Behavioral and Physical Activity Interventions for HAND

Approximately 30-50% of persons living with HIV manifest some degree of neurocognitive impairment. Even mild-to-moderate forms of HIV-associated neurocognitive disorders (HAND) can result in difficulties with everyday functioning, such as suboptimal medication adherence and impaired driving. Despite the pervasive presence and consequences of HAND, there is a significant unmet need to develop effective behavioral strategies to reduce the incidence and consequences of HAND. Although there is an absence of evidence-based behavioral interventions specific to HAND, the literature reviewed in this chapter suggest the following modifiable lifestyle factors as intervention targets: physical activity, diet, sleep, and antiretroviral medication adherence. Adoption and maintenance of these healthy lifestyle factors may reduce inflammation and oxidative stress, which, in turn, may reduce the incidence and/or severity of HAND

Correlates of Executive Dysfunction in HIV

Despite advancements in combination antiretroviral therapy rates of mild neurocognitive impairment remain elevated amongst persons living with HIV (PLWH). Concomitant with the greater rate of survival into old age PLWH show accelerated cognitive Aging in multiple domains. Executive function is among the domains where early onset of decline is most evident. This chapter will discuss what are known correlates of executive dysfunction in PLWH in this era of antiretroviral therapy. The goal of this chapter is to expand on what is known regarding HIV disease severity and executive dysfunction to provide a more nuanced look at how other central and peripheral biomarkers, psychosocial and behavioral risk factors relate to deficits in inhibition, updating and working memory, cognitive set-shifting, and mental flexibility