Journal of the International Neuropsychological Society

Journal of the International Neuropsychological Society (1999), 5:7:579-592 Cambridge University Press
Copyright © 1999 The International Neuropsychological Society


The impact of HIV-related neuropsychological dysfunction on driving behavior


THOMAS D.  MARCOTTE a1c1, ROBERT K.  HEATON a1, TANYA  WOLFSON a1, MICHAEL J.  TAYLOR a1, OMAR  ALHASSOON a1, KAIVON  ARFAA a1, IGOR  GRANT a1a2 and THE HNRC GROUP
a1 University of California at San Diego, Department of Psychiatry, San Diego, CA
a2 Veterans Affairs Healthcare System, San Diego, CA

Abstract

HIV infection often results in neuropsychological (NP) impairment. In order to assess the impact that HIV-related NP deficits may have on automobile driving, we evaluated 68 HIV-seropositive drivers using an NP battery and two PC-based driving simulations. Thirty-two participants were classified as NP impaired; most (72%) evidenced only mild impairment, and none met criteria for HIV-associated dementia. After controlling for degree of immunosuppression and disease stage, NP-impaired participants failed a previously validated driving simulation at a much higher rate than cognitively intact participants [OR = 5.3, 95% CI (1.7, 17.0), p = .006]. Similarly, on a simulation of city driving, NP impaired participants were more likely to fail based upon the number of accidents [OR = 6.1, 95% CI (1.5, 24.6), p = .01]. Simulator performance was predicted by functioning in a number of NP domains, with NP tests accounting for 13–30% of the variance on the simulations. Although it would be premature to extrapolate these findings to impairment in on-the-road driving, they do argue for greater attention to the impact that even mild HIV-related NP deficits may have on driving skills. (JINS, 1999, 5, 579–592.)

(Received July 2 1998)
(Revised February 10 1999)
(Accepted February 25 1999)


Key Words: HIV infection; AIDS; Driving; Neuropsychological impairment.

Correspondence:
c1 Reprint requests to: Thomas D. Marcotte, HIV Neurobehavioral Research Center, 2760 Fifth Avenue, Suite 200, San Diego, CA 92103. E-mail: tmarcotte@ucsd.edu


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