In:
Journal of the International Neuropsychological Society, Cambridge University Press (CUP), Vol. 24, No. 2 ( 2018-02), p. 163-175
Abstract:
Objectives: Human immunodeficiency virus (HIV) disproportionately affects Hispanics/Latinos in the United States, yet little is known about neurocognitive impairment (NCI) in this group. We compared the rates of NCI in large well-characterized samples of HIV-infected (HIV+) Latinos and (non-Latino) Whites, and examined HIV-associated NCI among subgroups of Latinos. Methods: Participants included English-speaking HIV+ adults assessed at six U.S. medical centers (194 Latinos, 600 Whites). For overall group, age: M =42.65 years, SD =8.93; 86% male; education: M =13.17, SD =2.73; 54% had acquired immunodeficiency syndrome. NCI was assessed with a comprehensive test battery with normative corrections for age, education and gender. Covariates examined included HIV-disease characteristics, comorbidities, and genetic ancestry. Results: Compared with Whites, Latinos had higher rates of global NCI (42% vs . 54%), and domain NCI in executive function, learning, recall, working memory, and processing speed. Latinos also fared worse than Whites on current and historical HIV-disease characteristics, and nadir CD4 partially mediated ethnic differences in NCI. Yet, Latinos continued to have more global NCI [odds ratio (OR)=1.59; 95% confidence interval (CI)=1.13–2.23; p 〈 .01] after adjusting for significant covariates. Higher rates of global NCI were observed with Puerto Rican ( n =60; 71%) versus Mexican ( n =79, 44%) origin/descent; this disparity persisted in models adjusting for significant covariates (OR=2.40; CI=1.11–5.29; p =.03). Conclusions : HIV+ Latinos, especially of Puerto Rican ( vs . Mexican) origin/descent had increased rates of NCI compared with Whites. Differences in rates of NCI were not completely explained by worse HIV-disease characteristics, neurocognitive comorbidities, or genetic ancestry. Future studies should explore culturally relevant psychosocial, biomedical, and genetic factors that might explain these disparities and inform the development of targeted interventions. ( JINS , 2018, 24 , 163–175)
Type of Medium:
Online Resource
ISSN:
1355-6177
,
1469-7661
DOI:
10.1017/S1355617717000832
Language:
English
Publisher:
Cambridge University Press (CUP)
Publication Date:
2018
detail.hit.zdb_id:
2000018-2
SSG:
5,2
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