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This study's objective was determining whether gap detection deficits are present in a longstanding cohort of people living with HIV (PLWH) compared to those living without HIV (PLWOH) using a new gap detection modelling technique (i.e. fitting gap responses using the Hill equation and analysing the individual gap detection resulting curves with non-linear statistics). This approach provides a measure of both gap threshold and the steepness of the gap length/correct detection relationship.The relationship between the correct identification rate at each gap length was modelled using the Hill equation. Results were analysed using a nonlinear mixed-effect regression model.45 PLWH (age range 41-78) and 39 PLWOH (age range 38-79) were enrolled and completed gap detection testing.The likelihood ratio statistic comparing the full regression model with the HIV effects to the null model, assuming one population curve for both groups, was highly significant (PLWH showed degraded gap detection ability compared to PLWOH, likely due to central nervous system effects of HIV infection or treatment. The Hill equation provided a new approach for modelling gap detection ability.

Background: Personal listening device (PLD) use with headphones is increasing in young adults and in most listening environments occur in background noise. Headphone choice can be important because certain headphones are more effective in limiting background noise than stock earbuds. Binge drinking, marijuana, and hard drug use have also been associated with high-volume PLD use. The purpose of this study was to explore the relationship between preferred headphone type, listening level, and other health risk behaviors. Methods: Two-hundred and twenty undergraduates were recruited and completed a PLD use and risk behavior survey. Survey data included self-reported alcohol and marijuana use. Bilateral otoscopy, tympanometry, and pure-tone threshold testing (0.25–8 kHz) were completed. Participants listened to one hour of music using preferred headphone type with a probe microphone in the ear canal to measure equivalent continuous sound level (LAeq). Results: Mean LAeq was similar for the three types of headphones used. Participants who reported higher amounts of drinks per month and smoking marijuana within the last month had significantly higher LAeq levels than those who reported lower amounts of drinks per month and not smoking marijuana in the last month. There was no significant interaction between headphone type and reported drinks per month or marijuana use. Conclusion: Young adults with normal hearing who have higher preferred listening levels also reported more alcohol and marijuana use, although headphone type was not associated with any of these variables.

Purpose The purpose of this study was to examine marijuana or other substance use on pure-tone thresholds and distortion product otoacoustic emissions (DPOAEs) in young adults. Method Young adults ( n = 243; 182 women, 61 men; M age = 20.9 years, SD = 2.7 years) participated in this study. Survey data included personal music system use, marijuana use, and misuse of prescription medications. Otoscopy, tympanometry, pure-tone audiometry, and DPOAEs were obtained. Pure tones from octave frequencies of 0.25 through 8 kHz were obtained, and DPOAEs were recorded between f 2 frequencies of 1 and 6 kHz using two continuously presented stimulus tones swept in frequency. Results Those who reported marijuana or stimulant use had similar pure-tone averages (0.5, 1, 2, and 4 kHz) compared to those who reported never using marijuana or stimulants. Women who reported marijuana use in the past 30 days > two times had statistically significant higher mean DPOAEs compared to women who reported ≤ two times or no marijuana use in the past 30 days. Men, however, who reported marijuana use in the past 30 days > two times had lower, but not statistically significant, mean DPOAEs compared to men who reported ≤ two times or no marijuana use in the past 30 days. Women who reported ever using stimulants had statistically significant higher mean DPOAEs compared to women who reported never using stimulants; for men, mean DPOAEs were similar between those who reported ever using stimulants and those who never used stimulants. Conclusions The results of this study demonstrate different and contradictory associations between marijuana use, stimulant use, and hearing outcomes as a function of sex. Future research is needed to explore these associations utilizing larger sample sizes while accounting for additional harmful exposures to other noise exposures.

PurposeThe purpose of this study was to compare Words-in-Noise (WIN) data between young adults with perinatal HIV (PHIV) infection and those with PHIV exposure but uninfected (PHEU) and to evaluate associations between antiretroviral therapy (ART) exposures and WIN data.MethodThe WIN test and cognitive function were assessed in participants of the Pediatric HIV/AIDS Cohort Study Adolescent Master Protocol Up. Impaired WIN (IWIN) performance was defined as a signal-to-babble ratio of > +10 dB. Cognitive function was determined based on fluid cognition composite scores (FCCSs) and crystallized cognition composite scores, and < 70 was considered a fluid or crystallized cognitive impairment. Log binomial models were used to calculate the relative risks of IWIN between PHIV and PHEU.ResultsPHIV (n= 334) and PHEU (n= 52) participants had similar WIN thresholds and IWIN percentages. For young adults with FCCS ≥ 70, participants with PHIV were less likely to have IWIN for the better ear and worse ear as compared to participants with PHEU. For young adults with FCCS < 70, there was no association between HIV status and risk of IWIN for the better ear or worse ear. For those adults with crystallized cognition composite score of ≥ 70, young adults with PHIV were less likely to have IWIN for the better ear than young adults with PHEU; there was no association between HIV status and IWIN for the worse ear. For young adults with PHIV without a Centers for Disease Control and Prevention Class C diagnosis, a longer combination ART duration was associated with a higher risk of IWIN for the better ear.ConclusionsFor those without cognitive impairment, young adults with PHEU had poorer WIN thresholds than those young adults with PHIV. In young adults with PHIV who had no prior Centers for Disease Control and Prevention Class C diagnosis, a longer combination ART duration was associated with IWIN only in the better ear.

