Social Support, Relationship Power, and Knowledge of HIV+ Serostatus in Sexual Risk Behavior Among Women in Psychiatric Treatment.

This study examined social support, perceived relationship power, and knowledge of HIV+ serostatus in relation to frequency of unprotected sex acts and number of partners among women with comorbid psychiatric illness receiving treatment. Data were drawn from an initial assessment of participants enrolled in an HIV risk reduction intervention (N = 284), and two generalized linear models were used to examine the potential associations. Relationship power was significantly associated with fewer unprotected sex acts. This relationship was stronger among those with greater social support. Knowledge of HIV+ serostatus was linked with fewer sexual partners and less unprotected sex. Findings also revealed that the protective nature of support varies by level of perceived relationship power, with higher power indicative of a stronger protective relationship. Study findings suggest that the potential protective benefits of social support may depend on one's perceived relationship power. Implications for HIV prevention intervention for this at-risk group are discussed.

Gender differences in the association between childhood sexual abuse and risk behaviors among people living with HIV in Haiti.

Research shows that in the Caribbean one-third of people living with HIV continue to engage in unprotected sexual practices. Childhood sexual abuse (CSA) and HIV-related risk behaviors have been found to play a contributory role in HIV transmission. We aimed to analyze gender differences in the association between CSA and substance use and sexual risk behaviors among Haitians living with HIV. A total of 276 HIV-positive individuals participated in this study with 56% experiencing sexual abuse during childhood. Results showed that participants who experienced CSA had increased odds of hazardous drinking compared to those who did not experience CSA; men (OR 2.9, 95% CI 1.2-7.3) and women (OR 2.5, 95% CI 1.2-5.6). While, marijuana use was only significantly associated in women (OR 5.2, 95% CI 2.1-13.5). For sexual risk behaviors, unprotected sex was significantly associated in both men (OR 3.0, 95% CI 1.3-7.1) and women (OR 2.0, 95% CI 1.5-7.7) who experienced CSA. Results of this study underscore the need for further research to better understand the role of gender in the relationship between CSA and risky behaviors among PLWH.

The Effects of Childhood Sexual Abuse: The Role of Anxiety and Alcohol Use among Haitian Women Living with HIV.

Childhood abuse has been linked to problematic drinking in adulthood. It is also documented that people living with HIV have higher rates of alcohol use than the general population. In Haiti, a total of 25% of women living with HIV have experienced childhood sexual abuse (CSA), which puts them at an increased risk for alcohol abuse. CSA has also been associated with anxiety disorders in adulthood. Therefore, it is critical to understand the relationship between CSA, anxiety, and alcohol use among women living with HIV. A total of 244 women living with HIV participated in this study, with 35% reporting CSA. Alcohol abuse was measured with the AUDIT, anxiety with the State-Trait Anxiety Inventory test, and sexual abuse with the Childhood Trauma Questionnaire. Compared to participants who did not experience childhood sexual abuse, participants who experienced childhood sexual abuse reported greater levels of alcohol use [(17.0, SD = 9.1) (11.9, SD = 8.6) p =.001] and anxiety [(55.8, SD = 9.8) (48.9 SD = 8.3) p =.001] respectively. The indirect effect of anxiety on the association between CSA and alcohol use was significant [(ß =.19 p =.05) 95% bootstrap CI.019 -.13] Thus, women who reported being sexually abused as children reported anxiety, which in turn, was associated with an increased risk for alcohol abuse. Results demonstrate that alcohol may be used as a negative coping mechanism to alleviate anxiety symptoms triggered by CSA. These findings elucidate the need for further research examining the impact that sexual trauma has on mental health.

Depression, Abuse, Relationship Power and Condom Use by Pregnant and Postpartum Women with Substance Abuse History.

