The proposed pilot study addresses two topic areas: 1) HIV/AIDS and Aging and 2) Racial/Ethnic Differences and Health Disparities. The primarily objective of the proposed study is to examine the synergistic effects of ethnicity and older age on neurocognitive functioning in HIV-infected adults. Ethnic disparities exist in the rate of HIV infection and mortality, relative to European Americans. As highly active anti-retroviral therapy permits HIV seropositive (HIV+) individuals to live longer, there is also a growing number of HIV+ individuals who are over the age of 50 and appear to be at increased risk for poor health outcome. Older African Americans may be at greatest risk for poor neurocognitive outcome because of the combined effects of age- and HIV- related cognitive decline as well as other factors that put them at increased risk for poor health (e.g., hypertension, diabetes, low socioeconomic status). Despite the high prevalence of HIV infection in African Americans and the growing number of older individuals infected with HIV, there has been minimal research investigating ethic differences in the neurocognitive sequelae of HIV infection especially in older HIV+ persons. The central aim of the proposed investigation is to examine the synergistic effects of ethnicity and older age on neurocognitive functioning in 1 HIV+ adults (50 African American; 50 European American); fifty percent of the participants will be over age 50. Another object is to identify those factors that differentially predict neurocognitive outcome in HIV+ African Americans and European Americans. Multivariate analyses of variance will be used to examine the effects of age and ethnicity, and the interactive effects of both on neurocognitive functions particularly affected by the aging process and HIV/AIDS. In addition to main effects for age and ethnicity, it is hypothesized that older African American participants will evidence particularly poor neurocognitive functioning. After accounting for age, education, and income, it is expected that acculturation and health risk factors that disproportionately affect African Americans (e.g., hypertension) will account for these ethnic disparities.
