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Neurocognition and Medication Adherence in HIV-Infected Adults

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Social Neuroscience and Public Health

Abstract

Pharmacological advances in the treatment of HIV infection have transformed what was once a terminal illness into a chronic illness. Although an increasing number of patients are being placed on antiretroviral therapy, poor adherence to treatment remains one of the leading causes of treatment failure. As such, research assessing factors that predict medication adherence to antiretroviral therapy is highly important from a public health perspective. This chapter will focus on the relationship between cognition and medication adherence among HIV-infected adults, with special emphasis on older HIV+ adults, one of the fasting growing subgroups in the HIV-infected populace. The chapter is intended to provide a broad overview of neuropsychological factors associated with medication adherence to antiretroviral therapy. We will begin with a brief review of some of the many methodological complexities important to consider in the study of medication adherence and cognition. The balance of the chapter will focus on key neurocognitive, psychiatric (including substance use), and psychosocial factors that are related to medication adherence in the HIV population.

Drs. Panos and Patel are supported

By the National Institute of Mental Health Training Grant T32MH19535 (PI: C. H. Hinkin). Dr. Thames is supported National Institute of Mental Health Career Development Award K23MH095661 (PI: A. Thames)

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Notes

  1. 1.

    Readers familiar with gerontology research, or who themselves are on the far side of 50, might balk at the use of age 50 to define “older” adults. This cut point was not arrived at arbitrarily but instead has its roots in the proceedings of several working groups convened by the NIH in the late 1990s/early 2000s on this topic when the “graying” of the HIV epidemic was first recognized. Now that increasing numbers of HIV+ adults are living into their 70s and beyond, it may be time to soon revisit and revise this convention.

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Author information

Authors and Affiliations

  1. Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, 90095, USA

    Stella E. Panos, Sapna M. Patel & April D. Thames

  2. Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles and VA Greater Los Angeles Healthcare System, Los Angeles, CA, 90095, USA

    Charles H. Hinkin

Authors
  1. Stella E. Panos
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  2. Sapna M. Patel
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  3. April D. Thames
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  4. Charles H. Hinkin
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Corresponding author

Correspondence to Stella E. Panos .

Editor information

Editors and Affiliations

  1. , Department of Applied Health Sciences, University of Waterloo, University Avenue West 200, Waterloo, N2L 3G1, Ontario, Canada

    Peter A. Hall

Highlights

Highlights

  • Those living with HIV face the prospect of dealing with complex medication regimens and disease-related cognitive dysfunction.

  • Cognitive dysfunction has been shown to disrupt medication adherence in HIV+ individuals.

  • Executive function appears to be most centrally implicated in non-adherence.

  • The consequences of non-adherence among HIV+ individuals is of significant concern to affected individuals and public health as a whole.

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Panos, S.E., Patel, S.M., Thames, A.D., Hinkin, C.H. (2013). Neurocognition and Medication Adherence in HIV-Infected Adults. In: Hall, P. (eds) Social Neuroscience and Public Health. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6852-3_6

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  • DOI: https://doi.org/10.1007/978-1-4614-6852-3_6

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  • Publisher Name: Springer, New York, NY

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  • Online ISBN: 978-1-4614-6852-3

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