Primary Spanish speaking subjects have been neglected in the research conducted to date on the prevalence of HIV-l-associated cognitive-motor disorder. Argentina is a moderate-resource country that has been highly impacted by the AIDS epidemic. Fundacion Huesped (FH) is the largest clinic for the primary care of HIV-1 infected individuals in Argentina and is highly influential in care delivery policies there. While FH has integrated mental health side-by-side with general medical care since its inception, there is no routine screening of cognitive-motor disorders (minor cognitive-motor disorder and HIV-1 associated dementia). This project will provide a training program to FH staff on the diagnosis and treatment of HIV-1 associated cognitive-motor disorders during the first six months. The educational impact of the program will then be evaluated. Upon confirmation of training by a knowledge-based examination, the second phase of the project will commence During this phase a total of 150 consecutive HIV-1 infected patients seen at the FH will be screened for cognitive-motor disorders. The rate of diagnostic agreement between the University of Miami staff and the Argentinean team will be determined over the first 50 patients. Discrepancies will be reviewed and presented around achieving diagnostic consensus. The final phase of the project will be the review of the last 100 patients seen and any discrepancies amongst these cases. Treatment plan recommendations will also be incorporated into the educational plan and review of cases, although criteria justifying agreement on treatment plan are not as highly developed. Results will be used to validate the HIV University of Miami Annotated Neuropsychological test battery in Spanish (the HUMANS battery) in a homogeneous Spanish-speaking culture (that of Argentina). Current NIMH-funded study hypotheses on aging and HIV-1 infection in Miami will also be preliminarily investigated in the Argentinean cohort to be accrued with the aim of developing a subsequent R01 grant application.
