title: Education effects on the International HIV Dementia Scale.
abstract: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) within the Indian subcontinent continues to spread. Although the primary clade of HIV in India differs from that of most Western countries, recent evidence suggests that the Indian clade (Clade C) also impacts neurocognitive functioning. India also has extremely high illiteracy rates that may confound detection of neurocognitive impairment, since many assessments to detect such impairment are heavily influenced by formal schooling. Among those with HIV/AIDS who have had limited educational opportunities and who are in the early stage of infection, the confounding effects of education on tests for neurocognitive impairment may be particularly salient. We therefore tested influence of HIV serostatus and education on a commonly used tool to screen for cognitive impairment, the International HIV Dementia Scale (IHDS), among Indian men and women in the catchment area of the Post Graduate Institute of Medical Education and Research (PGIMER) located in Chandigarh, India. Adjusted analyses showed that from a sample of 295 HIV-positive and HIV-negative individuals, only education was significantly associated with performance on the IHDS. HIV-negative and HIV-positive individuals, who were in the early stages of infection, performed similarly. Further development of this test to account for the effects of education on cut-off scores used to indicate possible dementia are needed, particularly for use in resource-limited settings such as India where low levels of education are widespread.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Miami, Miller School of Medicine, Miami, Florida 33136, USA. dwaldrop@med.miami.edu
authors.forename: Drenna
authors.initials: D
authors.lastname: Waldrop-Valverde
authors.forename: Ritu
authors.initials: R
authors.lastname: Nehra
authors.forename: Sunil
authors.initials: S
authors.lastname: Sharma
authors.forename: Ashima
authors.initials: A
authors.lastname: Malik
authors.forename: Deborah
authors.initials: D
authors.lastname: Jones
authors.forename: Adarsh M
authors.initials: AM
authors.lastname: Kumar
authors.forename: Raymond L
authors.initials: RL
authors.lastname: Ownby
authors.forename: Ajay
authors.initials: A
authors.lastname: Wanchu
authors.forename: Steve
authors.initials: S
authors.lastname: Weiss
authors.forename: Sudesh
authors.initials: S
authors.lastname: Prabhakar
authors.forename: Mahendra
authors.initials: M
authors.lastname: Kumar
mesh_terms: D015526:AIDS Dementia Complex / Q000175:diagnosis*; D000328:Adult; D004522:Educational Status; D005260:Female; D015497:HIV-1; D006266:Health Education; D006801:Humans; D007194:India; D008297:Male; D009483:Neuropsychological Tests