Wisconsin Card Sorting Task-64 performance among HIV+ Black/African American and Latinx adults compared to normative samples and by sociocultural and health variables

Abstract

Many people living with HIV experience cognitive impairment, and HIV disproportionately affects racial/ethnic minority groups. Independent of HIV, racial/ethnic minority individuals perform worse than White individuals on cognitive tasks, even after accounting for education. Our goals were to (1) compare WCST-64 scores between HIV+ Black/African American (Black/AA) (n = 45) and Latinx (n = 41) urban-dwelling adults; (2) compare our total sample to the WCST-64 manual’s normative (N) and clinical normative (CN) groups; and (3) explore relationships between WCST-64 performance and sociocultural/health variables. In our sample, employment (12%), mean annual income (<$10,000), and mean education (<12 years) were low, while mean medication adherence rates were high for both Black/AA (90%) and Latinx (87%). WCST-64 scores were similar between groups (p > .05). Percentages of “below average” and “mildly impaired” scores in our sample were higher than the N group, and similar to the CN group. Lifetime heroin use, dementia, and longer HIV illness duration were significantly associated with worse WCST-64 performance (ps < .05). The observed low scores in our asymptomatic sample are likely due to the intersectionality of sociocultural and medical burden, highlighting complexities in interpreting neuropsychological data in real-world HIV+ clinics. Executive deficits are linked to poorer outcomes, and routine cognitive screening may be clinically indicated.

Keywords:

• Cultural neuropsychology
• executive functioning
• HIV
• neuropsychology

Acknowledgments

We would like to thank the research participants and staff at Montefiore Medical Center’s Center for Positive Living.

Disclosure statement

The authors have no conflicts of interest to report.

Notes

1 Gender neutral term denoting individuals of Latin American origin or descent.

2 Referring to individuals of European origin or descent.

Additional information

Funding

This work was supported in part by the National Institutes of Health under Grants [R01-DA036445, R01-CA192954, R34-DA037042] and Ferkauf Departmental Funds.