title: Changes in cognitive function in women with HIV infection and early life stress.
abstract: HIV is frequently associated with deficits in brain function, including memory, psychomotor speed, executive function and attention. Early life stress (ELS) has also been shown to have a direct influence on neurocognitive performance. However, little is known about the combined impact of ELS and HIV on neurocognitive function over time. The aim of the present study was to follow a cohort of affected women, allowing us to assess the effects of HIV and childhood trauma on cognition and the change in cognition over time.
  
  
  
  A battery of neurocognitive tests was administered to 117 women at baseline and then a year later. The sample included a total of 67 HIV+and 50 HIV-women, 71 with ELS and 46 without ELS. Controlling for age, education and antiretroviral therapy (ART) at baseline and 12-month follow-up, raw scores were compared across groups using a repeated-measures analysis of covariance.
  
  
  
  More women were on ART at follow-up compared to baseline. Results revealed a significant combined HIV and childhood trauma effect over time on the Wisconsin Card Sorting Test (p = .003) and Category Fluency Test (p = .006). A significant individual HIV effect over time was evident on the WAIS-III Digit Symbol Test (p = .03) and the Controlled Oral Word Association Test (p = .003).
  
  
  
  Findings suggest better performance in abstract reasoning, speed of information processing and verbal fluency over time. While all groups showed improvements that may correspond to practice effects, effects of HIV and childhood trauma remained evident at 12-month follow-up despite greater ART uptake and improved HIV disease status. This is the first study to assess the combined impact of HIV and trauma on neurocognitive function over time in an all-female cohort with more advanced disease.
authors.affiliation: a South African Research Chairs Initiative (SARChI), PTSD program, Department of Psychiatry , Stellenbosch University , Stellenbosch , South Africa.
authors.forename: Georgina
authors.initials: G
authors.lastname: Spies
authors.affiliation: b Department of Psychiatry , University of California San Diego , La Jolla , CA , USA.|c Department of Radiology , University of California San Diego , La Jolla , CA , USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Fennema-Notestine
authors.affiliation: b Department of Psychiatry , University of California San Diego , La Jolla , CA , USA.
authors.forename: Mariana
authors.initials: M
authors.lastname: Cherner
authors.affiliation: a South African Research Chairs Initiative (SARChI), PTSD program, Department of Psychiatry , Stellenbosch University , Stellenbosch , South Africa.|d MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry , Stellenbosch University , Stellenbosch , South Africa.
authors.forename: Soraya
authors.initials: S
authors.lastname: Seedat
mesh_terms: D000328:Adult; D000069586:Adult Survivors of Child Adverse Events / Q000523:psychology*; D019380:Anti-HIV Agents / Q000627:therapeutic use; D003071:Cognition; D003072:Cognition Disorders / Q000821:virology*; D056344:Executive Function; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D007802:Language; D009483:Neuropsychological Tests; D013315:Stress, Psychological / Q000523:psychology*; D013850:Thinking; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: HIV/AIDS; childhood trauma; neurocognitive change; neurocognitive function; women