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

María J. Marquine, Anne Heaton, Neco Johnson, Monica Rivera-Mindt, Mariana Cherner, Cinnamon Bloss, Todd Hulgan, Anya Umlauf, David J. Moore, Pariya Fazeli, Susan Morgello, Donald Franklin, Scott Letendre, Ron Ellis, Ann C. Collier, Christina M. Marra, David B. Clifford, Benjamin Gelman, Ned Sacktor, David SimpsonJ. Allen McCutchan, Igor Grant, Robert K. Heaton

Research output: Contribution to journalArticle

8 Scopus citations

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).

Original languageEnglish (US)
Pages (from-to)163-175
Number of pages13
JournalJournal of the International Neuropsychological Society
Volume24
Issue number2
DOIs
StatePublished - Feb 1 2018

    Fingerprint

Keywords

  • Cognitive function
  • Culture
  • Health status disparities
  • Hispanics
  • Human immunodeficiency virus
  • Minority health

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Psychology
  • Clinical Neurology
  • Psychiatry and Mental health

Cite this

Marquine, M. J., Heaton, A., Johnson, N., Rivera-Mindt, M., Cherner, M., Bloss, C., Hulgan, T., Umlauf, A., Moore, D. J., Fazeli, P., Morgello, S., Franklin, D., Letendre, S., Ellis, R., Collier, A. C., Marra, C. M., Clifford, D. B., Gelman, B., Sacktor, N., ... Heaton, R. K. (2018). Differences in Neurocognitive Impairment among HIV-Infected Latinos in the United States. Journal of the International Neuropsychological Society, 24(2), 163-175. https://doi.org/10.1017/S1355617717000832