Substance-abusing pregnant and postpartum women are less likely to maintain consistent condom use and drug and alcohol abstinence, which is particularly concerning in high HIV-prevalence areas. Data from 224 pregnant and postpartum women in substance abuse treatment were analyzed to examine effects of history of substance use, child abuse, and mental health problems on current substance use and condom-use barriers. Mediators were depression, relationship power and social support. Most participants (72.9 %) evidenced current depression. Less social support (-0.17, p < 0.05) and relationship power (-0.48, p < 0.001), and greater depression (-0.16, p < 0.05) predicted more condom-use barriers. History of mental health problems predicted condom-use barriers, mediated by recent depression and relationship power (0.15, p < 0.001). These findings suggest depression and diminished relationship power limit highest-risk women's ability to negotiate condom use and abstain from substance use, increasing their risk of acute HIV infection and vertical transmission.

DRD2 and DRD4 genes related to cognitive deficits in HIV-infected adults who abuse alcohol.

BACKGROUND: HIV-infected individuals continue to experience neurocognitive deterioration despite virologically successful treatments. The causes of neurocognitive impairment are still unclear. However, several factors have been suggested including the role of genetics. There is evidence suggesting that neurocognitive impairment is heritable and individual differences in cognition are strongly driven by genetic variations. The contribution of genetic variants affecting the metabolism and activity of dopamine may influence these individual differences. METHODS: The present study explored the relationship between two candidate genes (DRD4 and DRD2) and neurocognitive performance in HIV-infected adults. A total of 267 HIV-infected adults were genotyped for polymorphisms, DRD4 48 bp-variable number tandem repeat (VNTR), DRD2 rs6277 and ANKK1 rs1800497. The Short Category (SCT), Color Trail (CTT) and Rey-Osterrieth Complex Figure Tests (ROCT) were used to measure executive function and memory. RESULTS: Results showed significant associations with the SNP rs6277 and impaired executive function (odds ratio = 3.3, 95% CI 1.2-2.6; p = 0.004) and cognitive flexibility (odds ratio = 1.6, 95% CI 2.0-5.7; p = 0.001). The results were further stratified by race and sex and significant results were seen in males (odds ratio = 3.5, 95% CI 1.5-5.5; p = 0.008) and in African Americans (odds ratio = 3.1, 95% CI 2.3-3.5; p = 0.01). Also, DRD4 VNTR 7-allele was significantly associated with executive dysfunction. CONCLUSION: The study shows that genetically determined differences in the SNP rs6277 DRD2 gene and DRD4 48 bp VNTR may be risk factors for deficits in executive function and cognitive flexibility.

Depression in caregivers of status-naïve pediatric HIV patients participating in a status disclosure study in Haiti and the Dominican Republic: preliminary report.

A pilot study is underway to assess safety and acceptability of an intervention to disclose their HIV infection status to status-naïve pediatric antiretroviral therapy patients in Hispaniola [the island shared by Haiti and the Dominican Republic (DR)]. Of 22 Haiti and 47 DR caregivers recruited to date, 68.2% Haiti and 34.0% DR caregivers had clinically significant depressive symptomatology at the time of enrollment (p = 0.008). Depressive symptom prevalence was higher in Haiti caregivers who were female (81.3% vs. 0 in males; p = 0.02) and in DR caregivers who were patients' mothers (50.0%) or grandmothers (66.7%; 56.0% combined) than others (9.1%), (p < 0.001). Internalized stigma was more commonly reported by Haiti (85.7%) than DR (53.2%; p = 0.01) caregivers; 56.4% of Haiti and DR caregivers reporting internalized stigma vs. 26.1% of caregivers denying it had depressive symptoms (p = 0.02). Depression is common in Hispaniola caregivers possibly affecting disclosure timing. Study participation presents opportunities for addressing caregiver depression.

Depression, substance abuse and other contextual predictors of adherence to antiretroviral therapy (ART) among Haitians.

