Prospective memory in youth with perinatally-acquired HIV infection

ABSTRACT

Youth with perinatal HIV infection (PHIV) are at increased risk for neurocognitive impairment (NCI). Prospective memory (PM) is a complex neurocognitive function that has been shown to be impaired in adults with HIV disease and independently associated with poorer daily living skills, including medication nonadherence. The current study sought to determine the presence and extent of PM deficits in youth with PHIV. Participants included 173 youth with PHIV and 85 youth perinatally HIV-exposed but uninfected (PHEU), mean age 14.1 years, 75% black, 18% Hispanic. Among youth with PHIV, 26% had a past AIDS-defining condition (Centers for Disease Control and Prevention [CDC], Class C), 74% did not (non-C). Adjusted generalized estimating equation models were used to compare groups (PHIV/C, PHIV/non-C, and PHEU) on the Naturalistic Event-Based Prospective Memory Test (NEPT) and the Prospective Memory Assessment for Children & Youth (PROMACY). Secondarily, subgroups defined by HIV serostatus and global NCI were compared (PHIV/NCI, PHIV/non-NCI, PHEU). PHIV/C had significantly lower NEPT scores than PHEU, with decreases of 40% in mean scores, but did not differ from PHIV/non-C. PHIV/NCI had 11–32% lower PROMACY scores and 33% lower NEPT scores compared to PHIV/non-NCI (all p < .05); significantly, lower scores for PHIV/NCI versus PHEU also were observed for PROMACY and NEPT indices. Findings suggest a subset of youth with PHIV (those with a prior AIDS-defining diagnosis) is vulnerable to PM deficits. The extent to which PM deficits interfere with development and maintenance of independent living and health-related behaviors during transition to adulthood requires further study.

KEYWORDS:

• prospective memory
• perinatal HIV
• children
• adolescents
• executive functioning

Acknowledgment

We thank the children and families for their participation in PHACS, and the individuals and institutions involved in the conduct of PHACS. The following institutions, clinical site investigators and staff participated in conducting PHACS in 2015, in alphabetical order; sites participating in the Memory substudy and the site PI for the substudy are marked with an asterisk: Ann & Robert H. Lurie Children’s Hospital of Chicago*: Ram Yogev, Margaret Ann Sanders, Kathleen Malee*, Scott Hunter; Baylor College of Medicine*: William Shearer, Mary Paul, Norma Cooper, Lynnette Harris*; Bronx Lebanon Hospital Center: Murli Purswani, Mahboobullah Baig, Anna Cintron; Children’s Diagnostic & Treatment Center*: Ana Puga, Sandra Navarro, Patricia A. Garvie*, James Blood; Children’s Hospital, Boston*: Sandra Burchett, Nancy Karthas, Betsy Kammerer*; Jacobi Medical Center*: Andrew Wiznia, Marlene Burey, Molly Nozyce*; Rutgers – New Jersey Medical School: Arry Diedonne, Linda Bettica; St. Christopher’s Hospital for Children: Janet Chen, Maria Garcia Bulkley, Latreaca Ivey, Mitzie Grant; St. Jude Children’s Research Hospital*: Katherine Knapp, Kim Allison, Megan Wilkins*; San Juan Hospital/Department of Pediatrics: Midnela Acevedo- Flores, Heida Rios, Vivian Olivera; Tulane University Health Sciences Center*: Margarita Silio, Medea Gabriel, Patricia Sirois*; University of California, San Diego*: Stephen A. Spector, Kim Norris, Sharon Nichols*; University of Colorado Denver Health Sciences Center: Elizabeth McFarland, Julianna Darrow, Emily Barr, Paul Harding; University of Miami: Gwendolyn Scott, Grace Alvarez, Anai Cuadra. The Memory for Intentions Screening Test (MIST) was reproduced by special permission of the Publisher, Psychological Assessment Resources, Inc., 16204 North Florida Avenue, Lutz, Florida 33549, from the Memory for Intentions Screening Test by Sarah Raskin, PhD and Carol Buckheit, Copyright 1998, 2009 by PAR, Inc. Further reproduction is prohibited without permission from PAR, Inc

Disclosure statement

No potential conflict of interest was reported by the authors. The conclusions and opinions expressed in this article are those of the authors and do not necessarily reflect those of the National Institutes of Health or U.S. Department of Health and Human Services.

Additional information

Funding

This work was supported by the Division of Intramural Research, National Institute of Allergy and Infectious Diseases: [Grant Number R01 MH084794]. The Pediatric HIV/AIDS Cohort Study (PHACS) was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development with co-funding from the National Institute on Drug Abuse, the National Institute of Allergy and Infectious Diseases, the Office of AIDS Research, the National Institute of Mental Health, the National Institute of Neurological Disorders and Stroke, the National Institute on Deafness and Other Communication Disorders, the National Heart Lung and Blood Institute, the National Institute of Dental and Craniofacial Research, and the National Institute on Alcohol Abuse and Alcoholism, through cooperative agreements with the Harvard T.H. Chan School of Public Health (HD052102) (PI: George Seage; Project Director: Julie Alperen) and the Tulane University School of Medicine (HD052104) (PI: Russell Van Dyke; Co-PIs: Kenneth Rich, Ellen Chadwick; Project Director: Patrick Davis). The PHACS PH201 substudy was supported by the National Institute of Mental Health (R01 MH084794) (PI: Sharon Nichols). Data analysis services were provided by the Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health (PI: Paige Williams, Ph.D.); data management services were provided by Frontier Science and Technology Research Foundation (PI: Suzanne Siminski); and regulatory services and logistical support were provided by Westat, Inc. (PI: Julie Davidson).