Perceived discrimination and cognitive function in middle-aged and older adults living with HIV in China

ABSTRACT

Middle-aged and older adults with HIV experience double discrimination and cognitive impairment due to both their HIV status and their age. However, the relationship between perceived discrimination and self-reported cognitive ability in middle-aged and older people living with HIV (PLWH) is less clear. We measured self-reported perceived discrimination and cognitive ability using the Expanded Everyday Discrimination Scale and the subscale of the AIDS Health Assessment Questionnaire (AIDS-HAQ). The study sample included 324 middle-aged and older PLWH (over 45 years old) from five designated HIV hospitals in three regions (east coast, middle, and southwest regions) of China. The descriptive analysis showed that 45.37% of the participants reported perceiving discrimination at least once in the past twelve months, and 47.22% reported having at least one type of cognitive impairment. Multiple linear regression results showed that higher levels of perceived discrimination (β = −0.121, P = 0.036) were significantly associated with lower levels of self-reported cognitive ability after controlling for several covariates, including sociodemographic variables, mental health status, health behaviors, and social support. A longer duration of HIV was also related to a lower level of self-reported cognitive ability. Our findings indicate that perceived discrimination is related to self-reported cognitive ability and suggest that counseling services and support systems should be developed to reduce age- and disease-associated discrimination. A reduction in perceived discrimination would improve not only overall wellbeing but also cognitive ability in later life.

KEYWORDS:

• HIV
• AIDS
• aging
• stigma
• cognitive ability

Acknowledgements

Funding for this study was provided by the National Natural Science Foundation of China (Grant No.71673057). The authors are grateful to all participants who joined in this study; We would like to thank our partner in this study: Meijuan Bao, the director of Nursing Department, Shanghai Public Health Clinical Center; Lin Zhang, the vice director of Nursing Department, Shanghai Public Health Clinical Center; Canyun Wei, the director of Nursing Department, Nanning No.4 People's Hospital; Lian Yang, Hengyang No.3 People's Hospital; Qingfen Liu, the director of Nursing Department, Yunnan Infectious Disease Special Hospital; Yuquan Ruan, the dean of Dali University School of Nursing; Yanfeng Fu, the vice dean of Dali University School of Nursing; Dr. Michael V. Relf, Associate Professor of Duke University School of Nursing for generously helping us in the study.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Zheng Zhu http://orcid.org/0000-0001-9651-8311

Additional information

Funding

This work was supported by National Natural Science Foundation of China: [Grant Number 71673057].