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Neurocognitive impairment in Spanish-speaking Latinos living with HIV in the US: Application of the neuropsychological norms for the US-Mexico border region in Spanish (NP-NUMBRS).

Authors
  • Kamalyan, Lily1, 2
  • Hussain, Mariam A1, 2
  • Diaz, Monica M3
  • Umlauf, Anya1
  • Franklin, Donald R1
  • Cherner, Mariana1
  • Rivera Mindt, Monica4, 5
  • Artiola I Fortuny, Lidia6
  • Grant, Igor1
  • Heaton, Robert K1
  • Marquine, María J1
  • 1 Department of Psychiatry, HIV Neurobehavioral Research Program, UCSD School of Medicine, University of California, San Diego, CA, USA.
  • 2 Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California San Diego, San Diego, CA, USA.
  • 3 Department of Neurosciences, University of California, San Diego, CA, USA.
  • 4 Department of Psychology & Latin American Latino Studies Institute, Fordham University, New York, NY, USA.
  • 5 Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
  • 6 Private Practice, Tucson, AZ, USA.
Type
Published Article
Journal
The Clinical neuropsychologist
Publication Date
Feb 01, 2021
Volume
35
Issue
2
Pages
433–452
Identifiers
DOI: 10.1080/13854046.2019.1701084
PMID: 31847711
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Objective Latinos in the US are at increased risk for HIV-associated neurocognitive impairment (NCI). Most studies of US Latinos living with HIV have included primarily English-speakers only. We investigated the rate, pattern, and correlates of HIV-associated NCI in native Spanish-speaking Latinos living in the US near the Mexican border. Methods Participants included 407 native Spanish-speaking Latinos (Age: M = 37.65, SD = 10.0; Education: M = 10.75, SD = 4.1; 53% male): 153 persons living with HIV (PLWH; 56% AIDS) and 254 healthy controls. All participants completed comprehensive neuropsychological assessments in Spanish. Raw neuropsychological test scores from seven domains were converted to demographically-adjusted T-scores using norms developed with healthy controls. Global and domain NCI were defined per established criteria. Among PLWH we applied norms developed for non-Hispanic (NH) Whites and Blacks, and investigated correlates of global NCI, including HIV disease characteristics and psychiatric comorbidities. Results Utilizing population specific norms, rates of global NCI were significantly higher among PLWH (39%) than healthy controls (17%), comparable to previously published rates. In contrast, rates of global NCI in the same group of PLWH were significantly different when NH White norms (63%, p < 0.0001) and NH Black norms were used (18%, p < 0.0001). Among PLWH without a history of lifetime substance use disorder, more years of antiretroviral exposure were significantly associated with decreased rates of global NCI. Conclusions Present findings lend support to the validity of newly developed norms for native Spanish-speakers living near the US-Mexico border, and underscore the importance of utilizing appropriate norms to accurately identify HIV-associated NCI.

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