Sex and HIV serostatus differences in decision making under risk among substance-dependent individuals

ABSTRACT

HIV+ individuals with and without substance use disorders make significantly poorer decisions when information about the probability and magnitude of wins and losses is not available. We administered the Game of Dice Task, a measure of decision making under risk that provides this information explicitly, to 92 HIV+ and 134 HIV– substance-dependent men and women. HIV+ participants made significantly poorer decisions than HIV– participants, but this deficit appeared more prominent among HIV+ women. These data indicate that decision making under risk is impaired among HIV+ substance-dependent individuals (SDIs). Potential factors for the HIV+ women’s relatively greater impairment are discussed.

KEYWORDS:

• HIV
• drug abuse
• executive function
• sex differences
• decision making

Acknowledgements

We thank Christine Franco, Sida Chen, and Leslie Ladd for data collection, and Mike Keutmann for data management and analyses.

Notes

¹ These procedures were followed with the single exception that participants who tested positive for cannabis were not excluded if testing was negative for all other substances. The presence of tetrahydrocannabinol (THC) metabolites in the urine did not necessarily indicate cannabis use within 1–2 days prior to testing due to its much longer elimination.

² The value of n for one cell was too small for a full Sex × HIV Serostatus × 6 Month Cocaine Use analysis.

³ However, more detailed computational modeling indicated that different cognitive mechanisms contributed to IGT performance by HIV– and HIV+ groups.