Abstract
Working memory (WM) is a critical component of many neurocognitive functions. The literature has demonstrated consistently that WM impairment is more frequent and severe among substance-dependent individuals (SDIs) infected with HIV compared with uninfected SDIs; however, the SDIs who participated in these previous studies were primarily male. There are few published data on WM performance among HIV+ women with or without substance use disorders, and essentially no direct comparisons of WM performance between HIV+ men and women, regardless of substance use. We investigated potential sex and serostatus effects on WM among a sample of 360 SDIs (114 with HIV; 66% female) verified abstinent from alcohol and drugs of abuse at testing and generally comparable on substance use and comorbid characteristics. Participants were tested with the n-back task, a well-established WM measure that is sensitive to HIV-associated cognitive impairment. HIV+ men and women performed spatial and verbal versions of the n-back significantly less accurately compared with HIV− participants. Women showed slower response times compared with men on both versions, regardless of HIV serostatus. Individuals dependent on cocaine showed faster RTs compared with non-dependent users, but this effect was not apparent among opioid- or alcohol-dependent groups. Findings on n-back accuracy are consistent with our previous proposal that WM impairment represents a signature deficit among HIV+ SDIs; however, WM impairment appears less common among HIV+ women without a substance use history. The pattern of sex differences in response speed but serostatus effects on response accuracy is comparable to a recent report by our group of sex differences in learning speed but serostatus effects on delayed recall.
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Notes
These procedures were followed in all instances with the single exception that participants who tested positive for cannabis were not excluded if testing was negative for all other substances. The presence of THC metabolites in the urine did not necessarily indicate cannabis use within 1–2 days prior to testing due to its much longer half-life.
Mann–Whitney tests with z approximations were used to compare HIV disease variables among HIV+ men and women.
There was a highly significant correlation between education and mean WTAR IQ estimate, r = .52, p < .001, so mean WTAR scores were not included as a covariate.
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Acknowledgments
We thank Stan Chen, Christine Franco, Haley Sullins, and Leslie Ladd for data collection and Benjamin Spielberg for processing and managing the n-back data. Supported by the National Institute on Drug Abuse R01 DA12828 to Eileen Martin.
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Martin, E., Keutmann, M.K., Fogel, J.S. et al. Verbal and spatial working memory among drug-using HIV-infected men and women. J. Neurovirol. 24, 488–497 (2018). https://doi.org/10.1007/s13365-018-0639-z
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DOI: https://doi.org/10.1007/s13365-018-0639-z