Objectives To estimate birth prevalence of congenital cytomegalovirus (cCMV) in HIV-exposed uninfected children born in the current era of combination antiretroviral therapy and describe cCMV-related neurodevelopmental and hearing outcomes. Study design The Surveillance Monitoring for ART Toxicities cohort study follows HIV-exposed uninfected children at 22 sites in the US and Puerto Rico. Birth cCMV prevalence was estimated in a subset of participants who had blood pellets collected within three weeks of birth and underwent ≥1 of 6 assessments evaluating cognitive and language development including an audiologic examination between 1 and 5 years of age. Detection of CMV DNA by polymerase chain reaction testing of peripheral blood mononuclear cells was used to diagnose cCMV. Proportions of suboptimal assessment scores were compared by cCMV status using Fisher exact test. Results Mothers of 895 eligible HIV-exposed uninfected children delivered between 2007 and 2015. Most (90%) were on combination antiretroviral therapy, 88% had an HIV viral load of ≤400 copies/mL, and 93% had CD4 cell counts of ≥200 cells/μL. Eight infants were diagnosed with cCMV, yielding an estimated prevalence of 0.89% (95% CI, 0.39%-1.75%). After adjusting for a sensitivity of 70%-75% for the testing method, projected prevalence was 1.2%-1.3%. No differences were observed in cognitive, language and hearing assessments by cCMV status. Conclusions Although birth cCMV prevalence in HIV-exposed uninfected children born to women with well-controlled HIV is trending down compared with earlier combination antiretroviral therapy-era estimates, it is above the 0.4% reported for the general US population. HIV-exposed uninfected children remain at increased risk for cCMV.

Most young adults report using personal audio systems (PAS) with earphones as part of their daily activities. PAS exposure is intermittent and research examining the levels these young adults are listening to is increasing. On average, preferred listening levels are below what would be considered at risk in an occupational setting.The purpose of this study was to evaluate how two questions predicted preferred listening level in young adults with normal hearing; specifically, whether these young adults could identify if they listen at a high level or not.One hundred and sixty young adults (111 women, 49 men) with normal hearing completed a questionnaire that had questions about PAS listening habits and then had preferred listening level assessed using a probe microphone system while listening to 1 hour of music through earphones.Otoscopy, tympanometry, and pure-tone thresholds were completed in a randomly determined test ear. As part of the Risk Factors Survey, two closed-set questions were completed. First, “For a typical day, what is the most common volume used during this day?” with the following response options “Low,” “Medium/Comfortable,” “Loud,” or “Very Loud.” And second, “Do you listen to your personal music system at a volume where you…” with the following response options “Easily hear people,” “Have a little trouble hearing people,” “Have a lot of trouble hearing people,” or “Cannot hear people.” Using a probe microphone, chosen listening level (A-weighted, diffuse-field correction and a conversion to free-field equivalent [L DFeq]) was calculated over 1 hour while the participant listened to music with earphones. Sensitivity and specificity were determined to see how well young adults could identify themselves as listening at a high level (>85 dBA) or not. Linear regression analyses were performed to determine the amount of variance explained by the two survey questions as predictors of measured L DFeq.Almost half of the participants reported a longest single use of a PAS as About 11% of young adults in the present study listen to a PAS with earphones at a high level (>85 dBA) while in a quiet background. The participants who do report listening at a high level, however, do well at self-reporting this risk behavior in survey questions.

Objectives: The recent integration of portable music players into cell phones has further increased the use of personal listening devices (PLD) among young adults, raising concerns about potentially hazardous effects on hearing. Methods: Assessment of young adults’ hearing ability and listening preferences by subjective and objective measurement. Young adult users of PLDs (n = 50; 30 females, 20 males; mean age = 24.1 ± 4.2 years; average PLD use = 6.1 ± 2.1 years) were included. Subjective assessment of listening preferences was performed via a questionnaire as well as objective assessment of preferred volume levels in different background noise environments and hearing tests. Results: Preferred volume levels were significantly correlated with hearing thresholds. Most participants exhibited safe listening behavior according to National Institute for Occupational Safety and Health criteria. We identified a substantial high-risk subgroup of PLD users (22% of participants, daily use ⩾2 h at ⩾91 dB) in which pure tone audiometry showed increased hearing thresholds at 4000 and 6000 Hz, potentially indicating an early manifestation of noise-induced hearing loss (NIHL). Conclusions: These findings suggest that preventive measures may be warranted to prevent a future increase of clinically relevant NIHL among heavy users of PLDs.

