Cognitive function in women with HIV: Findings from the women's interagency HIV study

Pauline M. Maki, Leah H. Rubin, Victor Valcour, Eileen Martin, Howard Crystal, Mary Young, Kathleen M. Weber, Jennifer Manly, Jean Richardson, Christine Alden, Kathryn Anastos

Research output: Contribution to journalArticlepeer-review

83 Scopus citations


Objective: In the largest cohort study of neuropsychological outcomes among HIV-infected women to date, we examined the association between HIV status and cognition in relation to other determinants of cognitive function (aim 1) and the pattern and magnitude of impairment across cognitive outcomes (aim 2). Methods: From 2009 to 2011, 1,521 (1,019 HIV-infected) participants from theWomen's Interagency HIV Study (WIHS) completed a comprehensive neuropsychological test battery. We used multivariable regression on raw test scores for the first aim and normative regression-based analyses (t scores) for the second aim. The design was cross-sectional. Results: The effect sizes for HIV status on cognition were very small, accounting for only 0.05 to 0.09 SD units. The effect of HIV status was smaller than that of years of education, age, race, income, and reading level. In adjusted analyses, HIV-infected women performed worse than uninfected women on verbal learning, delayed recall and recognition, and psychomotor speed and attention. The largest deficit was observed in delayed memory. The association of low reading level with cognition was greater in HIV-infected compared to HIV-uninfected women. HIV biomarkers (CD4 count, history of AIDS-defining illness, viral load) were associated with cognitive dysfunction. Conclusions: The effect of HIV on cognition in women is very small except among women with low reading level or HIV-related comorbidities. Direct comparisons of rates of impairment in wellmatched groups of HIV-infected men and women are needed to evaluate possible sex differences in cognition.

Original languageEnglish (US)
Pages (from-to)231-240
Number of pages10
Issue number3
StatePublished - 2015
Externally publishedYes

ASJC Scopus subject areas

  • Clinical Neurology


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