Given the largely prefrontostriatal neuropathogenesis of
HIV-associated neurobehavioral deficits, it is often presumed that HIV
infection leads to greater impairment on letter versus category
fluency. A meta-analysis of the HIV verbal fluency literature was
conducted (k = 37, n = 7110) to assess this hypothesis
and revealed generally small effect sizes for both letter and category
fluency, which increased in magnitude with advancing HIV disease severity.
Across all studies, the mean effect size of category fluency was slightly
larger than that of letter fluency. However, the discrepancy between
category and letter fluency dissipated in a more conservative analysis of
only those studies that included both tests. Thus, HIV-associated
impairments in letter and category fluency are of similar magnitude,
suggesting that mild word generation deficits are evident in HIV,
regardless of whether traditional letter or semantic cues are used to
guide the word search and retrieval process (JINS, 2007,
13, 183–189.)