical trials. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 34(8), 1115–1121.

    Google Scholar 

  • Matsuyama, J. R., Mason, B. J., & Jue, S. G. (1993). Pharmacists’ interventions using an electronic medication-event monitoring device’s adherence data versus pill counts. The Annals of Pharmacotherapy, 27(7–8), 851–855.

    CAS  PubMed  Google Scholar 

  • McArthur, J. C., McClernon, D. R., Cronin, M. F., Nance-Sproson, T. E., Saah, A. J., & St Clair, M. et al. (1997). Relationship between human immunodeficiency virus-associated dementia and viral load in cerebrospinal fluid and brain. Annals of Neurology, 42(5), 689–698.

    Article  CAS  PubMed  Google Scholar 

  • Miller, E. N., Selnes, O. A., McArthur, J. C., Satz, P., Becker, J. T., & Cohen, B. A. et al. (1990). Neuropsychological performance in HIV-1-infected homosexual men: The multicenter AIDS cohort study (MACS). Neurology, 40(2), 197–203.

    CAS  PubMed  Google Scholar 

  • Palella, F. J. Jr., Delaney, K. M., Moorman, A. C., Loveless, M. O., Fuhrer, J., & Satten, G. A. et al. (1998). Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV outpatient study investigators. The New England Journal of Medicine, 338(13), 853–860.

    Article  PubMed  Google Scholar 

  • Parsons, T. D., Braaten, A. J., Hall, C. D., & Robertson, K. R. (2006). Better quality of life with neuropsychological improvement on HAART. Health and Quality of Life Outcomes [Electronic Resource], 4, 11.

    Article  Google Scholar 

  • Paterson, D. L., Swindells, S., Mohr, J., Brester, M., Vergis, E. N., & Squier, C. et al. (2000). Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Annals of Internal Medicine, 133(1), 21–30.

    CAS  PubMed  Google Scholar 

  • Power, R., Koopman, C., Volk, J., Israelski, D. M., Stone, L., & Chesney, M. A. et al. (2003). Social support, substance use, and denial in relationship to antiretroviral treatment adherence among HIV-infected persons. AIDS Patient Care and STDs, 17(5), 245–252.

    Article  PubMed  Google Scholar 

  • Rabkin, J. G., & Chesney, M. (1999). Treatment adherence to HIV medications: The Achilles heel of new therapeutics. In D. Ostrow, S. Kalichman (Eds.), New HIV therapies: Psychology and public health implications. New York: Plenum Press.

    Google Scholar 

  • Reger, M., Welsh, R., Razani, J., Martin, D. J., & Boone, K. B. (2002). A meta-analysis of the neuropsychological sequelae of HIV infection. Journal of the International Neuropsychological Society: JINS, 8(3), 410–424.

    Article  PubMed  Google Scholar 

  • Reitan, R., & Wolfson, D. (1993). The helstead-reitan neuropsychological test battery: Theory and clinical interpretation. Tucson, AZ: Neuropsychological Press.

    Google Scholar 

  • Rosselli, M., & Ardila, A. (1996). Cognitive effects of cocaine and polydrug abuse. Journal of Clinical and Experimental Neuropsychology: Official Journal of the International Neuropsychological Society, 18(1), 122–135.

    CAS  Google Scholar 

  • Sankar, A., Golin, C., Simoni, J. M., Luborsky, M., & Pearson, C. (2006). How qualitative methods contribute to understanding combination antiretroviral therapy adherence. Journal of Acquired Immune Deficiency Syndromes (1999), 43(Suppl. 1), S54–S68.

    Article  Google Scholar 

  • Shannon, K., Kerr, T., Lai, C., Ishida, T., Wood, E., & Montaner, J. S. et al. (2005). Nonadherence to antiretroviral therapy among a community with endemic rates of injection drug use. Journal of the International Association of Physicians in AIDS Care (Chicago, IL: 2002), 4(3), 66–72.

