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The association of perceived stress and verbal memory is greater in HIV-infected versus HIV-uninfected women

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Abstract

In contrast to findings from cohorts comprised primarily of HIV-infected men, verbal memory deficits are the largest cognitive deficit found in HIV-infected women from the Women’s Interagency HIV Study (WIHS), and this deficit is not explained by depressive symptoms or substance abuse. HIV-infected women may be at greater risk for verbal memory deficits due to a higher prevalence of cognitive risk factors such as high psychosocial stress and lower socioeconomic status. Here, we investigate the association between perceived stress using the Perceived Stress Scale (PSS-10) and verbal memory performance using the Hopkins Verbal Learning Test (HVLT) in 1009 HIV-infected and 496 at-risk HIV-uninfected WIHS participants. Participants completed a comprehensive neuropsychological test battery which yielded seven cognitive domain scores, including a primary outcome of verbal memory. HIV infection was not associated with a higher prevalence of high perceived stress (i.e., PSS-10 score in the top tertile) but was associated with worse performance on verbal learning (p < 0.01) and memory (p < 0.001), as well as attention (p = 0.02). Regardless of HIV status, high stress was associated with poorer performance in those cognitive domains (p’s < 0.05) as well as processing speed (p = 0.01) and executive function (p < 0.01). A significant HIV by stress interaction was found only for the verbal memory domain (p = 0.02); among HIV-infected women only, high stress was associated with lower performance (p’s < 0.001). That association was driven by the delayed verbal memory measure in particular. These findings suggest that high levels of perceived stress contribute to the deficits in verbal memory observed in WIHS women.

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Acknowledgments

Dr. Rubin’s effort was supported by Grant Number 1K01MH098798-01 from the National Institute of Mental Health (NIMH) and by Grant Number K12HD055892 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the National Institutes of Health Office of Research on Women’s Health (ORWH). This grant is also supported in part by the Chicago Developmental Center for AIDS Research (D-CFAR), an NIH-funded program (P30 AI 082151), which is supported by the following NIH Institutes and Centers (NIAID, NCI, NIMH, NIDA, NICHD, NHLBI, NCCAM). Data in this manuscript were collected by the Women’s Interagency HIV Study (WIHS). The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH). WIHS (Principal Investigators): UAB-MS WIHS (Michael Saag, Mirjam-Colette Kempf, and Deborah Konkle-Parker), U01-AI-103401; Atlanta WIHS (Ighovwerha Ofotokun and Gina Wingood), U01-AI-103408; Bronx WIHS (Kathryn Anastos), U01-AI-035004; Brooklyn WIHS (Howard Minkoff and Deborah Gustafson), U01-AI-031834; Chicago WIHS (Mardge Cohen), U01-AI-034993; Metropolitan Washington WIHS (Mary Young), U01-AI-034994; Miami WIHS (Margaret Fischl and Lisa Metsch), U01-AI-103397; UNC WIHS (Adaora Adimora), U01-AI-103390; Connie Wofsy Women’s HIV Study, Northern California (Ruth Greenblatt, Bradley Aouizerat, and Phyllis Tien), U01-AI-034989; WIHS Data Management and Analysis Center (Stephen Gange and Elizabeth Golub), U01-AI-042590; Southern California WIHS (Alexandra Levine and Marek Nowicki), U01-HD-032632 (WIHS I – WIHS IV). The WIHS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute on Mental Health (NIMH). Targeted supplemental funding for specific projects is also provided by the National Institute of Dental and Craniofacial Research (NIDCR), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Deafness and other Communication Disorders (NIDCD), and the NIH Office of Research on Women’s Health. WIHS data collection is also supported by UL1-TR000004 (UCSF CTSA) and UL1-TR000454 (Atlanta CTSA).

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Psychiatry, University of Illinois at Chicago, 912 S Wood St, Chicago, IL, 60612, USA

    Leah H. Rubin, Judith A. Cook & Pauline M. Maki

  2. Bureau of Health Services of Cook County, The Core Center, Chicago, IL, USA

    Kathleen M. Weber

  3. Departments of Medicine Stroger Hospital and Rush University, Chicago, IL, USA

    Mardge H. Cohen

  4. Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA

    Eileen Martin

  5. Department of Neurology, University of California, San Francisco, CA, USA

    Victor Valcour

  6. Institute for Health Promotion & Disease Prevention Research, University of Southern California, Los Angeles, CA, USA

    Joel Milam

  7. Departments of Medicine and Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA

    Kathryn Anastos

  8. Department of Medicine, Georgetown University, Washington, DC, USA

    Mary A. Young

  9. Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA

    Christine Alden

  10. Department of Neurology, SUNY-Downstate Medical Center, Brooklyn, NY, USA

    Deborah R. Gustafson

  11. Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA

    Pauline M. Maki

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  1. Leah H. Rubin
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  2. Judith A. Cook
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  10. Christine Alden
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  12. Pauline M. Maki
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Correspondence to Leah H. Rubin.

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Rubin, L.H., Cook, J.A., Weber, K.M. et al. The association of perceived stress and verbal memory is greater in HIV-infected versus HIV-uninfected women. J. Neurovirol. 21, 422–432 (2015). https://doi.org/10.1007/s13365-015-0331-5

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