The Impact of Psychological Stress on Neurocognitive Functioning and Decline in HIV-Positive Adults: A Systematic Review of the Literature

Adults infected with HIV have been living longer and healthier lives with the development of antiretroviral therapies. Aging with HIV, however, leads to a growing number of comorbidities. Evidence strongly supports that older HIV-positive (HIV+) adults are at increased risk for the development of HIV-Associated Neurocognitive Disorders (HAND). Currently, there is limited evidence on the etiological factors and mechanisms of this neurocognitive decline. Recent research suggests the potential interactive effects of psychological stress and HIV on decreased neurocognitive functioning. This systematic literature review seeks to examine existing research with the purpose of analyzing the relationship between psychological stress and neurocognitive outcomes in HIV+ adults. From an original search of 576 full-text and peer-reviewed articles, 11 were selected for investigation. A number of studies found combinative effects of stress and HIV on domains of neurocognition such as verbal learning, memory, delayed recall, executive functioning, memory retrieval and attention. These results help provide more insight into the mechanisms, such as psychological stress, contributing to and interacting with HAND. Conclusively, it is feasible that interventions for the prevention and treatment of HAND for this vulnerable population can potentially stem from HIV-related stress management techniques