학술논문

Everyday functional ability in HIV and methamphetamine dependence
Document Type
article
Source
Subject
Medical Microbiology
Biomedical and Clinical Sciences
Brain Disorders
Substance Misuse
Neurosciences
Clinical Research
HIV/AIDS
Infectious Diseases
Drug Abuse (NIDA only)
Prevention
Methamphetamine
Good Health and Well Being
Activities of Daily Living
Adolescent
Adult
Aged
Amphetamine-Related Disorders
Cohort Studies
Female
HIV Infections
Humans
Male
Middle Aged
Young Adult
HIV
UPSA
Everyday functioning
Cognition
Translational Methamphetamine AIDS Research Center
Medical and Health Sciences
Psychology and Cognitive Sciences
Substance Abuse
Biochemistry and cell biology
Pharmacology and pharmaceutical sciences
Epidemiology
Language
Abstract
BackgroundMethamphetamine (METH) use is a risk factor for the transmission of HIV. Each is associated with neurocognitive impairment and subsequent problems in everyday functioning, yet additive effects of HIV and METH are not consistently observed. This study used the UCSD Performance-Based Skills Assessment (UPSA-2) to assess whether METH use disorder and HIV together resulted in poorer functional outcome than either condition alone.MethodParticipants in the Translational Methamphetamine AIDS Research Center (TMARC) cohort were stratified based upon HIV infection and METH use disorder: HIV-/METH- (n=49), HIV-/METH+ (n=48), HIV+/METH- (n=37), and HIV+/METH+ (n=38). They were administered the UPSA-2 which measures abilities in six domains of everyday functioning. Main effects and interactions of HIV and METH were examined, as were relationships between UPSA-2 scores and disease characteristics.ResultsSignificant HIV-by-METH interactions were observed for the UPSA-2 total score and Comprehension/Planning and Financial subscales such that METH was associated with lower scores in HIV- participants but not HIV+ participants. METH was associated with lower scores on the Communications subscale. All three risk groups had lower scores than HIV-/METH- participants. Recency and frequency of METH use were associated with lower scores. Lower Medication Management scores were related to lower nadir CD4 counts.ConclusionsMETH use disorder and HIV each impair functional performance, but there is no additive effect when the two conditions occur together. The neurocognitive sequelae of combined HIV infection and METH use are complex and warrant further study, as do the potential effects of compensatory strategies and other factors.