Background Neurocognitive impairment (NI) prevalence in HIV is
estimated >50%, associated with disease severity (CD4-cell count), medication adherence, and
quality of life (QoL). Early detection is paramount but assessments are resource-intensive.
This study explores the reliability and validity of a 3-item NI screening tool to identify
patients eligible for comprehensive NI assessment. Methods A longitudinal study in which 138
patients completed baseline and follow-up (14.5 months later) questionnaires including NI and
QoL (sf12_v2). The CD4-cell count prior to baseline was collected from clinic records. We
examined internal consistency and test-retest reliability of the NI scale; and for convergent
validity we examined the association of NI with CD4-cell count and QoL. Findings Cronbach’s
alpha at baseline and follow-up (.86 to .84), and test-retest reliability were good (rho=.75,
p<.001). CD4-cell count predicted baseline and follow-up NI (rho=.22-.21, p<.01). NI
predicted mental (β.378, p<.001) but not physical QoL, while controlling for age, CD4-cell
count and baseline QoL. Discussion This 3-item NI screening tool seems reliable and valid and
could be considered for routine screening for NI in HIV-care.
