Promoting resilience through neurocognitive functioning in youth living with HIV

ABSTRACT

Using a phased model of intervention development, we developed an intervention to promote resilience in youth living with HIV via improved neurocognitive resources. First, youth completed a naturalistic prospective memory (PM) task and were randomized into a visualization condition or control condition. Next, 47 of these participants completed another naturalistic PM task and were randomized into Calendaring condition, an Alarm condition, a Combined condition, or a Control condition. Youth with low PM demonstrated observable gains from the visualization technique. Youth in the Combined Calendaring and Alarm condition demonstrated significantly better performance than participants in the Control and Calendaring conditions. In a Proof-of-Concept study with 16 youth, the previous findings were translated into a single session in-person intervention followed by tailored text messaging to improve adherence and viral load via improved neurocognitive resources. The resulting intervention showed a signal of effect with viral load reductions in youth with available data. Targeting compensatory strategies to enhance neurocognitive functioning may promote resilience and health outcomes. A randomized pilot study with a control condition is the next step.

KEYWORDS:

• Neuropsychological
• memory
• self-management
• medication adherence
• text messaging
• viral load
• adolescent

Acknowledgments

Amy L. Pennar contributed to the analysis of Phase 2 data, and the conceptualization and writing of the manuscript. Sylvie Naar contributed to the design and data collection of all 3 studies, and the conceptualization and writing of the manuscript. Steven Paul Woods contributed to the design and data collection of all 3 studies, and the conceptualization and writing of the manuscript. Sharon L. Nichols contributed to the design and data collection of Phase 1 studies and the conceptualization and writing of the manuscript. Angulique Y. Outlaw contributed to the design and data collections of all 3 studies, and the conceptualization and writing of the manuscript. Deborah A. Ellis contributed to the design and data collection of the Phase 2 study, and the conceptualization and writing of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research was funded by the National Institute on Drug Abuse [grant number 1RO1DA034497-01].