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Effects of cocaine and HIV on decision-making abilities


Our study aimed to understand the impact of cocaine dependence on high-risk decision-making abilities in individuals with the human immunodeficiency virus (HIV) and individuals with cocaine dependence. We recruited 99 participants (27 HIV/Cocaine, 20 HIV Only, 26 Cocaine Only, and 26 Healthy Controls). The Iowa Gambling Task (IGT) was applied to assess decision-making abilities. Independent and interactive effects of HIV status and cocaine dependence were examined using 2 × 2 factorial ANCOVA with premorbid IQ (WRAT-4: WR) as the covariate. We found cocaine dependence had a significant adverse effect on overall IGT performance (p = 0.015). We also found individuals who were HIV-positive tended to have less total money at the end of the game than individuals who were HIV-negative (p = 0.032), suggesting individuals living with HIV had less focus on long-term gains and more focus on short-term gains. Our findings highlight the significant impact of cocaine dependence on decision-making abilities and the difficulty individuals with HIV have in adequately weighing the cost and benefits of their decisions and making appropriate changes for the future.

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The authors thank Dr. Eileen Martin for her review of the initial manuscript draft. The authors also thank Dr. Pauline Maki for her help in the initial IRB application and Dr. Leah Rubin for her help in referring some subjects for this study.


This study was supported by the Chicago Developmental Center for AIDS Research (D-CFAR), a National Institutes of Health (NIH) funded program (P30 AI 082151).

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Correspondence to Shaolin Yang.

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Nigro, S.E., Wu, M., C. Juliano, A. et al. Effects of cocaine and HIV on decision-making abilities. J. Neurovirol. 27, 422–433 (2021).

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  • Cocaine
  • HIV
  • Iowa Gambling Task (IGT)
  • Decision-Making