Background: Young adults experience some type of recreational noise exposure on a daily basis; this includes using personal music (PM) systems with earphones. In most cases, this exposure is intermittent and the short-term effects of this exposure on the auditory system are becoming better understood. Purpose: The purpose of this study was to examine the effects of one hour of music exposure using a PM system on distortion product otoacoustic emission (DPOAE) absolute levels and generator and characteristic frequency (CF) component levels. Study Samples: Young adults (n = 101) between 18–30 years with normal hearing participated listened to one hour of music through earphones. A second group of young adults (n = 21) served as controls and did not listen to music, but sat in the sound-treated room for one hour. Data Collection and Analysis: Otoscopy, tympanometry, and a hearing screening (≤20 dB HL at 0.5, 1, 2, and 4 kHz) were completed in a randomly determined test ear. Preferred listening level, in dBA, was obtained and DPOAEs (2f 1 -f 2 ) were measured between 1 and 6 kHz with stimulus levels fixed at L1,L2 = 55,40 dB SPL. Absolute DPOAE levels, along with generator and CF components levels were measured before and after each participant listened to one hour of music at their preferred level in a quiet setting. For data analyses, absolute DPOAE and generator and CF component levels were collapsed into 1/3rd octave bands centered around 1, 1.5, 2, 3, 4, and 6 kHz. Results: Mean preferred listening level was 57.8 dBA, with males having a higher mean level of 61.1 dBA compared with females who had a mean level of 55.7 dBA. Females and males had negligible mean changes in absolute DPOAE levels at 1, 1.5, and 2 kHz, but males had 0.4–1 dB mean decreases after music at 3, 4, and 6 kHz compared to females, although not statistically significant. For DPOAE generator component data, females had small mean decreases for the two lower frequencies whereas males had mean decreases of 0.4–0.8 dB at 3, 4, and 6 kHz. Because of missing data, analyses of the CF component were limited, although females had small mean decreases at four frequencies while males had small mean decreases at two frequencies. There was no effect of listening to music on changes in DPOAEs but control participants had strong reliability (i.e., little or no change) after sitting in quiet for one hour. Conclusions: Young adults listened to music well below what would be considered hazardous. Because of the lower listening levels, DPOAEs showed very little change after music. Although there were no significant short-term changes in DPOAEs after music, the cumulative effect of this noise exposure is still unknown.

OBJECTIVES There is limited research about cochlear function in adults who are human immunodeficiency virus (HIV) positive (+). The aim of the present study was to collect measures of cochlear function in a large sample of adults with, or at risk for, HIV infection, to evaluate associations between HIV status, HIV treatment, and cochlear function. DESIGN Distortion product otoacoustic emissions (DPOAEs) were used to evaluate cochlear function in 506 participants; 329 men, 150 of whom were HIV+, and 177 women, 136 of whom were HIV+. DPOAEs were measured at frequencies 1000, 2000, 3000, 4000, and 6000 Hz. A DPOAE nonresponse (NR) was defined as an absolute DPOAE level less than -15 dB SPL or a difference between the absolute DPOAE level and the background noise level less than 6 dB. The total number of NRs was calculated for each ear. The associations of demographic variables, HIV status, and HIV treatment with number of NRs were evaluated with univariate and multivariate ordinal regression models. RESULTS There was a statistically significant increase in the odds of higher numbers of NRs with age, being male, and being non-Black, but not with HIV status. Among HIV+ participants, there were no statistically significant associations of the HIV disease status or treatment variables with higher number of NRs. CONCLUSION The authors found no evidence of impaired cochlear function by HIV disease status or highly active antiretroviral therapy-treated HIV infection in this cross-sectional study.

OBJECTIVES The prevalence of personal music (PM) system use with earphones is high among young adults. Although previous research has demonstrated that the majority of these adults may not be listening at levels or for durations considered dangerous, the long-term consequences of PM system use are not fully understood. In this report the relationship between self-reported PM use (i.e., non, light, moderate, or heavy) and peripheral auditory function as assayed through distortion product otoacoustic emission (DPOAE) components and fine structure was explored. The purpose was to evaluate the relationship between PM system use and peripheral auditory function. DESIGN One hundred and one (N = 101) young adults, 18 to 30 years of age, with normal hearing. Survey data were first obtained to determine PM system user status along with type of earphones used, most common listening volume, and most common listening duration. Once normal-hearing sensitivity was confirmed with a hearing screening, the DPOAE research protocol was administered. DPOAEs (2f1 to f2) were measured between 1 and 6 kHz with stimulus levels fixed at L1, L2 = 55,40 dB SPL and f2/f1 = 1.22. DPOAE level as well as fine-structure depth and spacing in 1/3rd octave (oct) bands around 1, 1.5, 2, 3, 4, and 6 kHz were compared across various PM system user groups. The ear-canal DPOAE was separated into the so-called generator and characteristic frequency (CF) components. The characteristics of the components were also compared across user groups. RESULTS Almost all participants reported listening to a PM system between < 1 hr/d to 3 hr/d, and 67% of the participants reported medium/comfortable as the most common volume used during a typical day. There was no significant effect of user status on 3rd oct DPOAE data, 1/3rd oct band component data, or fine-structure spacing data. Women exhibited significantly higher DPOAE as well as generator and CF component levels in the lower half of the frequency range evaluated. There were no significant gender differences for fine-structure spacing or depth. The slope of the CF component was significantly steeper in women. CONCLUSIONS In this cross-sectional study, there were no significant effects of self-reported PM use on either the ear-canal DPOAE or its constituent parts. Fine-structure depth varied across user groups in a nonsystematic manner. Women exhibited higher DPOAE and component levels in the lower portion of the frequency range evaluated. It is interesting to note that a greater proportion of men reported listening to their PM system at loud or very loud levels. The size of the effect relative to the sample size of each user group may be masking the deleterious effects of PM system use on the peripheral auditory system.

