Intersectionality of Socioecological Factors Associated With Cognitive Function Among Older Women With HIV in the United States: A Structural Equation Model Analysis Using Data From the Women's Interagency HIV Study

Veronica P S Njie-Carr; Shijun Zhu; Kristen A Stafford; Weiqun Tong; Michael Plankey; Anjali Sharma; Joel Milam; Mardge Cohen; Monica M Diaz; Anna A Rubtsova; Margaret A Fischl; Deborah Konkle-Parker; Deborah Gustafson; Leah H Rubin

doi:10.1097/JNC.0000000000000376

Intersectionality of Socioecological Factors Associated With Cognitive Function Among Older Women With HIV in the United States: A Structural Equation Model Analysis Using Data From the Women's Interagency HIV Study

J Assoc Nurses AIDS Care. 2023 Jan-Feb;34(1):83-95. doi: 10.1097/JNC.0000000000000376. Epub 2022 Dec 12.

Authors

Veronica P S Njie-Carr¹, Shijun Zhu, Kristen A Stafford, Weiqun Tong, Michael Plankey, Anjali Sharma, Joel Milam, Mardge Cohen, Monica M Diaz, Anna A Rubtsova, Margaret A Fischl, Deborah Konkle-Parker, Deborah Gustafson, Leah H Rubin

Affiliation

¹ Veronica P.S. Njie-Carr, RN, ACNS-BC, PhD, is an Associate Professor, School of Nursing, University of Maryland, Baltimore, Maryland, USA. Shijun Zhu, PhD, DrE, is an Associate Professor and Statistician, School of Nursing, University of Maryland, Baltimore, Maryland, USA. Kristen A. Stafford, MPH, PhD, is an Associate Professor and Infectious Disease Epidemiologist, School of Medicine, University of Maryland, Baltimore, Maryland, USA. Weiqun Tong, MS, is a Biostatistician, Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA. Michael Plankey, PhD, is a Professor, Division of Infectious Diseases, School of Medicine, Georgetown University, Washington, District of Columbia, USA. Anjali Sharma, MD, MS, is an Associate Professor, Department of Medicine, College of Medicine, Albert Einstein University Bronx, New York, USA. Joel Milam, PhD, is a Professor and Epidemiologist, Department of Epidemiology and Biostatistics, Program in Public Health, Susan & Henry Samueli College of Health Sciences, University of California Irvine, Irvine, California, USA. Mardge Cohen, MD, is a Medical Director in the WE-ACTx, Boston Health Care for the Homeless Program, Chicago, Illinois, USA. Monica M. Diaz, MD, MS, is an Assistant Professor, Department of Neurology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. Anna A. Rubtsova, MSc, PhD, is a Research Assistant Professor, Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA. Margaret A. Fischl, MD, is a Professor, School of Medicine, University of Miami Health Systems, Miami, Florida, USA. Deborah Konkle-Parker, PhD, FNP, FAAN, is a Professor, Schools of Nursing, Medicine, and Population Health Sciences, University of Mississippi Medical Center, Jackson, Mississippi, USA. Deborah Gustafson, MS, PhD, is a Professor, Department of Neurology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA. Leah H. Rubin, MPH, PhD, is an Associate Professor, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.

Abstract

Increased life expectancy of people with HIV has health implications including the intersection of the long-term use of antiretroviral treatment, inflammatory events, and age-related immunosenescence. In a cross-sectional study utilizing using the Socio-Eecological Model, we identified pathways of cognitive function (CF) among 448 women with HIV, 50 years and older. A structural equation model showed the direct effects of mood (β = -0.25, p < .01), comorbidities (β = --0.13, p < .05), race (β = --0.13, p < .05), and abuse (β = 0.27, p < .001) on the latent variable CF. Substance and alcohol use, depressive symptoms, cigarette smoking, and the number of comorbidities are important considerations when designing interventions utilizing using a multi-level and intersectional lens to maximize positive CF outcomes.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Aged
Cognition
Comorbidity
Cross-Sectional Studies
Female
HIV Infections* / complications
HIV Infections* / drug therapy
HIV Infections* / epidemiology
Humans
Intersectional Framework
United States / epidemiology

Abstract

Publication types

MeSH terms

Grants and funding