48| Neuropsychology of Human Immunodeficiency Virus (HIV) – With Dr. April Thames

The U.S. has the largest annual incidence of new human immunodeficiency virus (HIV) diagnoses among high-income nations.  This is relevant for neuropsychologists because many individuals with HIV develop a spectrum of cognitive, motor, and/or mood problems collectively known as HIV-Associated Neurocognitive Disorder (HAND).  In this episode, we talk with April Thames, Ph.D., about cross-cultural considerations and age-related cognitive decline in HIV.

Topics Covered

  • In light of current social events, Ryan and John promote cultural diversity in neuropsychology
  • Definition of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS)
  • HIV invades the central nervous system by disrupting the structural integrity of the blood brain barrier
  • HIV is associated with neuropathological changes in the basal ganglia and subcortical networks
  • Thames describes the various classifications of HIV-associated neurocognitive disorders (HAND)
  • Predictors of cognitive outcomes in HAND
  • Psychiatric sequalae of HIV
  • Effect of HIV in cognitive aging
  • The interaction between HIV and other medical conditions on cognition
  • Functional outcomes in HIV
  • Risks associated with low medication adherence
  • Cognitive effects of opportunistic infections
  • Clinical considerations when assessing individuals with HIV in respect to clinical interview, test battery, and recommendations
  • Cross-cultural issues in HIV
  • Bonus questions

About April

Dr. April Thames is an Associate Professor of Psychology at the University of Southern California (USC) and Director of the Social Neuroscience in Health Psychology Lab.  She has developed a translational neuroscience research program that focuses on the impact of chronic disease, substance abuse, socioeconomic disadvantage, and lifetime stress/adversity and resiliency on neurological, cognitive, and mental health outcomes.  Her work has also examined factors that obscure the validity of neuropsychological test performance among ethnic/racial minority groups.  She was previously a primary internship advisor and clinical supervisor at UCLA’s Medical Psychology Assessment Center (MPAC) and a primary mentor for postdoctoral fellows as part of UCLA’s Neuropsychology of HIV/AIDS fellowship.  She is actively involved in national professional organizations in her role as Member at Large for the American Psychological Association’s Society for Clinical Neuropsychology, and former role as past Chair of SCN’s Ethnic Minority Affairs Committee (EMA).

Selected References

Becker, B. W., Thames, A. D., Woo, E., Castellon, S. A., & Hinkin, C. H. (2011). Longitudinal change in cognitive function and medication adherence in HIV-infected adults. AIDS Behav, 15(8), 1888-1894.

Cody, S. L., & Vance, D. E. (2016). The neurobiology of HIV and its impact on cognitive reserve: A review of cognitive interventions for an aging population. Neurobiol Dis, 92(Pt B), 144-156.

Davies, O., Haynes, B. I., Casey, S. J., Gerbase, S., Barker, G. J., Pitkanen, M., et al. (2019). Clinical and neuroimaging correlates of cognition in HIV. J Neurovirol, 25(6), 754-764.

Eisinger, R. W., Dieffenbach, C. W., Fauci, A. S. (2019). HIV viral load and transmissibility of HIV infection: undetectable equals untransmittable. Journal of the American Medical Association. DOI: 10.1001/jama.2018.21167.

Foley, J., Ettenhofer, M., Wright, M. J., Siddiqi, I., Choi, M., Thames, A. D., et al. (2010). Neurocognitive functioning in HIV-1 infection: effects of cerebrovascular risk factors and age. Clin Neuropsychol, 24(2), 265-285.

Haynes, B. I., Pitkanen, M., Kulasegaram, R., Casey, S. J., Schutte, M., Towgood, K., et al. (2018). HIV: ageing, cognition and neuroimaging at 4-year follow-up. HIV Med, 19(6), 376-385.

Panos, S. E., Del Re, A. C., Thames, A. D., Arentsen, T. J., Patel, S. M., Castellon, S. A., et al. (2014). The impact of neurobehavioral features on medication adherence in HIV: evidence from longitudinal models. AIDS Care, 26(1), 79-86.

Thaler, N. S., Sayegh, P., Arentoft, A., Thames, A. D., Castellon, S. A., & Hinkin, C. H. (2015). Increased neurocognitive intra-individual variability is associated with declines in medication adherence in HIV-infected adults. Neuropsychology, 29(6), 919-925.

Thames, A. D., Arentoft, A., Rivera-Mindt, M., & Hinkin, C. H. (2013). Functional disability in medication management and driving among individuals with HIV: a 1-year follow-up study. J Clin Exp Neuropsychol, 35(1), 49-58.

Thames, A. D., Becker, B. W., Marcotte, T. D., Hines, L. J., Foley, J. M., Ramezani, A., et al. (2011). Depression, cognition, and self-appraisal of functional abilities in HIV: an examination of subjective appraisal versus objective performance. Clin Neuropsychol, 25(2), 224-243.

Thames, A. D., & Foley, J. M. (2011). Cognitive reserve masks neurobehavioral expression of human immunodeficiency virus associated neurological disorder in older patients.

Thames, A. D., Kim, M. S., Becker, B. W., Foley, J. M., Hines, L. J., Singer, E. J., et al. (2011). Medication and finance management among HIV-infected adults: the impact of age and cognition. J Clin Exp Neuropsychol, 33(2), 200-209.

Thames, A. D., Moizel, J., Panos, S. E., Patel, S. M., Byrd, D. A., Myers, H. F., et al. (2012). Differential predictors of medication adherence in HIV: findings from a sample of African American and Caucasian HIV-positive drug-using adults. AIDS Patient Care STDS, 26(10), 621-630.

Woods, S. P., Moore, D. J., Weber, E., & Grant, I. (2009). Cognitive neuropsychology of HIV-associated neurocognitive disorders. Neuropsychol Rev, 19(2), 152-168.

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