Social Cognition and HIV-Associated Neurocognitive Disorders

Introduction: The introduction of antiretroviral therapy has successfully transformed the Human Immunodeficiency Virus (HIV) into a long-term condition. However, nearly half of those living with HIV experience cognitive difficulties (HIV-associated Neurocognitive Disorders; HAND). The adverse effects of HIV on cognitive function have been well-documented. However, it has not been established whether individuals with HAND present with deficits in social cognition, specifically related to the ability to understand other people’s intentions and feelings (Theory of Mind; ToM). The present study aimed to address this gap in the research and explore whether individuals with HAND show deficits in cognitive and affective aspects of ToM, and whether these are related to general cognitive abilities. Method: Sixteen individuals with HAND between the ages of 26 and 60 (mean age = 46.81 years) were recruited from a rehabilitation centre for individuals living with HAND. Participants completed a neuropsychological test battery and two social cognition tests (verbal test of cognitive ToM and visual test of affective ToM). Data obtained using standardised measures was analysed quantitatively and descriptively. Results: The individual and group-level analyses indicate that individuals with HAND show impairments in social cognition, with greater deficits observed in the domain of mentalising (cognitive ToM) than affect recognition (affective ToM). Consistent with the correlational analyses, tentative links can be made between social cognition and processing speed, executive function and memory, although the manner in which these domains impact on social cognition requires further research. Implications: A key clinical implication is that social cognition should be routinely tested in individuals with HAND as part of a standard assessment of cognitive function. The findings further indicate that it might be useful to evaluate multiple domains of social cognition and interpret the results in the context of findings from other neuropsychological assessments