Problems screening for HAND among the educationally disadvantaged.

Area of Science:

• Neuroscience
• Infectious Diseases
• Public Health

Background:

• Neurocognitive screeners are vital for detecting HIV-Associated Neurocognitive Disorders (HAND).
• The impact of education and socioeconomic status (SES) on HAND screening tool accuracy is not well understood.
• Socioeconomically disadvantaged populations may be disproportionately affected by HAND, yet their performance on screeners is understudied.

Purpose of the Study:

• To evaluate the performance of common neurocognitive screeners in socioeconomically disadvantaged individuals with HIV.
• To determine the false positive rates of the Montreal Cognitive Assessment (MoCA), International HIV Dementia Scale (IHDS), and Modified HIV Dementia Scale (MHDS) in this population.
• To assess the utility of these screeners for baseline assessment versus longitudinal monitoring.

Main Methods:

• Administered three neurocognitive screeners (MoCA, IHDS, MHDS) to 187 HIV+ individuals.
• Participants were socioeconomically disadvantaged and entering treatment with no other known HAND risk factors.
• Calculated false positive rates for each screening tool.

Main Results:

• The Montreal Cognitive Assessment exhibited a high false positive rate of 84%.
• The International HIV Dementia Scale showed a false positive rate of 59%.
• The Modified HIV Dementia Scale had the lowest false positive rate at 28.3%.

Conclusions:

• Current neurocognitive screeners demonstrate high false positive rates in socioeconomically disadvantaged HIV+ individuals.
• These screeners may be less reliable for initial HAND diagnosis in this population.
• Screeners might be more valuable for establishing baseline neurocognitive function and monitoring changes over time to detect HAND progression.