Background: Mental health consequences of the COVID-19 pandemic have been observed. Psychiatric symptoms in people living with HIV, and their relationship to physical symptomatology and prior psychopathology, are not yet reported. Setting: An HIV cohort sheltering-in-place in New York City. Methods: Forty-nine participants in a longitudinal study were contacted by telephone in April 2020. A structured interview queried COVID-19-associated physical symptoms, and mental health screens were performed with the generalized anxiety disorder-2 (GAD-2) and patient health questionnaire-2 (PHQ-2). Prior medical and neuropsychiatric data were obtained from preceding study visits. Post-hoc analyses were performed. Results: The mean age of respondents was 62.1 years, 39% were women, and 35% African American, 37% Latinx, and 28% Caucasian. COVID-19-indicator symptoms were present in 69%; 41% had respiratory and 61% extra-pulmonary symptoms. Mental health symptoms were endorsed in 45% with PHQ-2 and 43% with GAD-2, although threshold for major depression was met in only 4% and for GAD in 14%. Higher PHQ scores were associated with respiratory symptoms, but not prior mood or anxiety disorders. GAD-2 scores were higher with past mood disorders, but not with prior anxiety disorders or respiratory symptoms. Conclusions: Physical symptoms were frequent and mild psychiatric symptoms were common, but serious anxiety and depression were not often endorsed by this group of people living with HIV at the acute height of the New York City COVID-19 pandemic. Reasons for this are unclear, as this preliminary report is descriptive in nature. Short- and long-term consequences of acute mental health symptoms require further study.

Objectives:As lifespans increase in people with HIV (PWH), there is concern that age-related neurodegenerative disorders may contribute to cognitive decline. We asked whether brain accumulation of Alzheimer's disease (AD)-associated proteins amyloid-beta (Aβ) and hyperphosphorylated tau (p-tau) predicted cognitive performance in middle-aged PWH.Methods:In a prospectively followed, cognitively-characterized autopsy sample of 135 PWH, we used immunohistochemistry to assess Aβ plaques and neuronal p-tau in medial temporal and lateral frontal lobes. These pathologies were tested for associations with cognitive performance in seven domains: motor, speed of information processing, working memory, memory encoding, memory retrieval, verbal fluency, and abstraction/executive function. Univariate and multivariate analyses accounting for HIV-associated variables, reading level, and comorbidities were conducted. Longitudinal trajectories of memory functions were evaluated in 60 individuals with a median follow-up of 6.0 years.Results:In this population with mean age 51.4 ± 0.9 years, 58% displayed neuronal p-tau and 29% Aβ plaques. Neuronal p-tau, but not Aβ, predicted worse memory encoding and retrieval, but not other cognitive functions. With an ordinal hierarchy of neuronal p-tau locations (entorhinal, hippocampal, neocortical), decreased memory performance correlated with neocortical distribution. Memory function trajectories could not be distinguished between individuals with and without neuronal p-tau, and over 80% of the sample showed no change over time.Conclusion:In this middle-aged sample, neuronal p-tau accumulation contributes to memory deficits, but is not associated with accelerated decline in function over time. In the absence of AD-like deterioration, other etiologies for neuronal p-tau in cognitively impaired PWH must be considered.

Objectives Few publications have documented the utility of in-home telephone-based cognitive screeners during COVID-19. This manuscript describes the adaptation of select face-to-face (FTF) neuropsychological tests to telephonic administration in a longitudinal cohort of people with HIV (PWH). Using the cohort’s pre-pandemic neuropsychological data, we explore the utility of telephonic administration in this population. Methods Of a longitudinal cohort of 170 adult PWH, 59 completed telephonic medical and cognitive screenings with comparable pre-pandemic FTF data. Telephone screeners and FTF evaluations were compared using repeated measures ANCOVAs to examine whether test performance differed between administration types and levels of pre-pandemic cognitive performance. Individuals with pre-pandemic test scores more than a standard deviation below the demographically-corrected mean were categorized as “below average” cognitive performance (n = 23), and the remainder as “average” (n = 36). Results Over 90% of participants gave positive feedback about the telephone encounter. The average cognitive performance group scored higher than the below average group on all measures across both administration types. Telephone and FTF test scores did not differ significantly for measures of category fluency, letter fluency, and verbal learning. However, the below average group scored higher on a verbal memory measure administered via telephone compared with FTF. Conclusions Support for telephonic adaptation of select FTF measures in longitudinal research is mixed, with verbal fluency tasks showing the strongest equivalency. When employed carefully with a clear understanding of their limitations, telephone adaptations can provide an opportunity to continue study objectives, promote equity, and monitor participant well-being during times of duress.

Research suggests that health locus of control (HLOC) is related to important health and neurocognitive outcomes in people living with HIV. However, the role of ethnicity in these relationships remains poorly understood. This study explored the role of HLOC on neurocognition in a diverse sample of 134 people living with HIV (Latinx: n = 96; non-Latinx White: n = 38) who completed comprehensive neurocognitive evaluations and the Multidimensional HLOC Scale-Form C. Results indicate no ethnocultural differences in HLOC beliefs (ps > .05). External HLOC (i.e., chance and powerful others) related to worse neurocognition in the Latinx group and contributed to significant variance in global neurocognition and learning, memory, and verbal fluency, underscoring the role of external HLOC beliefs on neurocognition, particularly for Latinx individuals. Additional research is needed to better characterize the mechanistic relationship between HLOC beliefs and neurocognitive function and to further explore this relationship among other underrepresented populations also disproportionately affected by HIV.

Objective Health locus of control (HLOC) refers to health attributions related to one’s actions, chance, doctors, or powerful others and impacts health service utilization. Locus of control (LOC) relates to better neurocognitive (NC) function in healthy adults, medication adherence, and quality of life in persons living with HIV (PLWH). No studies have examined HLOC and NC function in PLWH. This study examined how HLOC contributes to NC function in PLWH. Participants and Method This cross-sectional study included 130 PLWH (Latinx: n = 95; non-Latinx White [NLW]: n = 35) who completed an NC battery and Multidimensional Health Locus of Control Scale Form C (MHLS-C). MHLS-C has 4 subscales (internal, chance, doctors, and powerful others; 1 = Strongly Disagree – 6 = Strongly Agree). Demographically corrected NC T-scores were used for average global NC and domain T-scores. Results The Latinx group did worse than the NLW group in global NC, learning, memory, and verbal function (ps < .05). In the Latinx group, MHLS-C Chance negatively related to global NC, learning, memory, and fluency (ps < .05); Powerful Others was negatively related to global NC, learning, and memory (ps < .05). In the NLW group, MHLS-C Chance negatively related to learning and memory (ps < .05). In hierarchical regressions, our model (Step 1: ethnicity and Step 2: MHLC Chance and Powerful Others subscales) predicted global NC (R^2 = .10), learning (R^2 = .30), and memory (R^2=.27; all ps < .05), such that ethnicity was not significant (all ps > .05). Additionally, greater MHLS-C Chance predicted worse NC function (β’s = -.22 to -.40, ps < .05). Conclusions Chance HLOC is related to worse NC function in Latinx and NLW groups, but more strongly in the Latinx group. Ethnicity no longer predicted NC function once chance HLOC was considered. These findings align with prior research in the Latinx population about “fatalismo,” a belief that life events are predestined, and highlight the importance of health professionals addressing perceptions of control over one’s health to improve outcomes, including NC functioning.