There is cross-sectional evidence that neurocognitive intra-individual variability (IIV), or dispersion, is elevated in HIV disease and is associated with declines in activities of daily living, including medication adherence. This longitudinal study extends this literature by examining whether increased neurocognitive IIV in HIV+ persons over time predicts declines in medication adherence above and beyond changes in mean level of performance over a six-month observation. After controlling for drug use, declines in mean performance, and changes in depressive symptoms, results confirmed that increases in IIV were associated with overall poorer antiretroviral medication adherence. HIV+ individuals with the greatest increases in dispersion demonstrated marked reductions in adherence by the third month that exceed that observed in less variable individuals. Our results indicate that increases in dispersion are associated with poorer declines in medication adherence in HIV disease, which may have implications for the early detection and remediation of suboptimal antiretroviral adherence.

Objectives To examine the effects of aging and neuropsychological (NP) impairment on driving simulator performance within a human immunodeficiency virus (HIV)-infected cohort. Methods Participants included 79 HIV-infected adults (n = 58 > age 50, n = 21 ≤ 40) who completed a NP battery and a personnel computer-based driving simulator task. Outcome variables included total completion time (time) and number of city blocks to complete the task (blocks). Results Compared to the younger group, the older group was less efficient in their route finding (blocks over optimum: 25.9 [20.1] vs 14.4 [16.9]; P = .02) and took longer to complete the task (time: 1297.6 [577.6] vs 804.4 [458.5] seconds; P = .001). Regression models within the older adult group indicated that visuospatial abilities (blocks: b = –0.40, P < .001; time: b = –0.40, P = .001) and attention (blocks: b = –0.49, P = .001; time: b = –0.42, P = .006) independently predicted simulator performance. The NP-impaired group performed more poorly on both time and blocks, compared to the NP normal group. Conclusions Older HIV-infected adults may be at risk of driving-related functional compromise secondary to HIV-associated neurocognitive decline.

Forty-three homosexual/bisexual males with HIV-1 infection participated in a study that sought to determine: (1) whether increased levels of self-reported depressive symptomatology were associated with poorer performance on episodic or procedural memory tasks, (2) the relative strength of association between the affective/cognitive or somatic symptoms of depression and memory deficits and level of immunosuppression, and (3) whether increased depression or neuropsychological deficits are associated with degree of immunosuppression. Linear regression analyses revealed that increased affective/cognitive symptomatology was correlated with poorer performance on a procedural memory task, but was not correlated with performance on an episodic memory task or degree of immunosuppression. In contrast, somatic symptoms showed the strongest association with level of immunosuppression, but were not correlated with performance on the memory tasks. These findings underscore the complex interplay between neuropsychiatric and neuropsychological symptomatology in HIV-1 infection.

Welsh codes of Minnesota Multiphasic Personality Inventory-168 (MMPI-168) profiles were calculated for 151 HIV-1 seropositive gay men and 27 gay seronegative controls. Although 99% of seropositives' profiles were clinically elevated, the profile configurations among subjects were varied. These data document the presence of considerable emotional distress among HIV-infected individuals, yet the heterogeneity of codes encountered argues against generalizations of seropositive subjects based upon mean MMPI profiles.

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