AIDS and Behavior

, Volume 21, Issue 6, pp 1717–1727 | Cite as

Use of Western Neuropsychological Test Battery in Detecting HIV-Associated Neurocognitive Disorders (HAND) in Zambia

  • Norma Kabuba
  • J. Anitha Menon
  • Donald R. FranklinJr.
  • Robert K. Heaton
  • Knut A. Hestad
Original Paper


This is a study of neuroAIDS in sub-Saharan Africa, involving 266 Zambian adults infected with the human immunodeficiency virus (HIV), clade C. All HIV+ participants were receiving combination antiretroviral therapy (CART), and were administered a comprehensive neuropsychological (NP) test battery covering seven ability domains that are frequently affected by neuroAIDS. The battery was developed in the U.S. but has been validated in other international settings and has demographically-corrected normative standards based upon 324 healthy Zambian adults. Compared to the healthy Zambian controls, the HIV+ sample performed worse on the NP battery with a medium effect size (Cohen’s d = 0.64). 34.6 % of the HIV+ individuals had global NP impairment and met criteria for HIV associated neurocognitive disorder (HAND). The results indicate that the Western-developed NP test battery is appropriate for use in Zambia and can serve as a viable HIV and AIDS management tool.


HIV HAND Neuropsychological performance Zambia 


Este es un estudio sobre neuroAIDS en Africa subsahariana donde los estudiados fueron 266 adultos Zambianos infectados con virus de inmunodefiencia adquirida (VIH)  tipo C. Todos los participantes con VIH recibieron terapia antirretroviral (CART) y sometido a una batería de pruebas neuropsicológicas (NP) que examinan capacidades cognitivas que a menudo se ven afectadas por el neuroSIDA. Dicha batería fue elaborada en Estados unidos pero ha sido validada en entornos internacionales y ha sido corregida demograficamente según los estandares normativos de una seleccion de 324 adultos zambianos sin VIH. Comparados con los zambianos sin SIDA en el grupo de control los VIH-positivos muestran resultados peores en la batería neuropsicológica con un efecto de proporción mediana (Cohen’s d = 0.64). 34.6 % de los participantes con VIH tuvieron un deterioro neuropsicológico global y cumplían los criterios de un trastorno neurocognitivo asociado con el VIH (HAND). Estos resultados indican que la batería neuropsicológica elaborada en Estados Unidos (desarrollada en Occidente) es un instrumento adecuado y viable para su uso en Zambia y puede funcionar como una herramienta de gestión del VIH.

Palabras Clave

VIH HAND Rendimiento neuropsicológico Zambia 



Gratitude is extended to the staff and patients of the participating clinics for their contributions. The authors also thank the first and second cohort Masters students in clinical neuropsychology at The University of Zambia for their contribution in collecting the data of the healthy sample and the seropositive sample respectively. The study was financially supported by the NOMA funds from The Norwegian Agency for Development Cooperation (NORAD).


The study was financially supported by the NOMA funds from The Norwegian Agency for Development Cooperation (NORAD). Project title: Master of Science in Clinical Neuropsychology—Building expertise to deal with the Neuropsychological challenges of HIV-infection. (Grant No NOMAPRO-2007/10046).

Compliance with Ethical Standards

Conflict of interest

Norma Kabuba declares that she has no conflict of interest. J. Anitha Menon declares that she has no conflict of interest. Donald R. Franklin Jr. declares that he has no conflict of interest. Robert K. Heaton declares that he has no conflict of interest. Knut A. Hestad declares that he has no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Norma Kabuba
    • 1
    • 2
  • J. Anitha Menon
    • 1
  • Donald R. FranklinJr.
    • 3
  • Robert K. Heaton
    • 3
  • Knut A. Hestad
    • 2
    • 4
    • 5
  1. 1.Department of PsychologyThe University of ZambiaLusakaZambia
  2. 2.Department of PsychologyThe Norwegian University of Science and TechnologyTrondheimNorway
  3. 3.Department of PsychiatryUniversity of California, San DiegoSan DiegoUSA
  4. 4.Department of ResearchInnlandet Hospital TrustHamarNorway
  5. 5.Hedmark University CollegeElverumNorway

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