Cognitive Functioning and Its Stability Among Young Adults with Perinatal HIV Exposure or Acquisition in a U.S.-Based Longitudinal Cohort Study
12 affiliations
- 1Department of Neurosciences, University of California, 9500 Gilman Drive, Mail Code 0935 La Jolla, San Diego, CA 92093 USA
- 2Center for Biostatistics in AIDS Research, Harvard TH Chan School of Public Health, Boston, MA USA
- 3Independent Consultant, Fort Lauderdale, FL USA
- 4Department of Pediatrics, University of Illinois at Chicago, Chicago, IL USA
- 5Department of Psychiatry, Northwestern University, Chicago, IL USA
- 6Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN USA
- 7Department of Pediatrics, Baylor College of Medicine, Houston, TX USA
- 8Department of Pediatrics, University of California, Los Angeles, Los Angeles, CA USA
- 9Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA USA
- 10Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, TN USA
- 11Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA USA
- 12Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA USA
Abstract
The growing population of young adults with perinatal HIV acquisition (YAPHIV) or exposure without acquisition (YAPHEU) warrants investigation of ongoing cognitive effects of PHIV and lasting neurodevelopmental consequences of perinatal exposure to HIV and antiretroviral therapy (ART). Within the US-based AMP Up longitudinal cohort study, 608 YAPHIV and 131 YAPHEU completed the NIH Toolbox (NIHT) assessment of cognitive functioning and provided information on mental health, demographic variables, social determinants of health (SDOH), HIV-related health and ARTs. YAPHIV were categorized at entry as YAPHIV-C (history of CDC Class C AIDS-defining criteria or nadir CD4%<15) or YAPHIV-non-C. General linear regression models were fit to examine associations of HIV status with NIHT age-adjusted Fluid, Crystallized and Total Cognition Composite standard scores and change in scores from entry to the three-year follow-up visit. NIHT performance between YAPHEU and all YAPHIV was comparable, with borderline/low average Fluid and average Crystallized Composite scores; however, we observed overall differences among the three groups, with lowest mean scores among YAPHIV-C and highest among YAPHIV-non-C. In adjusted analyses, mean Fluid Composite scores increased longitudinally across groups, with significantly less increase in both YAPHIV groups versus YAPHEU. Differences were not mediated by mental health variables. Few associations with current or change in HIV disease severity were observed. SDOH analyses supported benefits of greater access to social and economic resources. Although results highlight concerns about long-term effects of perinatal HIV among young adults, differences were subtle and emphasize the importance of modifiable factors such as viral control and access to resources.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s10461-026-05133-2.
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BibTeX
@article{nichols2026cognitive,
title = {{Cognitive Functioning and Its Stability Among Young Adults with Perinatal HIV Exposure or Acquisition in a U.S.-Based Longitudinal Cohort Study}},
author = {Sharon Nichols and Yanling Huo and Patricia A. Garvie and Sara Caniglia and Renee Smith and Kathleen Malee and Megan Song McHenry and Mary E. Paul and Anna-Barbara Moscicki and Guadalupe Morales Avendano and Katherine Tassiopoulos and Megan L. Wilkins and Claire A. Berman and Paige L. Williams},
journal = {AIDS and Behavior},
year = {2026},
month = jun,
doi = {10.1007/s10461-026-05133-2},
url = {https://doi.org/10.1007/s10461-026-05133-2},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Cognitive Functioning and Its Stability Among Young Adults with Perinatal HIV Exposure or Acquisition in a U.S.-Based Longitudinal Cohort Study
AU - Sharon Nichols
AU - Yanling Huo
AU - Patricia A. Garvie
AU - Sara Caniglia
AU - Renee Smith
AU - Kathleen Malee
AU - Megan Song McHenry
AU - Mary E. Paul
AU - Anna-Barbara Moscicki
AU - Guadalupe Morales Avendano
AU - Katherine Tassiopoulos
AU - Megan L. Wilkins
AU - Claire A. Berman
AU - Paige L. Williams
PY - 2026
DA - 2026/06/02
JO - AIDS and Behavior
DO - 10.1007/s10461-026-05133-2
UR - https://doi.org/10.1007/s10461-026-05133-2
AB - The growing population of young adults with perinatal HIV acquisition (YAPHIV) or exposure without acquisition (YAPHEU) warrants investigation of ongoing cognitive effects of PHIV and lasting neurodevelopmental consequences of perinatal exposure to HIV and antiretroviral therapy (ART). Within the US-based AMP Up longitudinal cohort study, 608 YAPHIV and 131 YAPHEU completed the NIH Toolbox (NIHT) assessment of cognitive functioning and provided information on mental health, demographic variables, social determinants of health (SDOH), HIV-related health and ARTs. YAPHIV were categorized at entry as YAPHIV-C (history of CDC Class C AIDS-defining criteria or nadir CD4%<15) or YAPHIV-non-C. General linear regression models were fit to examine associations of HIV status with NIHT age-adjusted Fluid, Crystallized and Total Cognition Composite standard scores and change in scores from entry to the three-year follow-up visit. NIHT performance between YAPHEU and all YAPHIV was comparable, with borderline/low average Fluid and average Crystallized Composite scores; however, we observed overall differences among the three groups, with lowest mean scores among YAPHIV-C and highest among YAPHIV-non-C. In adjusted analyses, mean Fluid Composite scores increased longitudinally across groups, with significantly less increase in both YAPHIV groups versus YAPHEU. Differences were not mediated by mental health variables. Few associations with current or change in HIV disease severity were observed. SDOH analyses supported benefits of greater access to social and economic resources. Although results highlight concerns about long-term effects of perinatal HIV among young adults, differences were subtle and emphasize the importance of modifiable factors such as viral control and access to resources. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s10461-026-05133-2.
SN - 1090-7165
SN - 1573-3254
ER -