A longitudinal analysis of methamphetamine use, social relationships, and cognitive function among people living with HIV

PROJECT SUMMARY/ABSTRACT
There is compelling but scant evidence that the increasingly common combination of HIV, methamphetamine
use (MU), and aging form a deleterious trio that undermines cognitive functioning. HIV and MU are both risk
factors for decreased neurocognitive function and evidence shows that continued substance use (SU) after HIV
infection may erode cognitive functioning. Estimates indicate that over 70% of people living with HIV (PWH) will
be >50 years of age in the next decade and older PWH experience a high burden of both lifetime SU and
cognitive impairment. A gap exists in our understanding of the intertwining relationships of SU, HIV, and cognitive
function across biological ages and over time. Examining cognitive change over time and across ages will help
identify potential points of intervention to maintain brain health across the life course. Interventions to reduce MU
and support brain health among aging PWH are vital and improving social relationships is a promising area of
intervention. By applying advanced statistical modeling methods and capitalizing on an exceptional analytic
cohort of 527 adults with and without HIV (ages 18-87) and people who use meth, the proposed study is uniquely
positioned to rigorously advance scientific understanding of these intertwining relationships across ages and
over time among adults with and without HIV. The specific aims of this study are to 1) Assess the validity and
reliability
of the social relationship measures in the NIH Toolbox Emotions Battery in adults aging with vs. without
HIV, to inform Aims 2 and 3 analyses;
2) Examine a) age-varying cognitive impairment among our sample, and
Identify a) the
reciprocal associations between MU and cognitive function over time among people with and without HIV and b)
examine the extent to which social relationships mediate the longitudinal associations between MU and cognitive
function among adults with and without HIV.
b) variations in cognitive function across age by HIV status, MU, and social relationships; and 3)
The proposed K01 will also provide me with a rich opportunity to
become an NIH-funded leader in life course research who applies advanced quantitative and qualitative methods
to conduct high impact, rigorous NIH-funded about the psychosocial needs of PWH with co-occurring SU and
other mental and physical health comorbidities across the lifespan by: (1) deepening my expertise in the
substantive content and measurement of SU and cognitive function; (2) expanding my knowledge about the
measurement of social relationship factors that might mediate relationships of HIV, SU, and cognitive function;
(3) gaining expertise in time-varying effect modeling; and (4) developing my expertise in longitudinal structural
equation modeling, including cross-lagged panel analysis, to examine reciprocal change over time. This research
team of mentors. The findings and skills obtained
from this award will result in scientific publications
that provide insight into the intertwining relationships of MU, cognitive function, and social relationships across
the life span among PWH; and provide direction for intervention development.
and training will be conducted under a nationally recognized
ensure my success as an independent NIH-funded scientist;

Grant Number: 5K01DA053985-04
NIH Institute/Center: NIH
Principal Investigator: Alexis Bender