Dr. Enrique Lopez is an Assistant Professor, and the Head of the Psychology Section in the Department of Psychiatry and Behavioral Neurosciences at Cedars-Sinai Medical Center (CSMC) and an Assistant Clinical Professor in the Department of Psychiatry and Biobehavioral Sciences at the David Geffen School of Medicine at UCLA. Dr. Lopez's long-term goal is to develop an independent career in clinical research in the area of HIV-associated neurocognitive disorders. Dr. Lopez has had a long-term interest in creating better neurocognitive assessment tools and neurorehabilitation treatment programs for Spanish speaking individuals, specifically those diagnosed with HIV-associated neurocognitive disorders (HAND). Under the mentorship of Robert M. Cohen, Ph.D., M.D., Karl Goodkin, M.D., Ph.D., Charles H. Hinkin, Ph.D., ABPP-CN, and David J. Martin, Ph.D., Dr. Lopez will investigate HAND in Spanish-speaking individuals while obtaining a personalized training program by senior scientists in the area of neuroAIDS from CSMC, UCLA, and Harbor-UCLA Medical Center. The proposed career development plan provides an intense, closely mentored, patient-oriented research experience in association with a comprehensively structured didactic clinical research curriculum. The first objective of the study is to validate the Los Angeles version of the HUMANS battery for Hispanics infected by HIV. The original HUMANS battery has been developed by Dr. Karl Goodkin as part of an NIH grant he received. The newly revised battery will be administered in a sample of 30 HIV-seronegative adults to obtain preliminary data with this specific Spanish-speaking population as well as to 100 HIV-seropositive persons (20 participants will be re-administered the NP battery in order to obtain re-test reliability data). After establishment of a valid measure to assess for HAND among Spanish-speakers in the Los Angeles area, the study will investigate if Spanish language cognitive screening tools can detect HAND as well as a comprehensive neuropsychological evaluation. Rapid screening cognitive tests for HAND are of great need in this population because of their utility in clinical settings. Additionally, the relationship between medication adherence and neurocognition among this Spanish-speaking population will be evaluated. Little information is known about medication adherence and neurocognitive disorders among this Spanish-speaking population infected with HIV. Ultimately, this study will provide Dr. Lopez with reliable and valid HIV-1-associated neurocognitive impairment data among the unique Los Angeles disenfranchised group to develop a research clinical derived multidisciplinary treatment program for medication adherence in Spanish-speakers suffering from HAND in order to submit an R21 grant. This specialized training will further his collaborations among other senior scientists in the area of neuroAIDS for Dr. Lopez to conduct independent research among minority individuals who are impacted with HIV.
Primary Spanish speakers with HIV infection today are frequently assessed for neurocognitive and other neuropsychiatric disorders using instruments administered in English due to convenience. However, this may generate invalid results, over-estimating the rate of neurocognitive disorders due to less English familiarity. This study will address the need to modify and further evaluate the HUMANS battery, a translation of a battery derived from the NIMH Consensus Battery for neurocognitive evaluation of HIV infected persons into Spanish for its use in the greater Los Angeles area, meeting the outstanding clinical need.