Haiti has the highest number of individuals living with HIV in the Caribbean. Due to Haiti's resource-poor environment and inadequate mental health and substance abuse services, adherence to antiretroviral therapy (ART) may be especially difficult. This study examined associations among demographics, maladaptive coping, partner conflict, alcohol problems, depression, and negative attitudes about medications and their impact on adherence among 194 HIV-positive Haitians. In a mediated directional structural equation model, depression and negative attitudes about ART directly predicted poorer adherence. Greater partner conflict, maladaptive coping and alcohol problems predicted more depression. Maladaptive coping predicted a negative attitude about ART. Alcohol problems predicted partner conflict and maladaptive coping. Significant indirect effects on adherence mediated through both depression and negative attitudes about ART include negative effects of female gender, alcohol problems and maladaptive coping. Results highlight the importance of integrated care for depression, alcohol use and other psychosocial problems to increase ART adherence.

Post-traumatic stress disorder symptomatology and alcohol use among HIV-seropositive adults in Haiti.

Psychological trauma resulting from natural disasters can negatively affect the health of persons living with HIV/AIDS (PLWH). This study examined relationships of alcohol use and exposure to the 2010 Haiti earthquake on symptoms of posttraumatic stress disorder (PTSD) among HIV-positive adults enrolled in an intervention study. Baseline data were collected from male and female PLWH, 19-56 years old on: alcohol consumption and related harms; anxiety; and coping strategies used to deal with HIV. Two to three months postearthquake, data were collected from 104 of the study participants on PTSD and earthquake-related impacts. Most participants had less than a secondary education (66%) and very low income (92% ≤ H$10,000 or ≤ US$1250/year). Over two-thirds of participants felt at some point that they should cut down on drinking. Fifty-two (50.5%) met criteria for PTSD. More than 83% lost their belongings and 64% had someone close to them hurt or killed during the earthquake. Bivariate analysis showed that women, younger participants, those who lost all belongings, and those with greater overall alcohol impact were more likely to report PTSD symptoms. In the multivariate model, participants more likely to meet PTSD criteria (p<0.05) were those who reported feeling a need to cut down on drinking (OR = 3.14, [CI = 1.16, 8.49]) and participants who used behavioral disengagement as a coping mechanism (OR = 1.49, [CI = 1.15, 1.92]). Following a natural disaster, it is important to address trauma-related mental health needs of PLWH - particularly women and individuals who abuse alcohol.

Assessing the Preliminary Efficacy of a Nonrandomized, Clinic-Based HIV Risk Reduction Pilot Intervention for PrEP-Initiated, Alcohol- and Other Drug-Using Women of Color in Miami, FL.

In this paper, we assessed the preliminary efficacy and acceptability of a quasi-experimental, clinic-based sexual risk reduction pilot intervention for pre-exposure prophylaxis (PrEP)-initiated, alcohol- and other drug-using women of color and explored their self-reported barriers to, and facilitators of, PrEP use. Using a mixed methods design, analyses incorporated pre- and post-intervention study assessment data from 38 women and semi-structured process evaluations using a subsample of 25. The intervention administered over an 8-week period consisted of 4 one-on-one in person educational sessions, a process evaluation, and study assessments conducted at baseline and 3 and 6 months. Post intervention, statistically significant changes in sexual risk scores were not observed; however, we found significant decreases in alcohol use (Z = - 3.02, p = .003, η2 = .41). Process evaluation data revealed interpersonal relationships as a key motivator for PrEP initiation as well as a prominent barrier to PrEP use; these relationships rarely facilitated adherence. Overall, women found the intervention to be acceptable and reported a wide range of benefits of participation-most notably its therapeutic benefits. Findings from this study provide preliminary evidence of the potential for the Talking PrEP with Women of Color intervention to improve risky behaviors, knowledge, and attitudes related to sexual risk taking. Furthermore, findings suggest that interventions to increase PrEP uptake and adherence in at-risk women may benefit from supporting them in accurately estimating their risk for HIV and increasing their sense of social support.

An Adapted Self-screening Tool for Peripartum Cardiomyopathy in Haiti.

