Neurocognitive outcomes in HIV and childhood trauma

[摘要] ENGLISH ABSTRACT: It is well established that South African women are disproportionately affected byHIV/AIDS and gender based violence. Research to date has provided evidence forneurocognitive decline in individuals infected with HIV/AIDS and in individuals whohave experienced early life trauma. However, many gaps remain in our knowledge aboutthe neurocognitive profile of HIV and childhood trauma in South African women. Thepresent study focused on the neurocognitive effects of HIV infection and childhoodtrauma, both separately and in combination in South African women. The primary aim ofthe study was to assess neurocognitive functioning in HIV-positive and matched HIVnegativecontrols, with and without a history of childhood trauma. Moreover, the studysought to assess the synergistic relationship between HIV and childhood trauma ininfluencing neurocognitive outcomes, a relationship which has not yet been investigated.A neuropsychological battery sensitive to HIV-related impairments was administered to83 HIV-positive and 47 matched HIV-negative women with histories of childhoodtrauma. A history of childhood trauma was assessed using the Childhood TraumaQuestionnaire short form (CTQ-SF). Forty eight of the 83 HIV-positive women wereexposed to childhood trauma. Among the control subjects, a total of twenty women wereexposed to childhood trauma.Findings of the present study revealed neurocognitive deficits in memory and executivefunctions. Results demonstrated significant HIV effects in memory (HVLT-R learningand delay trials), and executive functions (Halstead Category test). Similarly, a trauma effect was evident in delayed recall (HVLT-R delay). Moreover, results revealed asignificant interaction effect between HIV status and trauma status on the WAIS-IIISymbol Search Task, a task of psychomotor speed. However, HIV-negative controls witha history of childhood trauma scored the highest on this task. Although this finding wasunexpected, it may suggest that psychomotor speed may not be a sensitive ordiscriminating test of childhood trauma in healthy adults.The present study demonstrated evidence for HIV and trauma effects in the abilitydomains of learning and delayed recall and executive functions. Although the presentstudy did not find evidence for a synergistic relationship between HIV and trauma, it didprovide evidence for both HIV and trauma effects on neurocognition, a finding inkeeping with previous studies. Future research should be prospective in nature and shouldbetter delineate the nature, severity, and temporal relationship of childhood trauma toneurocognitive outcomes, as well as the mediators and moderators of these outcomes.

[发布机构] Stellenbosch University