An explanatory factor analysis of a brief self-report scale to detect neurocognitive impairment among HIV-positive men who have sex with men and transgender women in Peru

ABSTRACT

Neurocognitive impairment (NCI) has been associated with poor clinical outcomes in various patient populations. This study used exploratory factor analysis (EFA) to examine the factor structure of the existing 95-item Neuropsychological Impairment Scale (NIS) to create a suitable NCI screening instrument for people living with HIV (PLH). In Lima, Peru, 313 HIV-positive men who have sex with men (MSM) and transgender women (TGW) prescribed antiretroviral therapy (ART) completed the NIS using computer-assisted self-interviews (CASI). The EFA used principal axis factoring and orthogonal varimax rotation, which resulted in 42 items with an 8-factor solution that explained 51.8% of the overall variance. The revised, 8-factor, Brief Inventory of Neurocognitive Impairment for Peru (BINI-P) showed a diverse set of factors with excellent to good reliability (i.e., F₁ α = 0.92 to F₈ α = 0.78). This EFA supports the use of the BINI-P to screen for NCI among Spanish-speaking, HIV-positive MSM and TGW. Future research should examine the effectiveness of the BINI-P in detecting NCI in clinical care settings and the impact of NCI on HIV health-related outcomes, including linkage and retention in care, ART adherence and HIV risk behaviors.

KEYWORDS:

• Brief inventory of neurocognitive impairment
• neurocognitive impairment
• explanatory factor analysis
• HIV/AIDS
• men who have sex with men
• transgender women

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Roman Shrestha http://orcid.org/0000-0003-4340-3101

Panagiotis Vagenas http://orcid.org/0000-0003-2107-0377

Frederick L. Altice http://orcid.org/0000-0002-7860-693X

Additional information

Funding

This research was funded by Yale College through the Fellowship for Research in Health Studies, the Thomas C. Barry Travel Fellowship, the CIPE Spanish and Latin America Fellowship and the International Summer Award. Additional funding was provided by the National Institute on Drug Abuse [grant number K24 DA017072 to FLA], [grant number K02 DA033139 to MMC] and by core funds from Asociacion Civil Impacta Salud y Educacion. Funding sources played no role in study design, data collection, data analysis, data interpretation, writing of the manuscript or the decision to submit the paper for publication.