Naveed Z, Fox HS, Wichman CS, et al. - Findings highlight that consistent ART (antiretroviral therapy) use may be of high value to preserving neurocognition in people living with HIV. A vigilant follow-up may be needed in Hispanic patients, those with a history of depression and substance use, and those facing challenges in essential activities of daily living.

• This analysis involved 581 people living with HIV, to determine risk factors linked with neurocognitive decline in them.

• A definition of decline that is statistically feasible, is based on a commonly used neuropsychological cut-off and may be clinically relevant, was applied.

• A follow-up of 12 years was conducted and neurocognitive decline was defined as the first observed fall in global T-scores of at least 2.67.

• Lifetime methamphetamine use was most strongly associated with neurocognitive decline (adjusted Hazard Ratio; aHR = 1.48) followed by no current antiretroviral medication use (aHR = 1.32).

• Other risk factors were: Hispanic ethnicity, lifetime history of major depressive disorder, lifetime cannabis use, hepatitis-C infection, and difficulty eating, dressing, bathing, or using the toilet.