BACKGROUND: Peripartum cardiomyopathy (PPCM) is considered rare in the United States; however, the literature notes that the disease has a higher prevalence in developing countries such as Haiti. Dr. James D. Fett, a US cardiologist, developed and validated a self-assessment measure for PPCM in the United States to aid women to easily differentiate the signs and symptoms of heart failure from those related to a normal pregnancy. Although this instrument was validated, it lacks the adaptation necessary to account for the language, culture, and education of the Haitian population. OBJECTIVE: The aim of this study was to translate and culturally adapt the Fett PPCM self-assessment measure for use among a Haitian Creole speaking population. METHODS: A preliminary Haitian Creole direct translation was developed from the original English Fett self-test. A total of four focus groups with medical professionals and 16 cognitive interviews with members of a community advisory board were conducted to refine the preliminary Haitian Creole translation and adaptation. RESULTS: The adaptation focused on incorporating cues that would be tangible and connected to the reality of the Haitian population while maintaining the intended meaning of the original Fett measure. CONCLUSIONS: The final adaptation provides an instrument suitable for administration by auxiliary health providers and community health workers to help patients distinguish symptoms of heart failure from symptoms related to normal pregnancy and further quantify the severity of signs and symptoms that might be indicative of heart failure.

Cognitive behavioral HIV risk reduction in those receiving psychiatric treatment: a clinical trial.

Among severely mentally ill (SMI) substance abusers, HIV rates are elevated and HIV risk reduction interventions have been shown to be less effective. An enhanced cognitive behavioral HIV risk reduction intervention (E-CB) for SMI was compared to a health promotion condition (HPC) in 222 psychiatric outpatients at 6 months postintervention. Compared to females, males in the E-CB improved on intention to practice safer sex and in condom use skills and in unprotected vaginal sex, but did not differ in HIV knowledge, perceived susceptibility, anxiety, condom attitudes, safer sex self-efficacy, unprotected vaginal sex acts, or sex partners. Across intervention groups, there were improvements in all areas except self-efficacy and number of partners. Risk reduction among SMI may be facilitated by increasing awareness of health related behaviors and HIV-targeted content. However, meaningful changes in critical risk reduction skills and intentions may require a more focused intervention and may vary by gender.

Neurological function, information-motivation-behavioral skills factors, and risk behaviors among HIV-positive alcohol users.

The purpose of this study was to examine neurological impairment in combination with information-motivation-behavioral skills (IMB) variables. The study tests the role of IMB variables as mediators of antecedent variables of demographics, life stress, social support, and neurological impairment with outcome measures of HIV preventive and risk behaviors in a sample of HIV-positive, alcohol-using adults (n = 250) with a history of alcohol abuse/dependence. Neurological impairment was measured with the Color Trails Test (CTT). Average performance on the CTT by the sample was substantially worse than established norms. In a directional latent variable model, neurological impairment directly predicted lower transmission knowledge scores and poorer performance on an observational condom skills assessment. Greater neurological impairment was significantly associated with greater age. Future interventions geared toward HIV+ adults who use alcohol should take into consideration HIV-related and age-related neurological functioning which may impede the facilitation of safe sex behaviors.

Alcohol, drugs, sexual behavior, and HIV in Trinidad and Tobago--the way forward.

The HIV epidemic in Trinidad and Tobago is primarily heterosexual, fueled by a high level of risky sex, gender inequality, and alcohol and drug use; however, the influence of alcohol and drugs has been neglected in the literature. Research shows that current HIV prevention approaches have failed to substantially impact sexual behavior change. This may be so because they do not incorporate a comprehensive understanding of the sociocultural factors underlying sexual behavior. There is an urgent need to understand how socially accepted patterns of alcohol and drug use contribute to sexual behaviors and HIV risk in Trinidad and Tobago. Moreover, specialized, evidence-based interventions are needed for HIV-infected substance abusers. Using an adaptation of the cognitive behavioral stress management (CBSM) protocol, this intervention project aimed to assess effectiveness in reducing relapse and risky behaviors among recovering HIV-infected substance abusers in Trinidad and Tobago.