Background The prevalence of congenital cytomegalovirus infection (cCMV) at birth is 0.5%–1% in the United States. Most cCMV newborns are asymptomatic at birth with 10%–15% subsequently developing sequelae, such as hearing loss. Higher cCMV prevalence (2.5%–11.4%) is reported in infants born to HIV-infected women, associated with maternal immune suppression and lack of antiretroviral therapy (ART), with few studies addressing neurodevelopmental (ND) outcomes in their offspring. We report birth prevalence of cCMV in a cohort of HIV-exposed, uninfected infants (HEU) born to women on combination ART with well-controlled HIV and describe ND outcomes through age 5 years. Methods The Surveillance Monitoring for ART Toxicities (SMARTT) study is an ongoing NICHD-funded observational multi-centered cohort study (United States and Puerto Rico) of growth and development of HEU children that commenced in 2007. As of August 1, 2017, participants with stored blood pellets collected ≤3 weeks after birth and at least 1 ND assessment ≥1 year of age had pellets tested by DNA PCR to establish cCMV. Comparisons of ND outcomes (defined in figure) at ages 1, 2, and 5 by cCMV status were made using Wilcoxon and Fisher’s Exact tests. Results Of 895 children meeting study criteria (55% black; 32% white; 40% Latino), 8 had cCMV, yielding a birth prevalence of 0.89% (95% CI 0.39–1.75%). All were asymptomatic and similar to CMV-uninfected infants in gestational age and anthropometric measurements at birth. The last HIV viral load prior to delivery was undetectable in 88% of women. The last available CD4% was Conclusion Birth prevalence of cCMV in HEU children born within the last decade approaches national US prevalence. Preschool HEU children with asymptomatic cCMV at birth did not show poorer language, hearing, and developmental outcomes compared with CMV-uninfected HEU children. Disclosures All authors: No reported disclosures.

The measurement of distortion product otoacoustic emissions (DPOAEs) allows for an evaluation of underlying outer hair cell (OHC) function as a possible indicator of decreases in pure-tone hearing sensitivity (hearing loss)1,2 because the OHCs are vulnerable to essentially all cochlear insults, including ototoxicity and noise exposure. However, little research has been conducted to address the relationship between HIV exposure and OAEs. To date, there are no OAE data from children or adolescents with HIV exposure, although OAEs have been measured as a screen for hearing loss in newborns born to HIV-infected mothers,3,4. Limited studies have been done in adults in which researchers specifically evaluated the effects of HIV infection on DPOAEs, but these studies reported no significant effect of HIV infection on DPOAEs.5,6 Recent data from the Adolescent Master Protocol (AMP) of the Pediatric HIV/AIDS Cohort Study (PHACS) suggested that children with perinatal HIV infection (PHIV) might have poorer hearing, as measured by pure-tone thresholds, than their perinatally HIV-exposed, but uninfected (PHEU) peers.7 Because hearing sensitivity is comprised of outer, middle, and inner ear function along with auditory neural function, the origin of such differences is unclear. More research is needed to determine the auditory mechanisms that lead to differences in hearing sensitivity. The purpose of this study was to evaluate OHC function specifically, as measured by DPOAEs, in PHIV and PHEU children.

The purpose of this study was to compare various speech audiometry measures between HIV+ and HIV- adults and to further evaluate the association between speech audiometry and HIV disease variables in HIV+ adults only. Three hundred ninety-six adults from the Multicenter AIDS Cohort Study (MACS) and Women's Interagency HIV Study (WIHS) completed speech audiometry testing. There were 262 men, of whom 117 (44.7%) were HIV+, and 134 women, of whom 105 (78.4%) were HIV+. Speech audiometry was conducted as part of the standard clinical audiological evaluation that included otoscopy, tympanometry, and pure-tone air- and bone-conduction thresholds. Specific speech audiometry measures included speech recognition thresholds (SRT) and word recognition scores in quiet presented at 40dB sensation level (SL) in reference to the SRT. SRT data were categorized in 5-dB steps from 0 to 25dB hearing level (HL) with one category as ≥30dB HL while word recognition scores were categorized as

