A History of Methamphetamine Use Disorder in People with HIV Is Associated with Altered Functional Response to Risky...

Area of Science:

• Neuroscience
• Neuroimaging
• Public Health

Background:

• Methamphetamine (METH) use is common in people with HIV (PWH), potentially worsening health outcomes.
• Both METH and HIV impact frontostriatal neural circuitry crucial for decision-making.
• Combined effects of METH and HIV on decision-making neural circuitry are understudied.

Purpose of the Study:

• To investigate the combined effects of HIV and METH use disorder on brain activity during risky decision-making.
• To examine neural circuitry differences in the anterior cingulate cortex (ACC), insula, and striatum.

Main Methods:

• Eighty-eight participants stratified by HIV status and METH use disorder history underwent functional magnetic resonance imaging (fMRI).
• Participants completed a risky decision-making task involving monetary choices.
• Linear mixed-effects models analyzed voxelwise differences in targeted brain regions.

Main Results:

• Despite similar behavioral choices, PWH with METH use disorder exhibited greater ACC and caudate activation compared to single-condition groups (HIV+/METH- or HIV-/METH+).
• This heightened activation in PWH with METH use disorder was comparable to HIV-negative, non-using controls.
• Longer HIV duration correlated with increased ACC activation during risky choices in PWH, irrespective of METH history.

Conclusions:

• PWH with METH use disorder may display compensatory neural activation in decision-making regions.
• The neural effects of HIV and METH use may not be additive.
• Findings highlight complex interactions between HIV, METH use, and neural decision-making processes.