Methods: We enrolled 50 HIV-infected monolingual Spanish-speakers. We administered the Trail Making Test (TMT) and the Hopkins Verbal Learning Test-Revised (HVLT-R), both of which are sensitive detecting HAND, and are also normed in Spanish-speakers. Participants were considered to be impaired on these tests if they scored greater than 1 standard deviation below the sociodemographically-adjusted mean (Frascati criteria, 2007). We administered a modified version of the Lawton & Brody Activities of Daily Living Scale and the MOS-HIV Functional/cognitive subscale to assess functional status. We abstracted potential correlates of NCI, including nadir CD4 count and peak HIV viral load. Using univariate and multivariate logistic regression analyses, we examined the relationships between our medical variables, functional status measures, and the presence of impairment on each neurocognitive test, in order to understand correlates of NCI in our sample.
Results: The proportion of participants demonstrating impairment in executive functioning (TMT-B), learning (HVLT- R), and memory (HVLT-R), were 48%, 56%, and 49%, respectively. Univariate logistic regression analyses revealed peak HIV viral load to be positively associated with impairment in executive functioning [OR = 2.663 (1.104-6.425)]. Subjective functional/cognitive deficits (MOS-HIV) were associated with impairment in both learning and memory [ORs =.847 (.719-.999) and .812 (.684-.963), resp.]
Conclusion: Rates of NCI in our sample were higher than those estimated for the general US population in previous studies. These neurocognitive deficits were associated with key medical and functional variables, which may represent risk factors for HAND. The results of this pilot study will inform the design of larger studies aiming to develop efficacious HAND screening algorithms for monolingual Spanish-speaking Hispanics living with HIV.
J. Seay, None