Little is known about hearing loss in children with HIV infection (HIV+). We examined the prevalence of hearing loss in perinatally HIV+ and HIV-exposed but uninfected (HEU) children, compared these with the percentage with hearing loss in the general population and evaluated possible risk factors for hearing loss in HIV+ and HEU children.Audiometric examinations were completed in children who met any prespecified criteria for possible hearing loss. The hearing examination consisted of a tympanogram in each ear and pure-tone air-conduction threshold testing from 500 through 4000 Hz. Hearing loss was defined as the pure-tone average over these frequencies ≥ 20 dB hearing level. The associations of demographic variables, parent/caregiver, HIV disease and HIV treatment with hearing loss were evaluated with univariate and multivariable logistic regression models.Hearing testing was completed in 231 children (145 HIV+ and 86 HEU). Hearing loss occurred in 20.0% of HIV+ children and 10.5% of HEU children. After adjusting for caregiver education level, HIV infection was associated with increased odds of hearing loss (adjusted odds ratio = 2.13, 95% confidence interval: 0.95-4.76, P = 0.07). Among HIV+ children, those with a Centers for Disease Control and Prevention class C diagnosis had over twice the odds of hearing loss (adjusted odds ratio = 2.47, 95% confidence interval: 1.04-5.87, P = 0.04). The prevalence of hearing loss was higher in both HIV+ and HEU children compared with National Health and Nutrition Examination Survey III children.Hearing loss was more common in both HIV+ and HEU children than in children from a US population sample. More advanced HIV illness increased the risk of hearing loss in HIV+ children.

This paper addresses effects of age and sex on certain acoustic properties of speech, given conflicting findings on such effects reported in prior research. The speech of 27 younger adults (15 women, 12 men; mean age 25.5 years) and 59 older adults (32 women, 27 men; mean age 75.2 years) was evaluated for identification of differences for sex and age group across measures of fundamental and formant frequencies ( F 0, F 1, F 2 and F 3) and voice onset time (VOT). There were significant sex-by-age group interactions for F 0, F 1, and VOT, some of which were specific to individual speech sounds. The findings suggest that further research on aging speech should focus on sex differences and the potential influence such changes may have on communication abilities of older adults with hearing loss. Learning Outcomes : The reader will be able to understand and describe (1) possible changes in specific acoustic properties with age, (2) how these changes may differ for women and men, and (3) the potential impact these changes may have on the speech understanding of older individuals with hearing loss.

This study examined the association between ultrahigh-frequency (UHF) hearing sensitivity and distortion-product otoacoustic emission (DPOAE) levels at conventional frequencies. Behavioral thresholds were measured from 2 through 16 kHz, and DPOAE levels were measured at discrete f2 frequencies between 2 through 8 kHz in 553 young normal-hearing adult male participants. A DPOAE frequency sweep was measured with primary stimulus levels of L1/L2 = 65/55 dB SPL and an f2/f1 of 1.2. Significant negative correlations, although weak, were found between UHF behavioral thresholds and DPOAE levels. As UHF behavioral thresholds worsened, DPOAE levels decreased at all frequencies. When the data were categorized into two groups, “better” and “worse” UHF behavioral thresholds, significant differences were apparent between the two groups for DPOAEs. Additionally, those with better UHF thresholds had better conventional thresholds compared to those in the worse UHF threshold group. The results of this age-restricted, large-sample-size study confirm and augment findings from earlier studies demonstrating that UHF hearing sensitivity has some influence on DPOAE measures at frequencies from 2 through 8 kHz with moderate stimulus levels. However, because those with better UHF thresholds also had better conventional thresholds and the significant correlations found were weak, this work supports the importance of UHF hearing testing in conjunction with otoacoustic emission measures to identify basal cochlear insults not evident from behavioral testing at conventional frequencies. Este estudio examinó la asociación entre la sensibilidad auditiva a ultra-alta frecuencia (UHF) y los niveles de las emisiones otoacústicas por productos de distorsión (DPOAE) en las frecuencias convencionales. Se midieron los umbrales conductuales desde 2 y hasta 16 kHz, y los niveles de la DPOAE se midieron a frecuencias discretas f2 entre 2 y 8 kHz en 553 adultos jóvenes masculinos oyentes normales. Se registró un barrido frecuencial de DPOAE con niveles primarios de estímulo de L1/L2 = 65/55 dB SPL y un f1/f2 de 1.2. Se encontraron correlaciones negativas significativas, aunque débiles, entre los umbrales conductuales de UHF y los niveles de las DPOAE. Conforme los umbrales conductuales de UHF se deterioraron, los niveles de DPOAE disminuyeron en todas las frecuencias. Cuando los datos se categorizaron en dos grupos – umbrales conductuales de UHF “mejores” y “peores” – se hicieron aparentes diferencias significativas entre los dos grupos para las DPOAE. Adicionalmente, aquellos con los mejores umbrales UHF tuvieron mejores umbrales convencionales, comparados con aquellos en el grupo de los peores umbrales UHF. Los resultados de este estudio con restricción de edad y con una muestra de gran tamaño confirman y destacan los hallazgos de estudio anteriores que demostraban que la sensibilidad auditiva en UHF tiene alguna influencia sobre las mediciones de las DPOAE, en las frecuencias de 2 a 8 kHz, con niveles moderados de estímulo. Sin embargo, dado que aquellos con mejores umbrales UHF también tenían mejores umbrales convencionales y que la correlación significativa encontrada era débil, este trabajo apoya la importancia de la evaluación de la audición en UHF en conjunto con mediciones de emisiones otoacústicas para identificar insultos cocleares basales, no evidentes en la evaluación conductual en frecuencias convencionales.

