Effects of cocaine and HIV on decision-making abilities

Abstract

Our study aimed to understand the impact of cocaine dependence on high-risk decision-making abilities in individuals with the human immunodeficiency virus (HIV) and individuals with cocaine dependence. We recruited 99 participants (27 HIV/Cocaine, 20 HIV Only, 26 Cocaine Only, and 26 Healthy Controls). The Iowa Gambling Task (IGT) was applied to assess decision-making abilities. Independent and interactive effects of HIV status and cocaine dependence were examined using 2 × 2 factorial ANCOVA with premorbid IQ (WRAT-4: WR) as the covariate. We found cocaine dependence had a significant adverse effect on overall IGT performance (p = 0.015). We also found individuals who were HIV-positive tended to have less total money at the end of the game than individuals who were HIV-negative (p = 0.032), suggesting individuals living with HIV had less focus on long-term gains and more focus on short-term gains. Our findings highlight the significant impact of cocaine dependence on decision-making abilities and the difficulty individuals with HIV have in adequately weighing the cost and benefits of their decisions and making appropriate changes for the future.

Keywords: Cocaine; Decision-Making; HIV; Iowa Gambling Task (IGT).

Fig. 1

Significant differences in Mean IGT Total Net Raw Score (Blocks 1–5) for cocaine users. Significant differences were detected between the Healthy Control and the two cocaine use groups (i.e., the HIV/Cocaine and Cocaine-Only groups) after controlling for premorbid IQ. * p < 0.05. ** p < 0.01.

Fig. 2

Between-group effects by block for the IGT Total Net Raw Scores. Significant differences were detected during Block 1 between the Healthy Control and HIV/Cocaine groups. During Block 2, there were significant differences between the Healthy Control group and the HIV-Only group as well as between the Healthy Control group and the HIV/Cocaine group. In Block 4, there was a significant difference between the HIV-Only group and the HIV/cocaine group. In Block 5, the Cocaine-Only group performed significantly worse than all the other groups (i.e., the HIV/Cocaine, HIV Only, and Healthy Control groups). *p < 0.05; **p < 0.01

Fig. 3

Significant differences in mean total amount of money won. Significant differences existed between the Healthy Control group and the two HIV- positive groups (i.e., the HIV/ Cocaine and HIV Only groups) after controlling for premorbid IQ and poverty level. *p < 0.05