The purpose of this study was to examine the independent
and interactive effects of HIV-1 serostatus and cocaine
on neuropsychological (NP) performance in a sample of 237
gay and bisexual urban-dwelling African American men. Consistent
with current evidence, it was expected that the greatest
neuropsychological performance deficits would be evident
(1) in the symptomatic seropositives (SSPs), especially
in domains affected by HIV (i.e., memory and psychomotor
speed), and on tests that are sensitive to subtle slowing;
(2) in those who are recent and frequent cocaine abusers;
and (3) in those who are both HIV seropositive and cocaine
abusers. Multivariate analyses controlling for age and
alcohol use confirmed expectations, with symptomatic seropositives
(SSPs) evidencing significantly poorer psychomotor speed
than the seronegatives (SNs), and slower reaction time
and poorer nonverbal memory than the asymptomatic seropositives
(ASPs). Moderate to heavy recent cocaine use was associated
with slower psychomotor speed. However, contrary to expectations,
no interaction of serostatus and cocaine was noted for
any NP domain, and the expected serostatus and cocaine
effects on verbal memory and frontal systems were not obtained.
Level of alcohol consumption exacerbated the detrimental
effects of HIV-1 on a computerized reaction time test which
is especially sensitive to subtle slowing. This study provides
one of the first descriptions of the neuropsychological
effects of HIV–AIDS in a noninjection drug-using
community sample of gay and bisexual African American men.
(JINS, 2000, 6, 322–335.)