Voice Quality in Individuals With Acquired Immunodeficiency Syndrome

Speech and voice disorders are frequently observed in individuals with acquired immunodeficiency syndrome (AIDS). However, the literature lacks detailed descriptions of how perceptual and acoustic characteristics manifest in the voice quality profiles of this population.

To characterize the voice quality profile of older adults living with AIDS by describing the relationship between perceptual and acoustic voice measures.

The research group (RG) comprised 20 individuals with AIDS, aged 50-60 years, all presenting with lipodystrophy, metabolic conditions including dyslipidemia, and 2-9 years of antiretroviral therapy. The control group (CG) comprised 9 age-matched individuals with metabolic conditions, including dyslipidemia, but without AIDS or antiretroviral therapy. The corpus included semi-spontaneous speech samples and repetitions of three key sentences designed for the perceptual evaluation of voice quality settings (VQS) across the vocal tract, muscular tension, and phonatory domains. For the acoustic analysis, data were processed using a script in the Praat software, which automatically extracted measures of fundamental frequency (f0), intensity, spectral slope, and the long-term average spectrum (LTAS). A preliminary statistical analysis was performed to establish the basis for presenting the results. Among the sociophonetic factors examined, gender emerged as the most influential variable and was included in the multivariate statistical approach.

The results indicated a significant prevalence of vocal tract VQS in the RG, including a retracted and lowered tongue body, pharyngeal constriction, and vocal tract hyperfunction, demonstrating strong discriminative power for classifying RG (98.7%) and CG (98.3%) samples. Acoustic measures showed a lower correlation factor (R²: 36.5%) for distinguishing the RG (77.4%) and CG (77.5%) samples. Regarding the relationship between acoustic measures and perceived voice qualities, f0 (particularly for females), LTAS (especially for males), and spectral slope were found to be relevant.

Vocal tract and tension VQS, together with correlated spectral measures, were relevant in the RG. These findings may reflect the combined functional consequences of long-term antiretroviral therapy, opportunistic diseases, lipodystrophy, and associated metabolic alterations. The results highlight the need for further studies to support the future development of preventive, monitoring, and rehabilitative speech-language pathology strategies during the long-term follow-up of individuals living with AIDS.

What is already known on this subject Research suggests a high prevalence of speech and voice disorders among patients with acquired immunodeficiency syndrome (AIDS). However, the relationship between perceived and acoustic voice quality in this population remains unexplored. What this study adds to existing knowledge Adjustments in vocal tract and tension-related voice quality, along with correlated spectral measures, were found to be significant in RG. These findings may relate to reported effects of lipodystrophy on the vocal tract and upper respiratory infections from opportunistic diseases. What are the clinical implications of this study? The findings of this study may be linked to the effects of lipodystrophy on the vocal tract in AIDS patients, as well as upper airway weakness due to opportunistic diseases. This underscores the need to develop therapeutic strategies for ongoing care in the AIDS population.