    Article  Google Scholar 

  • Starace, F., Bartoli, L., Aloisi, M. S., Antinori, A., Narciso, P., & Ippolito, G. et al. (2002). Cognitive and affective disorders associated to HIV infection in the HAART era: Findings from the NeuroICONA study. Cognitive impairment and depression in HIV/AIDS. the NeuroICONA study. Acta Psychiatrica Scandinavica, 106(1), 20–26.

    Article  CAS  PubMed  Google Scholar 

  • Tombaugh, T. N. (2004). Trail making test A and B: Normative data stratified by age and education. Archives of Clinical Neuropsychology: The Official Journal of the National Academy of Neuropsychologists, 19(2), 203–214.

    Google Scholar 

  • Tozzi, V., Balestra, P., Galgani, S., Narciso, P., Sampaolesi, A., & Antinori, A. et al. (2001). Changes in neurocognitive performance in a cohort of patients treated with HAART for 3 years. Journal of Acquired Immune Deficiency Syndromes (1999), 28(1), 19–27.

    CAS  Google Scholar 

  • Tozzi, V., Balestra, P., Murri, R., Galgani, S., Bellagamba, R., & Narciso, P. et al. (2004). Neurocognitive impairment influences quality of life in HIV-infected patients receiving HAART. International Journal of STD and AIDS, 15(4), 254–259.

    Article  CAS  PubMed  Google Scholar 

  • Treisman, G. J., Angelino, A. F., & Hutton, H. E. (2001). Psychiatric issues in the management of patients with HIV infection. JAMA: The Journal of the American Medical Association, 286(22), 2857–2864.

    Article  CAS  Google Scholar 

  • Turner, C. F., Ku, L., Rogers, S. M., Lindberg, L. D., Pleck, J. H., & Sonenstein, F. L. (1998). Adolescent sexual behavior, drug use, and violence: Increased reporting with computer survey technology. Science, 280(5365), 867–873.

    Article  CAS  PubMed  Google Scholar 

  • Valcour, V., & Paul, R. (2006). HIV infection and dementia in older adults. Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America, 42(10), 1449–1454.

    Google Scholar 

  • Wagner, G. J. (2002). Predictors of antiretroviral adherence as measured by self-report, electronic monitoring, and medication diaries. AIDS Patient Care and STDs, 16(12), 599–608.

    Article  PubMed  Google Scholar 

  • Wagner, G. J., & Rabkin, J. G. (2000). Measuring medication adherence: Are missed doses reported more accurately then perfect adherence? AIDS Care, 12(4), 405–408.

    Article  CAS  PubMed  Google Scholar 

  • Wainberg, M. A., & Friedland, G. (1998). Public health implications of antiretroviral therapy and HIV drug resistance. JAMA: The Journal of the American Medical Association, 279(24), 1977–1983.

    Article  CAS  Google Scholar 

  • Waterhouse, D. M., Calzone, K. A., Mele, C., & Brenner, D. E. (1993). Adherence to oral tamoxifen: A comparison of patient self-report, pill counts, and microelectronic monitoring. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 11(6), 1189–1197.

    CAS  Google Scholar 

  • Watters, J. K., & Biernacki, P. (1989). Targeted sampling: Options and considerations for the study of hidden populations. Social Problems, 36, 416–430.

    Article  Google Scholar 

Download references

Acknowledgments

This research was funded by a grant from the National Institute on Drug Abuse (Contract #R01DA12816).

Author information

Authors and Affiliations

  1. New York University School of Medicine, New York, NY, USA

    Todd M. Solomon

  2. Center for Health, Identity, Behavior & Prevention Studies (CHIBPS), New York University Steinhardt School of Culture, Education, and Human Development, New York, NY, USA

    Todd M. Solomon & Perry N. Halkitis

Authors
  1. Todd M. Solomon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Perry N. Halkitis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Perry N. Halkitis.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Solomon, T.M., Halkitis, P.N. Cognitive Executive Functioning in Relation to HIV Medication Adherence Among Gay, Bisexual, and other Men who have Sex with Men. AIDS Behav 12, 68–77 (2008). https://doi.org/10.1007/s10461-007-9273-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-007-9273-0

Keywords

Search

Navigation