Journal of NeuroVirology

, Volume 21, Issue 4, pp 422–432 | Cite as

The association of perceived stress and verbal memory is greater in HIV-infected versus HIV-uninfected women

  • Leah H. RubinEmail author
  • Judith A. Cook
  • Kathleen M. Weber
  • Mardge H. Cohen
  • Eileen Martin
  • Victor Valcour
  • Joel Milam
  • Kathryn Anastos
  • Mary A. Young
  • Christine Alden
  • Deborah R. Gustafson
  • Pauline M. Maki


In contrast to findings from cohorts comprised primarily of HIV-infected men, verbal memory deficits are the largest cognitive deficit found in HIV-infected women from the Women’s Interagency HIV Study (WIHS), and this deficit is not explained by depressive symptoms or substance abuse. HIV-infected women may be at greater risk for verbal memory deficits due to a higher prevalence of cognitive risk factors such as high psychosocial stress and lower socioeconomic status. Here, we investigate the association between perceived stress using the Perceived Stress Scale (PSS-10) and verbal memory performance using the Hopkins Verbal Learning Test (HVLT) in 1009 HIV-infected and 496 at-risk HIV-uninfected WIHS participants. Participants completed a comprehensive neuropsychological test battery which yielded seven cognitive domain scores, including a primary outcome of verbal memory. HIV infection was not associated with a higher prevalence of high perceived stress (i.e., PSS-10 score in the top tertile) but was associated with worse performance on verbal learning (p < 0.01) and memory (p < 0.001), as well as attention (p = 0.02). Regardless of HIV status, high stress was associated with poorer performance in those cognitive domains (p’s < 0.05) as well as processing speed (p = 0.01) and executive function (p < 0.01). A significant HIV by stress interaction was found only for the verbal memory domain (p = 0.02); among HIV-infected women only, high stress was associated with lower performance (p’s < 0.001). That association was driven by the delayed verbal memory measure in particular. These findings suggest that high levels of perceived stress contribute to the deficits in verbal memory observed in WIHS women.


HIV Verbal memory Stress Women Cognition 



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), 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 (Alexandra Levine and Marek Nowicki), 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

The authors declare that they have no conflict of interest.


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Copyright information

© Journal of NeuroVirology, Inc. 2015

Authors and Affiliations

  • Leah H. Rubin
    • 1
    Email author
  • Judith A. Cook
    • 1
  • Kathleen M. Weber
    • 2
  • Mardge H. Cohen
    • 3
  • Eileen Martin
    • 4
  • Victor Valcour
    • 5
  • Joel Milam
    • 6
  • Kathryn Anastos
    • 7
  • Mary A. Young
    • 8
  • Christine Alden
    • 9
  • Deborah R. Gustafson
    • 10
  • Pauline M. Maki
    • 1
    • 11
  1. 1.Department of PsychiatryUniversity of Illinois at ChicagoChicagoUSA
  2. 2.Bureau of Health Services of Cook CountyThe Core CenterChicagoUSA
  3. 3.Departments of Medicine Stroger Hospital and Rush UniversityChicagoUSA
  4. 4.Department of PsychiatryRush University Medical CenterChicagoUSA
  5. 5.Department of NeurologyUniversity of CaliforniaSan FranciscoUSA
  6. 6.Institute for Health Promotion & Disease Prevention ResearchUniversity of Southern CaliforniaLos AngelesUSA
  7. 7.Departments of Medicine and Epidemiology & Population HealthAlbert Einstein College of MedicineBronxUSA
  8. 8.Department of MedicineGeorgetown UniversityWashingtonUSA
  9. 9.Department of EpidemiologyJohns Hopkins School of Public HealthBaltimoreUSA
  10. 10.Department of NeurologySUNY-Downstate Medical CenterBrooklynUSA
  11. 11.Department of PsychologyUniversity of Illinois at ChicagoChicagoUSA

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