Journal of AIDS & Clinical Research

Computer-Assisted Speech Perception Assessment (CASPA) Data in Adults with and without HIV

Abstract

Peter Torre III*, Gayle Springer, Christopher Cox, Howard J. Hoffman, Abigail Fellows, Jay Buckey Jr and Michael Plankey

Objective: There is increasing literature on the association of HIV disease with hearing loss in adults, although only very limited research regarding communication, specifically in a background noise condition. The purpose of this study was to first, evaluate computer-assisted speech perception assessment (CASPA) data among adults living with HIV (ALHIV) and adults living without HIV (ALwoHIV). And second, to examine the association of HIV disease variables and HIV treatment with CASPA measures among ALHIV.

Methods: A sample of 101 ALHIV (n=57) and ALwoHIV (n=44) participants from the Baltimore-Washington DC site of the Multicenter AIDS Cohort Study (MACS) and the Washington DC site of the Women’s Interagency HIV Study (WIHS) completed CASPA testing. Testing was performed in sound treated rooms using a speaker placed 3 ft away from the listener.

Results: ALHIV and ALwoHIV had similar mean thresholds for phoneme and consonant scoring. ALHIV had poorer phoneme and consonant thresholds despite better ear 4 kHz thresholds compared to the ALwoHIV, suggesting difficulty with detecting speech-in-noise not related to diminished pure-tone thresholds. In ALHIV only, after adjusting for age, sex, nadir CD4+ T-cell count, and better ear 4 kHz threshold, total time on protease inhibitors (PIs) was significantly negatively associated with both phoneme threshold and consonant threshold, while total time on nonnucleoside reverse transcriptase inhibitors (NNRTIs) was marginally associated with both threshold measures.

Conclusion: CASPA performance appeared to be poorer in ALHIV and these results suggest that HIV treatment (i.e., cumulative PI or NNRTI use) may preserve speech communication abilities in noise.