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.