Matthew C Sullivan, Megan R Wirtz, Samantha M McKetchnie, Lauren R Gulbicki, S Wade Taylor, Jonathan D Jampel, Nikhil Banerjee, Conall O'Cleirigh
{"title":"Neurocognitive Impairment and HIV Treatment Engagement in Men Who Have Sex With Men Living With HIV Who Report Chronic Pain and Substance Use.","authors":"Matthew C Sullivan, Megan R Wirtz, Samantha M McKetchnie, Lauren R Gulbicki, S Wade Taylor, Jonathan D Jampel, Nikhil Banerjee, Conall O'Cleirigh","doi":"10.1155/arat/3404193","DOIUrl":null,"url":null,"abstract":"<p><p>This study explored relationships between neurocognitive impairment (NCI), engagement in HIV care, and functional disability among sexual minority men aged 50 years or older living with HIV, chronic pain, and recent substance use. Sixty-three participants completed cross-sectional assessments including a neurocognitive screening measure, self-reported HIV medication adherence, past-year attendance at HIV-care appointments, and indices of pain and functional impairment. Mean participant age was 57.2 years; most identified as White (55%), followed by Black/African American (42%). On average, participants reported moderate pain; 66.7% met DSM-5 criteria for a substance use disorder. Average Montreal Cognitive Assessment (MoCA) performance reflected mild NCI. Regression analyses indicated an association between poorer MoCA performance and past-year missed HIV-care appointments (<i>B</i> = -0.09, <i>t</i> (59) = -3.10, <i>p</i> = 0.004). Self-reported cognitive impairment was associated with more missed HIV-care visits (<i>B</i> = 0.20, <i>t</i> (59) = 4.82, <i>p</i> < 0.001) and greater functional disability, whereas poorer semantic fluency was associated with fewer missed HIV-care visits (<i>B</i> = -0.49, <i>t</i> (59) = -3.99, <i>p</i> < 0.001). Increased brief neuropsychological assessment and linkage to tailored interventions for HIV-care engagement and substance use mitigation are warranted to support PLWH with NCI in clinical care.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2025 ","pages":"3404193"},"PeriodicalIF":1.1000,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11824763/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"AIDS Research and Treatment","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/arat/3404193","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
Abstract
This study explored relationships between neurocognitive impairment (NCI), engagement in HIV care, and functional disability among sexual minority men aged 50 years or older living with HIV, chronic pain, and recent substance use. Sixty-three participants completed cross-sectional assessments including a neurocognitive screening measure, self-reported HIV medication adherence, past-year attendance at HIV-care appointments, and indices of pain and functional impairment. Mean participant age was 57.2 years; most identified as White (55%), followed by Black/African American (42%). On average, participants reported moderate pain; 66.7% met DSM-5 criteria for a substance use disorder. Average Montreal Cognitive Assessment (MoCA) performance reflected mild NCI. Regression analyses indicated an association between poorer MoCA performance and past-year missed HIV-care appointments (B = -0.09, t (59) = -3.10, p = 0.004). Self-reported cognitive impairment was associated with more missed HIV-care visits (B = 0.20, t (59) = 4.82, p < 0.001) and greater functional disability, whereas poorer semantic fluency was associated with fewer missed HIV-care visits (B = -0.49, t (59) = -3.99, p < 0.001). Increased brief neuropsychological assessment and linkage to tailored interventions for HIV-care engagement and substance use mitigation are warranted to support PLWH with NCI in clinical care.
本研究探讨了50岁及以上艾滋病病毒感染者、慢性疼痛和近期药物使用的性少数男性的神经认知障碍(NCI)、参与艾滋病护理和功能残疾之间的关系。63名参与者完成了横断面评估,包括神经认知筛查措施、自我报告的艾滋病毒药物依从性、过去一年参加艾滋病毒护理预约以及疼痛和功能损伤指数。参与者平均年龄为57.2岁;大多数被认为是白人(55%),其次是黑人/非裔美国人(42%)。平均而言,参与者报告有中度疼痛;66.7%符合DSM-5的物质使用障碍标准。蒙特利尔认知评估(MoCA)平均表现反映轻度NCI。回归分析表明,较差的MoCA表现与过去一年错过hiv护理预约之间存在关联(B = -0.09, t (59) = -3.10, p = 0.004)。自我报告的认知障碍与错过hiv护理的次数更多相关(B = 0.20, t (59) = 4.82, p B = -0.49, t (59) = -3.99, p
期刊介绍:
AIDS Research and Treatment is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies focused on all aspects of HIV and AIDS, from the molecular basis of disease to translational and clinical research. In addition, articles relating to prevention, education, and behavior change will be considered