The relationship between cognitive change and physical health and behavioural outcomes in a Ugandan cohort of adults living with HIV – a longitudinal study

ABSTRACT

We investigated changes in cognitive function and physical health and behavioural outcomes (HIV disease progression, health-seeking behaviour, adherence to HIV medications and risky sexual behaviour) at baseline and 12 months later among 1126 Ugandan adults living with HIV. Overall, cognitive function improved from baseline to follow-up, except for gait speed, which was slower at follow-up compared to baseline. There were improvements in physical health and behavioural outcomes by follow-up, with greater improvements among individuals on ART compared to those not on ART. Change in gait speed over time significantly predicted risky sexual behaviours at follow-up. This is the first study to investigate the longitudinal relationships between cognitive function and health outcomes among Ugandan adults living with HIV and provide insights into the possible links between cognitive function and negative clinical and behavioural health outcomes in people living with HIV.

KEYWORDS:

• Cognitive function
• ART
• risky sexual behaviour
• HIV disease progression
• health-seeking behaviour

Acknowledgements

Professor Martin Kidd from the Department of Statistics and Actuarial Sciences of Stellenbosch University provided statistical assistance. We would also like to acknowledge the support and cooperation of the management and clients of The AIDS Support Organisation (TASO) Service Centres of Entebbe and Masaka.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was funded by a Senior Fellowship from the European & Developing Countries Clinical Trials Partnership (EDCTP) Project No. TA.2010.40200.011 to Eugene Kinyanda. In addition, this work is supported by the South African Research Chair in PTSD awarded to S. Seedat and hosted by Stellenbosch University, funded by the DST and administered by the NRF.