HIV-1, cocaine, and neuropsychological performance in African American men

The purpose of this study was to examine the independent and interactive ef fects of HPV-I serostatus and cocaine on neuropsychological (NP) performanc e in a sample of 237 gay and bisexual urban-dwelling African American men. Consistent with current evidence, it was expected that the greatest neurops ychological performance deficits would be evident (1) in the symptomatic se ropositives (SSPs), especially in domains affected by MV (i.e., memory and psychomotor speed), and on tests that are sensitive to subtle slowing; (2) in those who are recent and frequent cocaine abusers; and (3) in those who are both HIV seropositive and cocaine abusers. Multivariate analyses contro lling for age and alcohol use confirmed expectations, with symptomatic sero positives (SSPs) evidencing significantly poorer psychomotor speed than the seronegatives (SNs), and slower reaction time and poorer nonverbal memory than the asymptomatic seropositives (ASPs). Moderate to heavy recent cocain e use was associated with slower psychomotor speed. However, contrary to ex pectations, no interaction of serostatus and cocaine was noted for any NP d omain, and the expected serostatus and cocaine effects on verbal memory and frontal systems were nor obtained. Level of alcohol consumption exacerbate d the detrimental effects of HIV-I on a computerized reaction time test whi ch is especially sensitive to subtle slowing. This study provides one of th e first descriptions of the neuropsychological effects of HIV-AIDS in a non injection drug-using community sample of gay and bisexual African American men.