Self-Predictions of Prospective Memory Performance in HIV Infection: Evidence of a Meta-memory Deficit

Objective: HIV infection is associated with deficits in prospective memory (PM; remembering to remember), which confer risk of declines in everyday functioning. One potential moderating factor of such functional decline may be awareness of one's PM abilities ("meta-PM"); however, little is known regarding meta-PM in HIV. Our study examined meta-PM in HIVinfected and control participants. Method: Performance-based PM abilities (Memory for Intentions Screening Test), self-reported prediction of PM performance, and PM complaints in everyday life (Prospective-Retrospective Memory Questionnaire) were assessed in 49 individuals with HIV-associated neurocognitive disorders (HAND), 93 HIV+ without HAND (noHAND), and 121 seronegative adults (HIV-) matched on demographics and lifetime substance use disorders. Results: After controlling for depression, HAND individuals reported lower confidence in predicted PM performance, more PM complaints in everyday life, and worse actual PM performance when compared with noHAND and HIV- individuals (ps < .05). However, among HAND individuals, PM prediction and complaints were not related to actual PM performance (ps > .05). Overconfidence in PM predictions (PM performance - PM prediction) was associated with greater executive dysfunction (rho's = 0.33-0.34, ps = .02) within the HAND group, but not mood or PM complaints (ps > .05). Conclusion: HIV+ individuals with neurocognitive impairment evidenced a meta-PM deficit, such that overconfidence in PM was associated with greater objective executive dysfunction, but not affective functioning. Individuals with HAND, especially with deficits in PM and executive functions, may be at risk of overestimating their PM abilities thereby leading to errors in daily functioning (e.g., absence of compensatory strategy use when needed). Interventions to improve awareness of HIV-associated cognitive limitations are warranted in this population.