Document Type

Dissertation

Degree

Doctor of Philosophy (PhD)

Department

Public Health

First Advisor's Name

Jessy G. Devieux

First Advisor's Committee Title

Committee Chair

Second Advisor's Name

Consuelo Beck-Sague

Second Advisor's Committee Title

Committee Member

Third Advisor's Name

William Darrow

Third Advisor's Committee Title

Committee Member

Fourth Advisor's Name

Helen Tempest

Fourth Advisor's Committee Title

Committee Member

Fifth Advisor's Name

Jean Lud Cadet

Fifth Advisor's Committee Title

Committee Member

Keywords

genetic association, genetics, neurocognitive impairment, gene-environment interaction, HIV, serotonin, serotonin genes, dopamine, dopamine genes, Holistic Health Recovery Program, HIV-associated neurocognitive impairment

Date of Defense

11-12-2014

Abstract

Memory deficits and executive dysfunction are highly prevalent among HIV-infected adults. These conditions can affect their quality of life, antiretroviral adherence, and HIV risk behaviors. Several factors have been suggested including the role of genetics in relation to HIV disease progression. This dissertation aimed to determine whether genetic differences in HIV-infected individuals were correlated with impaired memory, cognitive flexibility and executive function and whether cognitive decline moderated alcohol use and sexual transmission risk behaviors among HIV-infected alcohol abusers participating in an NIH-funded clinical trial comparing the efficacy of the adapted Holistic Health Recovery Program (HHRP-A) intervention to a Health Promotion Control (HPC) condition in reducing risk behaviors.

A total of 267 individuals were genotyped for polymorphisms in the dopamine and serotonin gene systems. Results yielded significant associations for TPH2, GALM, DRD2 and DRD4 genetic variants with impaired executive function, cognitive flexibility and memory. SNPs TPH2 rs4570625 and DRD2 rs6277 showed a risk association with executive function (odds ratio = 2.5, p = .02; 3.6, p = .001). GALM rs6741892 was associated with impaired memory (odds ratio = 1.9, p = .006). At the six-month follow-up, HHRP-A participants were less likely to report trading sex for food, drugs and money (20.0%) and unprotected insertive or receptive oral (11.6%) or vaginal and/or anal sex (3.2%) than HPC participants (49.4%, p

Identifier

FI14110727

 

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