The HIV epidemic in China has been increasing exponentially, yet there
have been no studies of the neurobehavioral effects of HIV infection in
that country. Most neuroAIDS research has been conducted in Western
countries using Western neuropsychological (NP) methods, and it is unclear
whether these testing methods are appropriate for use in China.
Twenty-eight HIV seropositive (HIV+) and twenty-three HIV seronegative
(HIV−) individuals with comparable gender, age, and education
distributions were recruited in Beijing and the rural Anhui province in
China. Thirty-nine HIV+ and thirty-one HIV− individuals were
selected from a larger U.S. cohort recruited at the HIV Neurobehavioral
Research Center, in San Diego, to be matched to the Chinese sample for
age, disease status, and treatment variables. The NP test battery used
with the U.S. and China cohorts included instruments widely used to study
HIV infection in the United States. It consisted of 14 individual test
measures, each assigned to one of seven ability areas thought to be
especially vulnerable to effects of HIV on the brain (i.e., verbal
fluency, abstraction/executive function, speed of information
processing, working memory, learning, delayed recall, and motor function).
To explore the cross-cultural equivalence and validity of the NP measures,
we compared our Chinese and U.S. samples on the individual tests, as well
as mean scaled scores for the total battery and seven ability domains. On
each NP test measure, the mean of the Chinese HIV+ group was worse than
that of the HIV− group. A series of 2 × 2 analyses of variance
involving HIV+ and HIV− groups from both countries revealed highly
significant HIV effects on the Global and all Domain mean scaled scores.
Country effects appeared on two of the individual ability areas, at least
partly due to education differences between the two countries.
Importantly, the absence of HIV-by-Country interactions suggests that the
NP effects of HIV are similar in the two countries. The NP test battery
that was chosen and adapted for use in this study of HIV in China appears
to have good cross-cultural equivalence, but appropriate Chinese norms
will be needed to identify disease-related impairment in individual
Chinese people. To inform the development of such norms, a much larger
study of demographic effects will be needed, especially considering the
wide range of education in that country. (JINS, 2007,
13, 781–790.)