Increased neurocognitive intra-individual variability is associated with declines in medication adherence in HIV-infected adults.
OBJECTIVE
There is cross-sectional evidence that neurocognitive intra-individual variability (IIV), or dispersion, is elevated in human immunodeficiency virus (HIV) disease and is associated with declines in activities of daily living, including medication adherence.


METHODS
This longitudinal study extends this literature by examining whether increased neurocognitive IIV in HIV-positive persons over time predicts declines in medication adherence above and beyond changes in mean level of performance over a 6-month observation.


RESULTS
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-positive individuals with the greatest increases in dispersion demonstrated marked reductions in adherence by the third month that exceeded what was observed in less variable individuals.


CONCLUSIONS
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.
Department of Psychiatry and Biobehavioral Sciences.
Nicholas S
NS
Thaler
Department of Psychiatry and Biobehavioral Sciences.
Philip
P
Sayegh
Department of Psychiatry and Biobehavioral Sciences.
Alyssa
0000-0002-4235-4638
A
Arentoft
Department of Psychiatry and Biobehavioral Sciences.
April D
AD
Thames
Department of Psychiatry and Biobehavioral Sciences.
Steven A
SA
Castellon
Department of Psychiatry and Biobehavioral Sciences.
Charlie H
CH
Hinkin
D000328:Adult; D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D011597:Psychomotor Performance / Q000502:physiology*