The purpose of this study was to examine the accuracy of self-reported hearing loss in older Latino-American adults. Fifty-nine individuals, 32 women (mean age 62.2 years) and 27 men (mean age 62.4 years), participated. The questionnaire addressed hearing loss, hearing aid use, and other people's views of their hearing abilities. Based on the question, ‘Do you feel you have a hearing loss?’, the prevalence of self-reported hearing loss was 57.6%, with 56.3% of women and 59.3% of men reporting a hearing loss. Sensitivity, specificity, and accuracy were calculated using this question and compared to the pure-tone average (PTA) at 500, 1000, 2000, and 4000 Hz in the poorer ear. Overall, sensitivity was 75.7%, specificity was 72.7%, and accuracy was 74.6%. Results of this smaller scale study suggest that a single question, used as a screening measure, is both sensitive and specific for hearing loss in older Latino-American adults and may overcome language and cultural barriers. This question can be easily imp...

The purpose of this research was to evaluate the relation between self-reported cardiovascular disease (CVD) and cochlear function in older adults. The Epidemiology of Hearing Loss Study (EHLS) is an ongoing population-based study of hearing loss and its risk factors in Beaver Dam, Wisconsin. As part of the EHLS questionnaire, participants were asked about their cardiovascular medical history. CVD history was determined from questions regarding history of angina, myocardial infarction (MI), and stroke. Questions about the use of antihypertensive medication and blood pressure measurements determined the presence or absence of hypertension. Among the audiologic measures completed were distortion product otoacoustic emissions (DPOAEs). Cochlear function was measured using DPOAEs and participants were categorized as having (a) cochlear impairment, (b) possible cochlear impairment, or (c) no cochlear impairment. There were 1,501 participants with complete CVD and DPOAE data from the 1998–2000 examination phase. Women with a self-reported history of MI were twice as likely (age-adjusted odds ratio [OR]=2.00, 95% confidence interval [CI]=1.15–3.46) to have cochlear impairment than women without a history of MI. This association was not significant in men (age-adjusted OR=0.98, 95% CI=0.61–1.58). Additionally, no other CVD variables were associated with cochlear impairment. This study provides data on a possible sex-specific association between CVD and DPOAEs in older adults.

Age-related alterations in auditory function were evaluated in adult male rhesus monkeys (Macaca mulatta) involved in a long-term study evaluating the effects of caloric restriction (CR) on aging. We assessed 26 monkeys in a control group fed a low fat, high fiber diet at approximately ad libitum levels and 24 monkeys in a CR group that were fed the same diet reduced in amount by 30% compared to age- and weight-matched controls. The following measures of auditory function were obtained while monkeys were maintained under anesthesia: (1) distortion product otoacoustic emissions (DPOAEs); (2) auditory brainstem responses (ABRs); and (3) middle latency responses (MLRs). All DPOAE measures and peak II amplitude significantly decreased with age, while peak IV latency and ABR threshold significantly increased with age. We found no significant effects of CR on any auditory parameters examined.

Objective The primary purpose of this study was to determine the distortion product otoacoustic emission (DPOAE) and noise response characteristics in a large sample of older adults. Another purpose was to evaluate how specific absolute DPOAE levels or DPOAE/Noise ratios differentiated hearing status in these individuals. Design A cross-sectional design was utilized for this study. As a part of the Epidemiology of Hearing Loss Study (EHLS), DPOAEs were measured in 937 of the 3,429 participants aged 48 to 92 yr. The DPOAE and noise response characteristics were evaluated at 1,000, 2,000, 4,000, and 8,000 Hz. Absolute DPOAE level and DPOAE/Noise ratios were measured in the participants. The DPOAE data were compared with individual pure-tone frequencies (1,000, 2,000, 4,000, and 8,000 Hz) in the participants to investigate how DPOAE responses differentiated ears with normal hearing from impaired ears. Sensitivity, specificity, positive and negative predictive values, and accuracies were calculated for various absolute DPOAE levels and DPOAE/Noise ratios. Results Due to the considerable overlap between DPOAE responses and the noise levels at 1,000 Hz, this frequency was not used for any analyses. Sensitivity and specificity were calculated for various DPOAE responses. Sensitivity and specificity varied by frequency for absolute DPOAE levels and DPOAE/Noise ratios. Receiver operator characteristic (ROC) analyses were used to determine which DPOAE responses differentiated normal hearing from hearing loss. The ROC analyses demonstrated that -6 dB SPL at 2,000 Hz, -14 dB SPL at 4,000 Hz, and -22 dB SPL at 8,000 Hz and a +9 dB DPOAE/Noise ratio at each of these frequencies yielded the highest discrimination. Conclusions Sensitivity and specificity varied by DPOAE response characteristics and frequency. The decision as to which DPOAE response criterion used should be based on careful consideration of objectives and the possible consequences of misdiagnosis. The results of this study support the use of DPOAEs as a clinical measure for older adults.