Patterns of sexual and HIV-related stigma among men who have sex with men and women living with HIV in Haiti.

Vulnerability to contracting HIV among Men who have Sex with Men and Women (MSMW) was recognized early in the epidemic. However, while global HIV efforts have made tremendous progress for the heterosexually-identified population, the specific needs of MSMW were not directly addressed with tailored and context-adapted interventions. The purpose of this study was to inform this area of research by exploring patterns of stigma through sexual identity developmental history as well as coping mechanisms among MSMW living with HIV in Haiti. A qualitative descriptive study comprised of in-depth interviews with 32 MSMW living with HIV was carried out. Participants were recruited using snowball techniques. An inductive thematic analysis was conducted in NVivo, contextualized by the socio-ecological context of Haiti. MSMW reported struggling with their sexuality since their adolescence, often because of enacted stigma from family members, the community, and cultural conflicts. Most participants described experiencing anxiety, psychological distress, depression, social isolation, suicidal ideation and suicide attempts. Mechanisms for coping with stigma included self-acceptance, social support, hiding their sexual orientation, and tolerance of the voodoo religion. To combat stigma, and improve HIV treatment adherence and retention among MSMW, culturally-tailored multilevel initiatives should be implemented.

Understanding the Impact of Intimate Partner Violence Type and Timing on Pre-exposure Prophylaxis Knowledge, Acceptability, Sexual Behavior, and Gender Roles Among Women of Color.

Knowledge and acceptability are key factors for pre-exposure prophylaxis (PrEP) use among women with a history of intimate partner violence (IPV) and research suggests that different types of IPV affect PrEP uptake differently. Few studies have examined whether the type (i.e., physical, sexual, and psychological) and timing (i.e., lifetime, past year) of IPV experiences are related to PrEP knowledge and acceptability, or whether gender roles and sexual risk behaviors affect PrEP use. We aimed to examine the associations between lifetime and past-year physical, sexual, and psychological IPV experiences on PrEP-related outcomes (i.e., knowledge, acceptability, sexual behavior if on PrEP) and the association between gender roles and PrEP-related outcomes. A total of 186 women of color at risk for HIV participated in this study, of whom 54% had ever experienced partner violence. Results showed that lifetime psychological (OR 3.0, 95% CI 1.1-9.4) and lifetime physical IPV (OR 5.5, 95% CI 1.2-18.9) were significantly associated with increased PrEP knowledge. lifetime psychological (OR 6.3, 95% CI 1.0-13.6) and lifetime physical IPV (OR 4.3, 95% CI 4.3-11.5) were significantly associated with increased sexual behavior if on PrEP. Past year physical IPV was significantly associated with interest in using PrEP (OR 1.9, 95% CI 1.7-4.3) and with sexual behavior if on PrEP (OR 4.0, 95% CI 1.1-13.1). Being subordinate to others was also significantly associated with interest in using PrEP (OR 1.5, 95% CI 1.2-2.4) Self-silencing was significantly associated with increased sexual behavior if on PrEP (OR 1.2, 95% CI 1.0-1.5). Gender norms and IPV type and timing can influence whether a person is interested in PrEP use. Both lifetime and past-year IPV experiences need to be examined in the context of gender norms when prescribing PrEP to encourage uptake and continuation among vulnerable women at risk for HIV.

Association between intimate partner violence and HIV status among Haitian Women.

