Antiretroviral CNS efficacy and health disparities in longitudinal neurological

Healthcare inequality may influence the types of HIV regimens prescribed, which may contribute to disparities in HIV-related treatment outcomes, including disparities observed among individuals from racial/ethnic minority backgrounds. This is particularly relevant given that HIV medications differ in their neuropenetrance, or their ability to penetrate the blood-brain-barrier, which may be linked to neurologic outcomes. This study will explore changes in cognition and white matter integrity, using DTI, as a function of HIV medication neuropenetrance, accounting for healthcare quality. The study will recruit approximately 40 participants. Participants will be interviewed about their medical history, including HIV medications, as well as data on their recent CD4 counts and plasma viral load. Quality of healthcare will be assessed using the Quality of Healthcare Through the Patient's Eyes-HIV (QUOTE-HIV) Questionnaire. Participants will undergo a neuropsychological test battery supplemented with computerized cognitive measures thought to be sensitive to frontostriatal dysfunction (e.g., testing the domains of processing speed, verbal fluency, attention/working memory, learning, memory, executive functioning, and motor functioning). HIV medication adherence will be assessed using the AIDS Clinical Trial Group (ACTG)-Adherence Questionnaire. MRI scans will be acquired at the UCLA Center for Cognitive Neurosciences (CCN).