| Summary: | Rationale/statement of the problem : Acute and chronic stress is commonly reported by HIV-seropositive (HIV + ) individuals and may contribute to cognitive dysfunction that interferes with treatment adherence and daily functioning. Here we present data from two studies aimed at characterizing the effects of stress and stress hormones on cognition in HIV+ women. Methods : Six hundred and forty-five HIV+ and 345 at risk HIV-, predominantly African-American participants of the Women's Interagency HIV Study (WIHS), completed the 10 item Perceived Stress Scale (PSS-10) and a comprehensive neurocognitive test battery including measures of verbal learning and memory, verbal fluency, psychomotor speed, executive function, fine motor skills, working memory, attention, and concentration. High stress was defined by scores in the top quartile. Salivary cortisol levels were assessed concurrently with the neurocognitive battery and PSS-10 in 25 HIV+ women as a pilot at the Chicago WIHS. Results : After adjusting for relevant demographic and behavioral characteristics, HIV+ women performed worse than HIV- women on measures of verbal learning, memory and attention (p's < 0.05). High stress was negatively associated with measures of both attention and executive function (p's < 0.05). There was a significant interaction between HIV status and perceived stress on verbal memory (p=0.02). Among HIV+ women, those with high stress performed worse on verbal memory compared to women with low stress (β = − 1.89, SE = 0.74, p=0.01). Conversely, among HIV- women, there was no difference in verbal memory performance by stress level (β = 0.73, SE = 0.99, p=0.46). There were no significant interactions between stress and HIV status on executive functioning, attention, fine motor skills, or processing speed. In HIV+ women, cortisol levels were not correlated with most outcomes, though levels were marginally associated with working memory (r = − 0.37, p=0.08) which was likely attributable to women with high (r= − 0.55, p=0.03) not low stress. Conclusion : Our findings indicate that HIV is associated with verbal memory difficulties among women and that high perceived stress may exacerbate the effect of HIV infection on poor memory performance. Longitudinal assessments are underway to determine the robustness of these associations.
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