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American Journal of Epidemiology Vol. 136, No. 11: 1338-1348
Copyright © 1992 by The Johns Hopkins University School of Hygiene and Public Health

research-article

Effect of Chronic Substance Abuse on the Neuropsychological Performance of Intravenous Drug Users with a High Prevalence of HIV-1 Seropositivity

Mauricio Concha1,, Neil M. H. Graham2, Alvaro Muñoz2, David Vlahov2, Walter Royal, III1, Marcia Updike1, Tish Nance-Sproson1, Ola A. Seines1 and Justin C. McArthur1

1Department of Neurology, School of Medicine, The Johns Hopkins University Baltimore, MD
2Department of Epidemiology, School of Hygiene and Public Health, The Johns Hopkins University Baltimore, MD

Reprint requests to M. Concha, Department of Neurol-ogy, Meyer 6–109, The Johns Hopkins Hospital, Baltimore, MD 21205.

Limited data are available on cognitive performance in populations of intravenous drug users during the early, asymptomatic stages of human immunodeficiency virus type 1 (HIV-1) infection. Between 1988 and 1990, 151 participants from the AIDS Link to Intravenous Experience (ALIVE) Study in Baltimore, Maryland, were evaluated neuropsychologically on a semiannual basis. This analysis focused on whether history of substance abuse influenced neuropsychological test performance. At baseline, 102 participants were HIV-1-seropositives who were free of acquired immunodeficiency syndrome and 49 participants were seronegative. Multivariate analyses, adjusting for correlation of repeated outcome measures, were conducted to determine predictors of neuropsychological functioning. Effects of the frequency of reported past use of marijuana, heroin, cocaine, barbiturates, and alcohol were not statistically associated with performance on the tests. Age and education were the most important predictors of test performance, and a significant practice effect was observed for most measures. After adjustment for age, education, the practice effect, and frequency of drug use, neuropsychological performance over time did not vary by HIV-1 serostatus. Overall, after acutely intoxicated individuals were excluded, neither frequency of drug and alcohol use nor HIV-1 seropositivity significantly influenced neuropsychological test performance over a 1-year period. Am J Epidemiol 1992; 136: 1338–48.

acquired immunodeficiency syndrome; cognition; HIV; neuropsychology; substance abuse


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