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HIV- and AIDS-associated neurocognitive functioning in Zambia – a perspective based on differences between the genders

Authors Kabuba N, Menon JA, Franklin Jr DR, Heaton RK, Hestad KA

Received 31 January 2016

Accepted for publication 19 April 2016

Published 11 August 2016 Volume 2016:12 Pages 2021—2028

DOI https://doi.org/10.2147/NDT.S105481

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Xiang Mou

Peer reviewer comments 4

Editor who approved publication: Dr Roger Pinder


Norma Kabuba,1,2 J Anitha Menon,1 Donald R Franklin Jr,3 Robert K Heaton,3 Knut A Hestad2,4,5

1Department of Psychology, The University of Zambia, Lusaka, Zambia; 2Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway; 3Department of Psychiatry, University of California, San Diego, CA, USA; 4Department of Research, Innlandet Hospital Trust, Hamar, Norway; 5Department of Public Health, Hedmark University of Applied Sciences, Elverum, Norway

Abstract: Human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) are frequently associated with neurocognitive impairment (NCI). However, few studies have examined the interrelationship between gender and NCI in the HIV and AIDS population. This cross-sectional study examined the neurocognitive (NC) functioning of HIV-infected male and female adults from urban Zambia. The participants included 266 HIV seropositive (HIV+) adults (males [n=107] and females [n=159]). Participants completed NC assessment by means of a comprehensive test battery using normative data from 324 HIV-seronegative (HIV-) controls. The norms corrected for effects of age, education, and gender in the general population, and the test battery measures domains of attention/working memory (learning and delayed recall), executive function, verbal fluency, processing speed, verbal and visual episodic memory, and fine motor skills. An overall comparison of the HIV+ male and female participants yielded no statistically significant differences. Analysis of covariance results controlling for disease characteristics showed that HIV+ female participants had worse delayed recall scores than males, F(1,117) =9.70, P=0.002, partial ƞ2=0.077. The females also evidenced a trend toward greater impairment on learning efficiency (P=0.015). The findings suggest that there are gender-related differences in NCI after controlling for disease characteristics. It was observed that although the HIV+ females enjoyed better health compared to their HIV+ male counterparts, they still had worse performance on the neuropsychological tests. This implies that HIV may have more NC consequences for Zambian females than males.

Keywords: HIV-1, neurocognitive functioning, gender, Zambia

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