Characterization and sociocultural predictors of neuropsychological test performance in HIV+ Hispanic individuals.

Abstract

Hispanic individuals in the U.S. have been disproportionately impacted by HIV/AIDS, yet little is known regarding the neuropsychological sequelae of HIV within the Hispanic population. This study characterized neuropsychological (NP) test performance of HIV+ English-speaking Hispanic participants (n= 51) and investigated the combined roles of sociocultural factors (e.g., ethnicity, socioeconomic status [SES] proxy, and reading level) on NP test performance among our HIV+ Hispanic and non-Hispanic White participants (n=49). Results revealed that the pattern of NP impairment in HIV+ Hispanic participants is consistent with the frontal-striatal pattern observed in HIV-associated CNS sequelae, and the overall prevalence of global NP impairment was high compared to previous reports with more ethnically homogeneous, non-Hispanic White cohorts. Multivariate prediction models that considered both sociocultural factors and CD4 count revealed that reading level was the only unique predictor of global NP functioning, learning, and attention/ working memory. In contrast, ethnicity was the only unique predictor of abstraction/executive functioning. This study provides support for the use of neuropsychological evaluation in detecting HIV-associated NP impairment among HIV+ Hispanic participants, and adds to the growing literature regarding the importance of considering sociocultural factors in the interpretation of NP test performance. KeywordsHispanic; Human Immunodeficiency Virus; AIDS; Neuropsychological Functioning; Sociocultural Factors; Literacy HIV has a unique affinity for the central nervous system (CNS), and neuropsychological impairment significantly increases mortality risk among HIV+ adults, regardless of physiological disease progression (Davis et al., 1992;Goudsmit et al., 1986;Mayeux et al., 1993;Sevigny et al., 2007;Wilkie et al., 1998). HIV-related neuropathology in fronto-striatal regions, along with elevated HIV viral load in CSF, are associated with neuropsychological Correspondence concerning this article should be sent to Monica Rivera Mindt, Ph.D.; Fordham University Department of Psychology, LL 808-F, 113 W. 60 th Street, New York, NY 10023; (212) FAX: (212) ; E-mail: monica.mindt@mssm.edu.. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript sequelae in up to 50% of HIV+ persons (Cherner et al., 2002;Ellis et al., 2002;Heaton et al., 1995;Masliah, Ge, DeTeresa, Terry & Wiley, 1992;Masliah, Ge & Mucke, 1996;Zhao, Kim, Morgello & Lee, 2001). While HIV-associated CNS disease has been extensively studied over prior decades, little has been done to investigate how the epidemic's changing demographics might be associated with HIV's neuropsychological complications.Initially, non-Hispanic White men accounted for the majority of HIV/AIDS cases in the U.S.(Centers for Disease Control; CDC, 2001CDC, , 2003. Hispanic individuals have since become a disproportionately affected at-risk group for HIV/AIDS. Hispanic individuals account for 20% of reported AID...

Differences in Neurocognitive Impairment Among HIV-Infected Latinos in the United States

“…Latinos also might be at increased risk for HIV-associated NCI in the era of combination ART (Durvasula, Miller, Myers, & Wyatt, 2001; Heaton et al, 2014; Rivera-Mindt et al, 2008; Rivera-Mindt et al, 2014; Wojna et al, 2006). In a recent longitudinal study of HIV+ persons in the CNS HIV Anti-Retroviral Therapy Effects Research (CHARTER) study, Latino ethnicity was a significant, independent predictor of neurocognitive decline over an average of three years (Heaton et al, 2014).…”

“…(i.e., New York). One of these studies included participants in the Manhattan HIV Brain Bank, with advanced HIV disease (51 Latino and 49 White; Rivera-Mindt et al, 2008). Findings indicated Latinos performed worse than Whites on tests of abstraction/executive function in a model adjusting for socioeconomic status, English reading level (i.e.…”

The impact of ethnicity/race on the association between the Veterans Aging Cohort Study (VACS) Index and neurocognitive function among HIV-infected persons

“…HIV-infected Hispanics and NH blacks also appear to be at increased risk for worse neurocognitive outcomes than HIV-infected NH whites (Durvasula et al 2001; Heaton et al 2014; Manly et al 1998; Mindt et al 2008; Ryan et al 2005; Wojna et al 2006). Despite the availability of more effective combination antiretroviral treatment (cART), neurocognitive impairment (NCI) continues to be common and impactful in HIV.…”

The Relative Utility of Three English Language Dominance Measures in Predicting the Neuropsychological Performance of HIV+ Bilingual Latino/a Adults

“…Differential performances between racial/ethnic groups can lead to increased likelihood that an individual within a minority group will be misclassified as neuropsychologically impaired (Harris et al, 2003; Heaton, Taylor, & Manly, 2003; Low et al, 2012; Norman, Evans, Miller, & Heaton, 2000; Taylor & Heaton, 2001). Furthermore, there is evidence for higher rates of neuropsychological impairment in Latino samples than in samples containing greater proportions of non-Hispanic White participants (Rivera Mindt et al, 2008). …”