Factors associated with driving simulator performance in vocational drivers with HIV

Neurocognitive symptoms persist in many people living with HIV (PLWH). Safe driving practices are dependent on intact cognition. Research in the general driving population suggests that PLWH with neurocognitive impairment (NCI) perform worse on driving assessment tasks than cognitively intact PLWH. We explored the relationship between HIV status, NCI, and driving ability in vocational drivers. Two-hundred-and-four male drivers [68 drivers with HIV] completed neuropsychological testing and two driving simulator tasks assessing driving under routine and challenging circumstances. Drivers with NCI, regardless of HIV status, exhibited worse driving performance than cognitively intact drivers overall (p = .032), and on the challenging drive (p = .048) in particular. Better driving performance was associated with having received professional driver training. Other favorable predictors included being a truck driver and not having HIV. Drivers with NCI are at greater risk of making driving simulator errors, and errors are more evident under challenging driving conditions. Driver training interventions may be effective in remediating poorer driving performance in drivers with NCI. Studying the impact of HIV and cognition in individuals who are working professionally is a complex undertaking that requires consideration of factors (e.g., training and experience) alongside the usual variables considered when studying the general population.