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Post-traumatic stress is associated with verbal learning, memory, and psychomotor speed in HIV-infected and HIV-uninfected women

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Abstract

The prevalence of post-traumatic stress disorder (PTSD) is higher among HIV-infected (HIV+) women compared with HIV-uninfected (HIV−) women, and deficits in episodic memory are a common feature of both PTSD and HIV infection. We investigated the association between a probable PTSD diagnosis using the PTSD Checklist-Civilian (PCL-C) version and verbal learning and memory using the Hopkins Verbal Learning Test in 1004 HIV+ and 496 at-risk HIV− women. HIV infection was not associated with a probable PTSD diagnosis (17 % HIV+, 16 % HIV−; p = 0.49) but was associated with lower verbal learning (p < 0.01) and memory scores (p < 0.01). Irrespective of HIV status, a probable PTSD diagnosis was associated with poorer performance in verbal learning (p < 0.01) and memory (p < 0.01) and psychomotor speed (p < 0.001). The particular pattern of cognitive correlates of probable PTSD varied depending on exposure to sexual abuse and/or violence, with exposure to either being associated with a greater number of cognitive domains and a worse cognitive profile. A statistical interaction between HIV serostatus and PTSD was observed on the fine motor skills domain (p = 0.03). Among women with probable PTSD, HIV− women performed worse than HIV+ women on fine motor skills (p = 0.01), but among women without probable PTSD, there was no significant difference in performance between the groups (p = 0.59). These findings underscore the importance of considering mental health factors as correlates to cognitive deficits in women with HIV.

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Acknowledgments

Dr. Rubin’s effort was supported by grant number 1K01MH098798-01 from the National Institute of Mental Health (NIMH) and by grant number K12HD055892 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the National Institutes of Health Office of Research on Women’s Health (ORWH). This grant is also supported in part by the Chicago Developmental Center for AIDS Research (D-CFAR), an NIH-funded program (P30 AI 082151), which is supported by the following NIH Institutes and Centers (NIAID, NCI, NIMH, NIDA, NICHD, NHLBI, NCCAM). Data in this manuscript were collected by the Women’s Interagency HIV Study (WIHS). The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH). WIHS (principal investigators): UAB-MS WIHS (Michael Saag, Mirjam-Colette Kempf, and Deborah Konkle-Parker), U01-AI-103401; Atlanta WIHS (Ighovwerha Ofotokun and Gina Wingood), U01-AI-103408; Bronx WIHS (Kathryn Anastos), U01-AI-035004; Brooklyn WIHS (Howard Minkoff and Deborah Gustafson), U01-AI-031834; Chicago WIHS (Mardge Cohen and Audrey French), U01-AI-034993; Metropolitan Washington WIHS (Mary Young), U01-AI-034994; Miami WIHS (Margaret Fischl and Lisa Metsch), U01-AI-103397; UNC WIHS (Adaora Adimora), U01-AI-103390; Connie Wofsy Women’s HIV Study, Northern California (Ruth Greenblatt, Bradley Aouizerat, and Phyllis Tien), U01-AI-034989; WIHS Data Management and Analysis Center (Stephen Gange and Elizabeth Golub), U01-AI-042590; Southern California WIHS (Joel Milam), U01-HD-032632 (WIHS I–WIHS IV). The WIHS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute on Mental Health (NIMH). Targeted supplemental funding for specific projects is also provided by the National Institute of Dental and Craniofacial Research (NIDCR), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Deafness and other Communication Disorders (NIDCD), and the NIH Office of Research on Women’s Health. WIHS data collection is also supported by UL1-TR000004 (UCSF CTSA) and UL1-TR000454 (Atlanta CTSA).

Conflict of interest

Dr. Valcour has consulted for ViiV Healthcare and declares no conflict. All other authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Psychiatry (MC 913), University of Illinois at Chicago, 912 S Wood St, Chicago, IL, 60612, USA

    Leah H. Rubin, Judith A. Cook & Pauline M. Maki

  2. Hektoen Institute of Medicine, Chicago, IL, USA

    Maria Pyra, Kathleen M. Weber & Mardge H. Cohen

  3. The Core Center, Bureau of Health Services of Cook County, Chicago, IL, USA

    Kathleen M. Weber & Mardge H. Cohen

  4. Department of Medicine, Stroger Hospital and Rush University, Chicago, IL, USA

    Mardge H. Cohen

  5. Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA

    Eileen Martin

  6. Department of Neurology, University of California, San Francisco, CA, USA

    Victor Valcour

  7. Institute for Health Promotion and Disease Prevention Research, University of Southern California, Los Angeles, CA, USA

    Joel Milam

  8. Department of Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA

    Kathryn Anastos

  9. Department of Medicine, Georgetown University, Washington, DC, USA

    Mary A. Young

  10. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Christine Alden

  11. Department of Neurology, SUNY-Downstate Medical Center, Brooklyn, NY, USA

    Deborah R. Gustafson

  12. Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA

    Pauline M. Maki

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  1. Leah H. Rubin
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  2. Maria Pyra
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Correspondence to Leah H. Rubin.

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Rubin, L.H., Pyra, M., Cook, J.A. et al. Post-traumatic stress is associated with verbal learning, memory, and psychomotor speed in HIV-infected and HIV-uninfected women. J. Neurovirol. 22, 159–169 (2016). https://doi.org/10.1007/s13365-015-0380-9

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