Vu Thi, Wise Jenni, Jones Deborah L, Wingood Gina, Diaz Monica M, Chandran Aruna, Cohen Mardge, Weiser Sheri D, Spence Amanda, Wilson Tracey, Norcini-Pala Andrea, Sharma Anjali, Rubin Leah H, Turan Bulent, Turan Janet M, Monin Joan K
Department of Social and Behavioral Sciences, School of Public Health, Yale University, New Haven, Connecticut, USA.
School of Nursing, The University of Alabama at Birmingham, Birmingham, Alabama, USA.
J Gerontol B Psychol Sci Soc Sci. 2025 May 8;80(6). doi: 10.1093/geronb/gbaf058.
Internalized HIV stigma refers to the negative beliefs, feelings, and attitudes that people with HIV (PWH) adopt about themselves due to societal HIV stigma. Internalized HIV stigma negatively affects mental health but less is known about this factor on cognitive function in PWH. This study examines associations between internalized HIV stigma and cognition among women aged 50+ with HIV.
Internalized HIV stigma was measured in the Women's Interagency HIV Study between 2013 and 2015 using the HIV stigma scale (negative self-image subscale). Executive function, processing speed, attention/working memory, verbal learning, verbal memory, verbal fluency, and fine motor function were assessed using a validated cognitive battery. Demographically adjusted T-scores were calculated for each domain (higher scores = better performance). A global cognition score was computed by averaging the domain-specific scores. Linear regression models adjusted for age, race, ethnicity, cognition at baseline, average annual income, undetectable viral load, smoking history, recent nonprescription drug use, menopausal status, depressive symptoms, and alcohol use.
Participants' (N = 760) mean age was 54 years; 61% identified as Black/African American; 13% were Hispanic; and 54% had an annual income below $12,000. The median time between the first and second cognitive assessments was 4 years. Higher internalized HIV stigma was associated with poorer global cognitive function, verbal learning, and verbal memory at time 2.
Findings suggest assessing and monitoring HIV stigma may benefit cognitive function for older women aging with HIV by identifying those at greater risk for cognitive decline who could be targeted for stigma reduction interventions.
内化的艾滋病毒污名是指感染艾滋病毒的人（PWH）由于社会对艾滋病毒的污名而对自己产生的负面信念、感受和态度。内化的艾滋病毒污名对心理健康有负面影响，但关于这一因素对艾滋病毒感染者认知功能的影响知之甚少。本研究调查了50岁及以上感染艾滋病毒女性内化的艾滋病毒污名与认知之间的关联。
在2013年至2015年期间的妇女机构间艾滋病毒研究中，使用艾滋病毒污名量表（负面自我形象子量表）测量内化的艾滋病毒污名。使用经过验证的认知测试组评估执行功能、处理速度、注意力/工作记忆、语言学习、语言记忆、语言流畅性和精细运动功能。计算每个领域的人口统计学调整T分数（分数越高=表现越好）。通过对特定领域分数进行平均来计算总体认知分数。线性回归模型对年龄、种族、民族、基线认知、平均年收入、病毒载量不可检测、吸烟史、近期非处方药使用、绝经状态、抑郁症状和饮酒情况进行了调整。
参与者（N = 760）的平均年龄为54岁；61%为黑人/非裔美国人；13%为西班牙裔；54%的年收入低于12,000美元。第一次和第二次认知评估之间的中位时间为4年。内化的艾滋病毒污名程度越高，在第二次评估时总体认知功能、语言学习和语言记忆越差。
研究结果表明，评估和监测艾滋病毒污名可能有益于感染艾滋病毒的老年女性的认知功能，通过识别认知能力下降风险较高的人群，这些人可以成为减少污名干预措施的目标对象。
