Neurobehavioral Model of HIV in Injection Drug Users

The purpose of this R01 study is to evaluate the association between neuropsychological
executive dysfunction and HIV infection among young injection and non-injection drug users.
A longitudinal study will be conducted in which the cohort of seronegative drug users
completing a baseline neuropsychological battery are re-assessed on three subsequent
occasions, roughly six months apart. The primary aim of the longitudinal study is to
estimate the magnitude of the suspected causal relationship between executive dysfunction
and HIV-risk behaviors while adjusting for time-invariant (e.g. sex, ethnicity) and
time-varying (e.g. degree of drug abuse) covariates. We also seek to evaluate: (1) the
degree to which specific executive dysfunctions predispose heroin and cocaine users to
high-risk injection practices or sex behaviors, and (2) whether observed relationship
between executive dysfunction and HIV-risk behaviors can be understood independent of levels
of drug -taking frequency, or whether the observed data are more consistent with complex
patterns of interdependency between executive dysfunction, drug-taking frequency, and
HIV-risk-behaviors. If successful, this project will shed new light on significant and
potentially malleable HIV-risk factors in injection and non-injection drug users. This will
be important evidence because injection drug abuse continues to account for a large
proportion of HIV seroconversions particularly among young women and minorities. As such,
this RO1 research project serves as an important initial step in a line of innovative
investigations about suspected causal associations between neuropsychological deficits and
HIV-risk behaviors in drug users. Ultimately, this line of investigation should lead to
changes in public and clinical practices designed to prevent HIV infection.