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The Impact of HIV-Associated Neurocognitive Impairment on Driving Performance in Commercial Truck Drivers

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Abstract

Driving ability can be diminished amongst people with HIV with associated neurocognitive impairment (NCI). We explore the relationship between HIV status, NCI and driving ability in professional truck drivers. Forty male professional drivers (20 HIV-positive; mean age = 39.20 ± 7.05) completed a neuropsychological test battery, two driving simulator tasks that assessed driving ability, and a driving history and habits questionnaire. A higher proportion of HIV-positive drivers exhibited impaired overall cognitive performance (p ≤ 0.001). Overall, drivers with NCI (defined as z ≤ 1.00) were more likely than those without NCI to crash (p = 0.002). There were no significant between-group (HIV-positive versus HIV-negative) differences with regard to self-reported on-road driving events. Professional drivers with NCI, as measured on a driving simulator, are at increased risk of making driving errors under high-risk conditions compared to their neurocognitively normal counterparts. These data should inform driver health management with regard to annual medical screening and surveillance.

Resumen

La capacidad de conducción puede verse disminuida entre las personas con VIH con deterioro neurocognitivo asociado (neurocognitive impairment, NCI). Exploramos la relación entre la situación frente al VIH, el NCI y la capacidad de conducción en conductores profesionales de camiones. Cuarenta conductores profesionales masculinos (20 seropositivos, edad media = 39.20 ± 7.05) completaron una batería de pruebas neuropsicológicas, dos tareas de simulador de conducción que evaluaron la capacidad de conducción y un cuestionario de hábitos y antecedentes de conducción. Una mayor proporción de conductores VIH positivos exhibió un desempeño cognitivo general deficiente (p ≤ 0.001). En general, los conductores con NCI (definido como z ≤ 1.00) tenían más probabilidades de chocar que aquellos sin NCI (p = 0.002). No hubo diferencias significativas entre los grupos (VIH positivo frente a VIH negativo) con respecto a los eventos autoinformados de conducción en carretera. Los conductores profesionales con NCI, según lo medido en un simulador de conducción, tienen un mayor riesgo de cometer errores de conducción en condiciones de alto riesgo en comparación con sus homólogos neurocognitivamente normales. Estos datos deberían informar a la gestión de la salud del conductor en lo que respecta a la vigilancia y los exámenes médicos anuales.

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Acknowledgements

We would like acknowledge and thank everyone who generously provided support, time and resources to recruit drivers for this project; and all the drivers who participated. And the HIV Neurobheavioral Research Center’s (HNRC) Developmental Grants Program for supporting this project. National Institute of Mental Health: P30 MH062512. Fogarty International Center: 1K43TW010361-01.

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Authors and Affiliations

  1. HIV Mental Health Research Unit and Neurosciences Institute, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa

    H. Gouse, C. J. Masson & J. A. Joska

  2. Centre for Higher Education Development, University of Cape Town, Cape Town, South Africa

    M. Henry

  3. ACSENT Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa

    K. G. F. Thomas

  4. HIV Center for Clinical and Behavioral Science, New York State Psychiatric Institute and Columbia University, New York, NY, USA

    R. N. Robbins

  5. School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa

    G. Kew & L. London

  6. HIV Neurovehavioral Research Program, Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA

    T. D. Marcotte

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  1. H. Gouse
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Gouse, H., Masson, C.J., Henry, M. et al. The Impact of HIV-Associated Neurocognitive Impairment on Driving Performance in Commercial Truck Drivers. AIDS Behav 25, 689–698 (2021). https://doi.org/10.1007/s10461-020-03033-7

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