As a means of partially distinguishing age effects and other risk factors in presbyacusis, hearing thresholds for 56– to 65–year-old participants screened for exclusion of selected risk factors were compared with thresholds for 48– to 55–year-old participants without the same risk factors. Hearing thresholds for both age groups were also compared with age-appropriate International Standards Organization (ISO) norms. Even after screening participants for exclusion of selected risk factors, differences in hearing sensitivity remained across age groups. Across the male and female groups, thresholds were generally better (lower) for 48 to 55 year olds than for 56 to 65 year olds. ISO norms generally underestimated the degree of hearing loss for participants of comparable age in the present study. The underestimation was small at lower test frequencies, was generally greater for men, and was largest at test frequencies above 2000 Hz. Abbreviations: ANSI = American National Standards Institute, EHLS = Epidemiology of Hearing Loss Study, ISO = International Standards Organization

The purpose of this study was to investigate the changes in auditory function associated with aging in rhesus monkeys ( Macaca mulatta ) as a model for age-related changes in humans. One advantage of using monkeys from the Wisconsin Regional Primate Research Center was that lifestyle factors such as diet and excessive noise exposure were controlled. Twenty younger (mean: 10 years, 9 months, S.D.=±6 months) and 20 older (mean: 25 years, 11 months, S.D.=±11 months) monkeys were used in this study. Cochlear function in these monkeys was measured with distortion product otoacoustic emissions (DPOAEs); neural function was measured with auditory brainstem responses (ABRs) and middle latency responses (MLRs). Older monkeys had (1) significantly smaller DPOAEs, (2) significantly smaller ABR peak amplitudes, and (3) significantly longer ABR peak latencies compared to younger monkeys. Overall, these results suggest that older monkeys have decreased cochlear and neural function to the level of the brainstem as compared to younger monkeys. The decrease in DPOAE level and the increase in age accounted for approximately 70% of the increase in peak IV latency.

This study provided tympanometric data on rhesus monkeys (Macaca mulatta) and more support for this monkey as a good model for human peripheral auditory function. There have been few published reports concerning middle ear function in rhesus monkeys, and these experiments addressed that need. In the first experiment, peak acoustic admittance (Ytm) and ear-canal volume (Vea) were measured in 17 older adult monkeys and 16 younger adult monkeys. In the second experiment, middle ear resonance frequency was measured in eight younger adult monkeys and four older adult monkeys. Overall, peak Ytm, Vea, and resonance frequency were similar for monkeys and humans. Specifically, peak mean Ytm and mean Vea in monkeys were comparable to those values in human children. There was a trend for older monkeys to have decreased peak Ytm and Vea, but these trends did not reach statistical significance. There was a significant sex effect similar to what has been reported in humans. Male monkeys had larger peak Ytm values and larger Vea values compared with female monkeys regardless of age. Finally, there were no significant age or sex effects on resonance frequency.

Objective: To investigate the risk for language impairment (LI) in children perinatally infected or exposed to HIV. Methods: We evaluated the prevalence of LI in 7- to 16-year-old children with perinatal HIV infection (HIV) compared with HIV-exposed and uninfected children, using a comprehensive standardized language test (Clinical Evaluation of Language Functioning-Fourth Edition (CELF-4)). LI was classified as primary LI (Pri-LI) (monolingual English exposure and no cognitive or hearing impairment), concurrent LI (Con-LI) (cognitive or hearing impairment), or no LI. Associations of demographic, caregiver, HIV disease, and antiretroviral treatment factors with LI category were evaluated using univariate and multivariable logistic regression models. Results: Of the 468 children with language assessments, 184 (39%) had LI. No difference was observed by HIV infection status for overall LI or for Pri-LI or Con-LI; mean (SD) CELF-4 scores were 88.5 (18.4) for HIV versus 87.5 (17.9) for HIV-exposed and uninfected children. After adjustment, black children had higher odds of Pri-LI versus no LI (adjusted odds ratio (aOR) 2.43, p .03). Children who were black, Hispanic, had a caregiver with low education or low intelligence quotient, or a nonbiological parent as caregiver had higher odds of Con-LI versus no LI. Among HIV children, viral load >400 copies/mL (aOR 3.04, p < .001), Centers for Disease Control and Prevention Class C (aOR 2.19, p .02), and antiretroviral treatment initiation

There are an increasing number of large-scale studies on the association between human immunodeficiency virus (HIV) and hearing loss; these studies include both HIV-infected adults from horizontal ...

1. To correlate exostosis severity with ear canal evaporative cooling. 2. To assess hearing and complications after canalplasty.Retrospective chart review.A retrospective chart review from 1990 to 2007 at a university tertiary referral center.Surfers from the west coast of the United States were twice as likely to have severe exostoses in the right ear compared with the left. Evaporative cooling from a predominant northerly wind direction during the coldest water temperature months in this region may contribute to this lateral bias because surfers on this coast spend most of their time facing west. Few postoperative complications were identified. No cases of facial nerve injury or entry into the temporomandibular joint occurred. Differences in preoperative versus postoperative pure-tone hearing thresholds were not significant.Exostosis severity seems to correspond to the ear that is more exposed to the predominant coastal wind. We propose that evaporative cooling in a cold water environment contributes to greater progression of exostoses in the ear with more exposure to the predominant wind. Exostosis removal using the postauricular approach carries a low complication rate.

