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AIDS Care. 2017 Oct;29(10):1297-1301. doi: 10.1080/09540121.2017.1322681. Epub 2017 Apr 27.

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.

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a Section of Infectious Diseases, AIDS Program , Yale School of Medicine , New Haven , CT , USA.
b Department of Epidemiology of Microbial Diseases , Yale School of Public Health , New Haven , CT , USA.
c Department of Community Medicine and Health Care , University of Connecticut Health Center , Farmington , CT , USA.
d Institute for Collaboration on Health , Intervention, and Policy, University of Connecticut , Storrs , CT , USA.
e Department of Allied Health Sciences , University of Connecticut , Storrs , CT , USA.
f Vía Libre , Lima , Peru.
g Asociación Civil Impacta Salud y Educación , Lima , Peru.


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.


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

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