HIV-associated neurocognitive impairment and antiretroviral adherence: secondary data analysis of the THINK2 prospective cohort study
The prevalence of HIV-associated dementia has declined substantially in the era of highly active antiretroviral therapy; meanwhile, milder forms of neurocognitive impairment continue to affect roughly half of all HIV-positive individuals. Current evidence from high-income settings and concentrated epidemics supports an association between mild-moderately impaired cognition and poor antiretroviral adherence. Sub-optimal adherence drives drug resistance, high viral loads, increased HIV transmission, and poor clinical outcomes. As such, identifying cognitive function and other potential determinants of antiretroviral adherence is particularly important in sub-Saharan Africa, where generalized epidemics and resource limitations render the consequences of non-adherence devastating. Kenyan adults in the year following HAART initiation?
Mentors: Sarah Macfarlane, PhD MSc & Ana-Claire Meyer, MD MPH