Neurocognitive Function in Persons with HIV and Healthy Controls from Tijuana, a Border Region in Mexico

Abstract

Abstract Objective To examine neurocognitive impairment (NCI) in vulnerable HIV infected (HIV+) adults in Mexico. Participants and Method Twenty-eight adults (15 HIV+ and 13 HIV-) living in Tijuana (Mexico) participated in the study (Age: M = 40.5, SD = 11.1; 54% female; Education: M = 8.6, SD = 4.7). Participants with HIV were recruited from the board-and-care home “Las Memorias” (100% AIDS; 93% on ART; Years since HIV diagnosis: Median = 11, IQR = 5,16). Healthy controls, matched in age and education to HIV+ participants, were recruited from the same city. Participants completed a neuropsychological test battery which was comprised of the Modified Wisconsin Card Sorting Test, letter and animal fluency, Trail Making Test Parts A and B, Stroop Color-Word Test, and Symbol-Digit Test. Raw scores garnered from these tests were transformed to percentiles using norms for a Mexican population, and averaged to calculate scores on global cognition and on three cognitive domains (verbal fluency, processing speed and executive function). Wilcoxon rank sum tests were conducted to investigate group differences. NCI was defined as global percentile scores < 16. Results HIV+ participants showed significantly lower scores in global cognition (p = .04, Cohen’s d = 0.86), as well as the domains of processing speed (p = .03, Cohen’s d = 0.87) and executive function (p = .04, Cohen’s d = 0.84), with no significant differences (but medium effect sizes) on verbal fluency (p = .10, Cohen’s d = 0.60). NCI was evident in 53% of HIV+ persons and 15% of healthy controls. Conclusions Approximately half of the persons living with HIV showed notable NCI, which is consistent with findings of prior studies of Latinos in the US with HIV. This pattern of neurocognitive function was also similar to those of prior studies in HIV. Future studies might examine key predictors of HIV-associated NCI in this vulnerable Mexican population, including biological and culturally relevant factors: such as deportation, and discrimination for sexual preference or HIV status.