The prevalence of intimate partner violence (IPV) among women living in Haiti increased from 25% in 2006-29% in 2012, with escalating reports of crisis in the last several years. We examined the association between IPV and HIV status among these women in Haiti. Participants were drawn from a larger sample of women (n = 513) with a history of IPV. Women living with HIV (n = 55) were matched to uninfected women (n = 110) to form a control group. Attitudes towards gender roles, mental and physical well-being, and partner violence were assessed and compared. Logistic regressions were utilised to calculate multivariable-adjusted odds ratios. Women living with HIV were more likely to report more severe forms of psychological violence (p < 0.01), and severe physical violence (p < 0.0001). Women who experienced severe forms of IPV were 3.5 times more likely to have an HIV positive status compared to those who did not experience severe IPV (p < 0.0001). There were significant associations between severe forms of IPV, and HIV status among Haitian women. IPV severity should be integrated into eligibility screening for biomedical strategies of prevention such as pre-exposure prophylaxis (PrEP) among Haitian women.

HIV risk and history of STDs in MCMI-III psychopathology subgroups of comorbid substance abusers.

The purpose of this investigation is to investigate HIV risk-related attitudes, beliefs, expectancies, behaviors, and histories of lifetime sexually transmitted diseases in the Millon Clinical Multiaxial Inventory III (MCMI-III) defined psychopathology cluster subgroups. Hierarchical agglomerative cluster analysis, using Ward's method, was employed that led to identification of high (n = 37), medium (n = 132), and low (n = 28) MCMI-III psychopathology cluster subgroups. Members of the low psychopathology subgroup demonstrated significantly higher levels of knowledge about HIV and AIDS and less anxiety about HIV infection than high and moderate psychopathology subgroups. The high psychopathology subgroup reported greater importance of approval of condom use by partners but less sexual self-efficacy than the moderate psychopathology subgroup. This high pathology group revealed less favorable condom attitudes than did the low psychopathology subgroup and a significantly higher percentage of unprotected vaginal sex acts in the past 6 months than did members of the other two subgroups. A comparatively low rate of lifetime syphilis was reported in the low psychopathology subgroup (all ps < .05). Results are discussed in the context of a growing literature indicating distinctive treatment needs among members of high psychopathology subgroups of drug treatment participants.

Oxidative Stress in HIV Infection and Alcohol Use: Role of Redox Signals in Modulation of Lipid Rafts and ATP-Binding Cassette Transporters.

AIMS: Human immunodeficiency virus (HIV) infection induces oxidative stress and alcohol use accelerates disease progression, subsequently causing immune dysfunction. However, HIV and alcohol impact on lipid rafts-mediated immune dysfunction remains unknown. In this study, we investigate the modulation by which oxidative stress induces reactive oxygen species (ROS) affecting redox expression, lipid rafts caveiloin-1, ATP-binding cassette (ABC) transporters, and transcriptional sterol regulatory element-binding protein (SREBP) gene and protein modification and how these mechanisms are associated with arachidonic acid (AA) metabolites in HIV positive alcohol users, and how they escalate immune dysfunction. RESULTS: In both alcohol using HIV-positive human subjects and in vitro studies of alcohol with HIV-1 gp120 protein in peripheral blood mononuclear cells, increased ROS production significantly affected redox expression in glutathione synthetase (GSS), super oxide dismutase (SOD), and glutathione peroxidase (GPx), and subsequently impacted lipid rafts Cav-1, ABC transporters ABCA1, ABCG1, ABCB1, and ABCG4, and SREBP transcription. The increased level of rate-limiting enzyme 3-hydroxy-3-methylglutaryl HMG-CoA reductase (HMGCR), subsequently, inhibited 7-dehydrocholesterol reductase (DHCR-7). Moreover, the expression of cyclooxygenase-2 (COX-2) and lipoxygenase-5 (5-LOX) mRNA and protein modification tentatively increased the levels of prostaglandin E2 synthases (PGE2) in plasma when compared with either HIV or alcohol alone. INNOVATION: This article suggests for the first time that the redox inhibition affects lipid rafts, ABC-transporter, and SREBP transcription and modulates AA metabolites, serving as an important intermediate signaling network during immune cell dysfunction in HIV-positive alcohol users. CONCLUSION: These findings indicate that HIV infection induces oxidative stress and redox inhibition, affecting lipid rafts and ABC transports, subsequently upregulating AA metabolites and leading to immune toxicity, and further exacerbation with alcohol use. Antioxid. Redox Signal. 28, 324-337.

