Health-Related Decision-Making in HIV Disease

J Clin Psychol Med Settings. 2016 Jun;23(2):135-46. doi: 10.1007/s10880-016-9455-x.

Abstract

Individuals living with HIV show moderate decision-making deficits, though no prior studies have evaluated the ability to make optimal health-related decisions across the HIV healthcare continuum. Forty-three HIV+ individuals with HIV-associated neurocognitive disorders (HAND+), 50 HIV+ individuals without HAND (HAND-), and 42 HIV- participants were administered two measures of health-related decision-making as part of a comprehensive neuropsychological battery: (1) The Decisional Conflict Scale (DCS), and (2) The Modified UCSD Brief Assessment for Capacity to Consent (UBACC-T). Multiple regression analyses revealed that HAND was an independent predictor of both the DCS and the UBACC-T, such that the HAND+ sample evidenced significantly poorer scores relative to comparison groups. Within the HIV+ sample, poorer health-related decision-making was associated with worse performance on tests of episodic memory, risky decision-making, and health literacy. Findings indicate that individuals with HAND evidence moderate deficits in effectively comprehending and evaluating various health-related choices.

Keywords: Episodic memory; HIV/AIDS; Health literacy; Neurocognition; Neuropsychology.

MeSH terms

  • Cognition Disorders / etiology*
  • Decision Making*
  • HIV Infections / complications
  • HIV Infections / psychology*
  • Humans
  • Neuropsychological Tests