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  13th International Workshop on
HIV and Aging
13-14 October 2022

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Lower Verbal Fluency Tied to Poor
Social Support in HIV+ Drug Users

  International Workshop on HIV and Aging, October 13-14, 2022
By Mark Mascolini for NATAP and Virology Education
A study of current and former drug users with HIV linked lower verbal fluency to worse social support by three measures [1]. This study of 383 mostly black, male Beacon Study participants found that almost two thirds reported a current illicit drug or alcohol problem.
Researchers from the Johns Hopkins Bloomberg School of Public Health noted that cognitive impairment is frequent in people with HIV and correlates with lower levels of social support and increasing isolation. HIV-positive people who use drugs, the Hopkins researchers reminded colleagues, run an even higher risk of cognitive impairment and challenges in securing support from family and friends.
This analysis used baseline data from the Beacon Study of 383 people with HIV who currently or formerly used injection drugs in the Baltimore area. Participants completed the Controlled Oral Word Association test (COWAT) to gauge verbal fluency. Researchers recorded details of their support networks including items from the Positive and Negative Social Exchange scale [2].
Among the 383 participants, 61% were men, 86% were black, and 41% had depressive symptoms (CES-D at or above 16). Their age averaged 48, and 71% had an undetectable HIV load. Almost two thirds, 63%, had a current illicit drug or alcohol problem. Most people, 84%, had a high school education or less, and 80% had a monthly income below $1000.
The Hopkins team classified almost three quarters of participants, 71%, as having low social support, that is, fewer support network members. They rated the COWAT verbal scores “approximately normally distributed” over a range of 19 to 76, averaging 47 (standard deviation 9). Linear regression linked lower COWAT verbal fluency scores to three support variables:
- Fewer support network members, β = 6.25, P < 0.01
- More negative interactions with support network members, β = 6.67, P < 0.01
- Fewer positive interactions with network members, β = -6.67, P < 0.05
The investigators recommend cognitive screening and early intervention for HIV-positive drug users to identify and respond to the social support needs of those with impaired cognitive function. They believe such interventions are “critical to ensuring optimal quality and functioning of community support structure and averting potential social isolation in later life.”
1. Knowlton A, Tseng T, Mitchell M, Moore D, Rubin L. Social support network factors linked to neuropsychological performance among disadvantaged persons living with HIV who use drugs: implications for multi-level intervention on cognitive impairment linked to HIV. International Workshop on HIV and Aging, October 13-14, 2022. Abstract 53. 2. Newsom JT, Rook KS, Nishishiba M, Sorkin DH, Mahan TL. Understanding the relative importance of positive and negative social exchanges: examining specific domains and appraisals. J Gerontol B Psychol Sci Soc Sci. 2005;60:P304-P312. doi: 10.1093/geronb/60.6.p304.