Evaluation of intraocular pressure in the immediate postoperative period after phacoemulsification.

PURPOSE: To determine the incidence of hypotony and intraocular pressure (IOP) elevation in the immediate and early postoperative period after temporal posterior limbal phacoemulsification and intraocular lens (IOL) implantation. SETTING: Ambulatory surgical center. METHODS: This prospective analysis comprised 310 eyes that had temporal posterior limbal phacoemulsification with IOL implantation. Surgical parameters included keratome incision of 2.85 mm, incision length of 2.5 mm, peribulbar anesthesia, case-completion IOP of 20 mm Hg, and postoperative lid taping. The IOP measurements were collected preoperatively and 30 minutes and 1 day after surgery. RESULTS: Nineteen eyes (6.1%) had an IOP lower than 5 mm Hg 30 minutes postoperatively in the absence of incision leakage at the paracentesis or keratome sites. Eighteen of the 19 eyes with postoperative hypotony received hydroxypropyl methylcellulose 2% (OcuCoat) and 1 received hypromellose 2% (Cellugel). None of the 23 eyes with an acrylic IOL implanted via a cylindrical lens inserter had an IOP lower than 5 mm Hg postoperatively. Suturing did not significantly affect the incidence of hypotony, and there were no postoperative complications related to hypotony. The mean IOP at 30 minutes was lower than at 1 day in the normal, glaucoma, and glaucoma-suspect groups. Twenty-one normal eyes (8.1%), 5 glaucoma eyes (15.6%), and 1 glaucoma-suspect eye (5%) had an IOP greater than 30 mm Hg 1 day postoperatively. CONCLUSIONS: Postoperative hypotony (IOP <5 mm Hg) occurred in 19 (6.1%) of 310 eyes. At 1 day, IOP higher than 30 mm Hg was more frequent in glaucoma eyes than in normal eyes. Although there were no direct problems related to hypotony at 30 minutes or to elevated IOP (>30 mm Hg) at 1 day, surgeons should be aware of and check for IOP variability (low and high) that can occur in normal, glaucoma, and glaucoma-suspect eyes within the first 24 hours after surgery.

Serotonin-Related Gene Polymorphisms and Asymptomatic Neurocognitive Impairment in HIV-Infected Alcohol Abusers.

HIV-infected individuals continue to experience neurocognitive deterioration despite virologically successful treatments. While the cause remains unclear, evidence suggests that HIV-associated neurocognitive disorders (HAND) may be associated with neurobehavioral dysfunction. Genetic variants have been explored to identify risk markers to determine neuropathogenesis of neurocognitive deterioration. Memory deficits and executive dysfunction are highly prevalent among HIV-infected adults. These conditions can affect their quality of life and HIV risk-taking behaviors. Single nucleotide polymorphisms in the SLC6A4, TPH2, and GALM genes may affect the activity of serotonin and increase the risk of HAND. The present study explored the relationship between SLC6A4, TPH2, and GALM genes and neurocognitive impairment in HIV-infected alcohol abusers. A total of 267 individuals were genotyped for polymorphisms in SLC6A4 5-HTTLPR, TPH2 rs4570625, and GALM rs6741892. To assess neurocognitive functions, the Short Category and the Auditory Verbal Learning Tests were used. TPH2 SNP rs4570625 showed a significant association with executive function in African American males (odds ratio 4.8, 95% CI, 1.5-14.8; P = 0.005). Similarly, GALM SNP rs6741892 showed an increased risk with African American males (odds ratio 2.4, 95% CI, 1.2-4.9; P = 0.02). This study suggests that TPH2 rs4570625 and GALM rs6741892 polymorphisms may be risk factors for HAND.