Utilizing the Color Figure Mazes Test to Assess Executive Functioning while Screening for HIV-Associated Neurocognitive Disorders in HIV-1 Seropositive Spanish-Speaking Adults

Abstract

Objective: Spanish-speaking individuals are disproportionately impacted by HIV in the United States. There are limited selections of valid and reliable measures to accurately assess the presence of HIV-associated neurocognitive disorders (HAND) with this population. The dearth of available measures places this vulnerable population at risk for receiving assessments that utilizes measures that are not adequately translated, modified, normed, or culturally sensitive. The purpose of this study was to investigate the clinical utility and efficacy of the Color Figure Mazes (CFM), a nonverbal measure of attention, concentration, working memory and executive functioning, to screen for deficits that characterize a HAND profile in Spanish-speaking adults. We hypothesized the HAND group would perform significantly worse than the non-HAND group and control group as the CFM tasks increased with difficul-ty. Methods: To explore the prevalence of HAND in Spanish-speaking individuals, we studied 100 HIV-1 seropositive participants (47 HAND; 53 non-HAND) who met criteria for the Center for Disease Control classification system category B or C and 27 HIV-seronegative controls. They were administered a comprehensive neuropsychological and psychosocial battery to assess for HAND. Results: While controlling for Pre-Morbid Intellectual Functioning, ANCOVA revealed that the HAND group performed significantly worse than the non-HAND group and HIV-seronegative control group on measures that placed a greater demand on skills requiring executive functioning including set-shifting over short periods of time, mental flexibility, and higher order thought processes. Conclusion: Our findings contribute to previous research by demonstrating that a brief, culturally sensitive measure, such as the CFM can help detect HAND in vulnerable populations, as is the case with Spanish speakers in the Unit-ed States. Furthermore, our results indicate that the CFM is sensitive in detecting executive function deficits associ-ated with HAND and may be culturally appropriate to use with HIV-seropositive Spanish-speaking adults.