All ETDs from UAB

Advisory Committee Chair

David E Vance

Advisory Committee Members

Lesley Ross

Virginia Wadley

Michael Crowe

Document Type

Dissertation

Date of Award

2012

Degree Name by School

Doctor of Philosophy (PhD) College of Arts and Sciences

Abstract

Research suggests that individuals with HIV may be at risk for declines in cognitive functioning. Cluster analytic studies have suggested that there may be unique cognitive subgroups in HIV, with some individuals exhibiting normal cognitive performance, some with global cognitive deficits, and some with unique cognitive deficits in specific domains. The purpose of the current study was to perform a cluster analysis in a sample of adults (N = 78; Mage = 46.61) with HIV and to compare these clusters with an HIV-negative reference group (N = 84; Mage = 47.93) on cognitive, functional, demographic, and mental and physical health variables. Two-Step cluster analysis was used to examine cognitive subtypes using six cognitive measures (Useful Field of View Test®, Complex Reaction Time, Letter and Pattern Comparison, Finger Tapping Test, Wisconsin Card Sorting Test, and Hopkins Verbal Learning Test). MANOVA and chi-square analyses were used to examine the differences between the HIV-positive clusters and the HIV-negative reference group. Results revealed a two cluster solution, with Cluster 1 (n = 32; 41% of HIV-positive group) exhibiting lower performance across all cognitive and functional measures except the Finger Tapping Test, and Cluster 2 (n = 46; 59% of HIV-positive group) displaying "normal" performance across the cognitive and functional measures compared to the HIV-negative reference group. The most influential factor to cluster membership was age, with Cluster 1 participants being significantly older on average than Cluster 2 and the HIV-negative reference group. There were no other significant differences between Clusters 1 and 2 on any of the HIV-specific, demographic, or mental and physical health variables. However, there was a trend for years with HIV, percentage currently employed, and percentage with hepatitis C, with Cluster 1 containing participants with a longer HIV diagnosis, fewer employed participants, and more participants with hepatitis C. The findings of this study suggest that in this sample there do not appear to be unique cognitive subtypes; rather, there is a subset with overall "normal" cognitive performance and a subset with lower cognitive performance compared to an HIV-negative group. Implications for future research and practice are provided.

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