Two factors that influence HIV health behaviors and therefore may contribute to gaps in the HIV treatment continuum are poor health-related self-efficacy and HIV-associated neurocognitive disorders (HAND). However, the relationship between HAND and self-efficacy has not been assessed. In an HIV sample, 91 individuals with intact cognition (HAND-) and 40 individuals with HAND (HAND+) were administered a measure of self-efficacy for healthcare interactions with providers. Participants with HAND had significantly lower scores on this measure, which were correlated with poorer episodic and semantic memory performance, as well as self-reported memory symptoms in daily life. Findings suggest that neurocognitive impairment, and particularly memory dysfunction, may play an important role in self-efficacy for healthcare interactions in HIV. Further examination of the interplay between HAND and self-efficacy is warranted as these two factors may be important for the public health goal of identifying targets for improving access, delivery, and maintenance of HIV care.

Introduction: Growing access to both legitimate and dubious sources of health information makes accurate source memory increasingly important, yet it may be negatively impacted by conditions that impair prefrontal functioning, including HIV. This study hypothesized that instructions supporting source encoding on a health-related memory task would disproportionately benefit source memory of people with HIV (PWH), and to examine the pattern of source memory errors that are observed.Method: 102 individuals (61 HIV+, 41 HIV-) completed comprehensive neurobehavioral (including health literacy) and neuromedical evaluations, and were randomly assigned to one of two conditions for a health-related memory task: Attend to Source Instructions explicitly participants to attend to the source of health statements presented to them, which were either health professionals or lay-persons, whereas no such instruction was provided in a Control Instructions condition.Results: There was no significant interaction of HIV status by condition or main effect of HIV (ps>.05). There was a main effect of condition whereby those who received Attend to Source Instructions performed better on item-corrected source memory than those in the Control Instructions condition (p =.04). Those who received Control Instructions were more likely to misattribute the source of the health information to a health professional when the correct source was a lay-person (Cohen's d = -0.53), which was correlated with poorer overall cognitive performance (p =.008) and performance-based measures of health literacy (ps<.05).Conclusions: Given that people are rarely reminded to attend to the source of new health information in the real world, the risk for misattributing health information to a qualified health professional in the absence of such instructions raises the concern that people may readily incorporate questionable health recommendations into their health regimen, particularly among persons with poorer cognitive functioning and lower levels of health literacy. This may have significant downstream health consequences such as drug interactions, side effects, and inefficacy.

Fe-containing transition-metal (oxy)hydroxides are highly active oxygen-evolution reaction (OER) electrocatalysts in alkaline media and ubiquitously form across many materials systems. The complexity and dynamics of the Fe sites within the (oxy)hydroxide have slowed understanding of how and where the Fe-based active sites form-information critical for designing catalysts and electrolytes with higher activity and stability. We show that where/how Fe species in the electrolyte incorporate into host Ni or Co (oxy)hydroxides depends on the electrochemical history and structural properties of the host material. Substantially less Fe is incorporated from Fe-spiked electrolyte into Ni (oxy)hydroxide at anodic potentials, past the nominally Ni2+/3+ redox wave, compared to during potential cycling. The Fe adsorbed under constant anodic potentials leads to impressively high per-Fe OER turn-over frequency (TOFFe) of ~40 s-1 at 350 mV overpotential which we attribute to under-coordinated surface Fe. By systematically controlling the concentration of surface Fe, we find TOFFe increases linearly with the Fe concentration. This suggests a changing OER mechanism with increased Fe concentration, consistent with a mechanism involving cooperative Fe sites in FeOx clusters.

Objective

HIV-associated neurocognitive disorders (HAND) are associated with deficits in prospective memory (PM). However, most PM research in HIV has used single-event tasks as opposed to habitual PM paradigms, which may be more relevant to clinical populations for whom many health-care behaviors must be performed both frequently and routinely.

Method

For the current study, we examined habitual PM and its associations with real-world functioning outcomes in 36 HIV+ individuals with HAND (HAND+), 70 HIV+ individuals without HAND (HAND-), and 115 HIV- individuals. The ongoing task consisted of 24 1-min Stroop trial blocks in which the emotive and cognitive load was manipulated. The habitual PM task required participants to press the spacebar once per block, but only after 20 s had elapsed.

Results

A series of MANOVAs covarying for relevant clinicodemographic factors revealed a main effect of study group on habitual PM, such that the HAND+ cohort made significantly more repetition errors than the HIV- and HAND- groups, particularly during early trial blocks. There was no main effect of ongoing task demands, nor was there an interaction between HAND group and task demands. Within the entire HIV+ sample, poorer habitual PM was associated with deficits in learning and dysfunction in real-world outcomes, including medication nonadherence and failures on a naturalistic health-care task.

Conclusion

Findings indicate that HAND may be associated with deficient internal source monitoring or temporal discrimination for habitual PM output that may play a critical role in real-world functioning, including HIV disease management.

Objective

Emotion processing has received little research focus in HIV, but emerging evidence suggests that abilities such as facial affect discrimination may be features of HIV-associated neurocognitive disorder (HAND). The present study hypothesized that individuals with HAND would evidence an emotion processing deficit relative to cognitively unimpaired individuals with HIV and seronegative comparison participants on a task assessing these abilities. Moreover, it was expected that this deficit would be significantly associated with social aspects of everyday functioning.

Method

To explore these hypotheses, 37 HIV+ individuals with HAND, 46 HIV+ without HAND, and 38 HIV-seronegative comparison participants were administered the CogState Social Emotional Cognition Task (SECT) and the UCSD Performance-based Skills Assessment-Brief (UPSA-B).

Results

Results revealed that the HAND group was more likely to have impaired accuracy and slower reaction time relative to the comparison groups on the SECT task. In fact, individuals with HAND were almost 10 times more likely to be impaired on emotion processing accuracy than HIV+ without HAND. Among individuals with HIV, accuracy (but not reaction time) was independently related to a functional capacity measure tapping social ability, but not to a similar measure without a social component (UPSA-B Communication and Finances subscales, respectively).

Conclusions

These results suggest that disruption of emotion processing may be an important feature of HAND that has clinical value as an independent predictor of real-world activities that involve social components. Future research should prospectively investigate this relationship, which may inform of intervention strategies for improving everyday functioning.