Department of Psychology, Fordham University, New York, NY, USA.
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Curr Top Behav Neurosci. 2021;50:193-223. doi: 10.1007/7854_2019_121.
Human Immunodeficiency Virus Type-I (HIV) is a health disparities issue that affects culturally and linguistically diverse (CALD) and underrepresented minority populations to a greater degree than non-Hispanic white populations. Neurologically speaking, CALD populations experience worse HIV-related health outcomes, which are exacerbated by inadequate neurocognitive measures, poor normative samples, and the complex interplay of sociocultural factors that may affect test interpretation. Although cross-cultural neuropsychologists are working diligently to correct this gap in the literature, currently, studies examining neurocognitive outcomes among CALD populations are sparse. The most well-studied CALD groups are of African American/Black and Latinx adults in the US, and the chapter therefore focuses on these studies. There is more limited work among other populations in the US, such as Asians, Native Hawaiians, Pacific Islanders, and American Indians/Alaskan Natives, and even fewer studies for many CALD populations outside of the US. For example, HIV neuropsychology data is rare or nonexistent in the First Peoples of Australia and Indigenous People of Canada. It is often not adequately reported in Europe for the migrant populations within those countries or other world regions that have historically large multicultural populations (e.g., South America, Caribbean countries, Asia, and Africa). Therefore, this chapter reviews HIV-related health disparities faced by CALD populations with focus on North American research where it has been specifically studied, with particular attention given to disparities in HIV-Associated Neurocognitive Disorders (HAND). International data was also included for research with focus on First Peoples of Australia and Indigenous People of Canada. The chapter also examines other sociocultural and health factors, including global and regional (e.g., rural versus urban) considerations, migration, and gender. Further, guidelines for incorporating sociocultural consideration into assessment and interpretation of neurocognitive data and HAND diagnosis when working with HIV-positive CALD populations that would be relevant internationally are provided.
人类免疫缺陷病毒 I 型（HIV）是一个健康差异问题，它对文化和语言多样化（CALD）以及代表性不足的少数族裔群体的影响程度大于非西班牙裔白人。从神经学上讲，CALD 人群的 HIV 相关健康结果更差，这是由于神经认知测量不足、规范样本较差以及可能影响测试解释的复杂社会文化因素相互作用所致。尽管跨文化神经心理学家正在努力纠正文献中的这一差距，但目前，检查 CALD 人群神经认知结果的研究仍然很少。研究最多的 CALD 群体是美国的非裔美国/黑人和拉丁裔成年人，因此本章重点介绍这些研究。在美国，其他人群的研究工作更为有限，例如亚洲人、夏威夷原住民、太平洋岛民和美洲印第安人/阿拉斯加原住民，而对于美国以外的许多 CALD 人群，研究甚至更少。例如，在澳大利亚的第一民族和加拿大的原住民中，HIV 神经心理学数据很少或根本没有。在欧洲，对于这些国家或其他历史上拥有大量多元文化人口的世界区域（例如南美洲、加勒比国家、亚洲和非洲）的移民人口，这种情况也没有得到充分报告。因此，本章重点介绍了北美针对 CALD 人群的 HIV 相关健康差异研究，特别关注与 HIV 相关的神经认知障碍（HAND）的差异。还包括了国际数据，重点研究了澳大利亚的第一民族和加拿大的原住民。本章还研究了其他社会文化和健康因素，包括全球和区域（例如，农村与城市）的考虑因素、移民和性别。此外，还提供了针对 HIV 阳性 CALD 人群的神经认知数据和 HAND 诊断的评估和解释中纳入社会文化因素的相关国际准则。