Objectives There are growing concerns over noise exposure via personal music system use by young adults. One purpose of this study was to evaluate the prevalence of personal music system use and the listening patterns associated with these systems in a large sample of young adults. A second purpose of this study was to measure the dB SPL in the ear canal of young adults while they blindly set the volume of a personal music system to four settings. Design In the first study, the personal music system use survey was completed by 1016 students at various locations on the San Diego State University campus. Questions included sex, age, ethnicity, race, and whether or not they used a personal music system. Students who answered Yes to using a personal music system were instructed to complete the remaining 11 closed-set questions. These questions dealt with type of earphones used with the system, most common listening environment, length of time per day the system was used, and the volume setting. The differences between women and men and across ethnicity and race were evaluated for the questions. In the second study, a probe microphone placed in the ear canal of 32 participants was used to determine the dB SPL of four loudness categories at which the participants blindly set the level of a personal music system: low, medium or comfortable, loud, and very loud. Results In study 1, over 90% of the participants who completed the survey reported using a personal music system. Over 50% of those who use a personal music system reported listening between 1 and 3 hrs and almost 90% reported listening at either a medium or loud volume. Men were significantly more likely to report listening to their system for a longer duration compared with women and more likely to report listening at a very loud volume. There was a trend for Hispanic or Latino students to report listening for longer durations compared with Not Hispanic or Latino students, but this difference was not statistically significant. Black or African American students were significantly more likely to report listening to their personal music system between 3 and 5 hrs and more than 5 hrs and to report listening at a very loud volume compared with other racial groups. In study 2, the mean dB SPL values for low, medium or comfortable, loud, and very loud were 62.0, 71.6, 87.7, and 97.8 dB SPL, respectively. Men set the level of very loud significantly higher than women. Conclusions It is clear that a vast majority of young adults who completed the personal music system use survey listen to a system using earphones. Most of the respondents listen between 1 and 3 hrs a day at a medium or loud volume. Based on the probe microphone measurement results, the volume settings for reported durations may not be hazardous for hearing. Long-term use of personal music systems, however, in combination with other noise exposures (i.e., recreational, occupational), and their effect on hearing remains a question for additional research.

The purpose of this study was to evaluate the possible effects of risk factors on distortion product otoacoustic emissions (DPOAEs) in young adult men with normal hearing. Four hundred thirty-six United States Marine recruit men (mean age = 19.2 years ± 1.8 years; age range = 17 - 29 years) participated in this study. Questionnaires were given to each recruit to obtain demographic data and history of noise exposure, solvent exposure, smoking history, and hearing-related histories. Otoscopy, tympanometry, pure-tone air-conduction audiometry (2.0 – 8.0 kHz) and DPOAEs (2.3 - 8.0 kHz) were measured. DPOAE levels were lower in Not Hispanic or Latino recruits, in heavy smokers, in recruits who reported loud live music exposure and ringing in their ears after noise exposure. These differences were not statistically significant at all frequencies. Recruits with multiple risk factors had the lowest DPOAEs as compared to recruits with fewer, or no, risk factors; these differences were not statistically significant. Obtaining risk factor data as part of an audiometric evaluation is important even though the individual may have normal hearing. El propósito de este estudio fue evaluar los posibles efectos de los factores de riesgo sobre las emisiones otoacústicas por productos de distorsión (DPOAE) en hombres adultos jóvenes con audición normal. Cuatrocientos cuarenta y seis reclutas masculinos de la Marina de los Estados Unidos (edad media de 19.2 años ± 1.8; rango de edad = 17 - 29 años) participaron del estudio. Los cuestionarios se entregaron a cada recluta para obtener datos demográficos e historias de exposición a ruido, exposición a solventes, historia de fumado, e historias relacionadas con la audición. Se realizaron otoscopias, timpanometrías, audiometrías de tonos puros por vía aérea (2.0 – 8.0 kHz) y DPOAE (2.3 – 8.0 kHz). Los niveles de las DPOAE fueron más bajos en reclutas no hispánicos o no latinos, en fumadores fuertes, en reclutas que reportaron exposición a música fuerte en vivo, y ruidos en los oídos después de exposición a ruido. Estas diferencias no fueron estadísticamente significativas en todas las frecuencias. Los reclutas con múltiples factores de riesgo tuvieron las DPOAEs más bajas, comparados con los reclutas con menos o ningún dato de factores de riesgo; estas diferencias no fueron estadísticamente significativas. Obtener datos de factores de riesgo como parte de una evaluación audiométrica es importante aunque los individuos tengan audición normal.

The purpose of this study was to measure noise levels during aerobics classes and to examine how outer hair cell (OHC) function, using distortion product otoacoustic emissions (DPOAEs), may be affected by this exposure. Fifty individuals (48 women and 2 men, ages 19–41 years) participated in 50-min aerobics classes. Noise levels were measured using noise dosimeters placed on the collar near the test ear. The audiometric protocol consisted of a questionnaire, otoscopy, screening tympanometry, and pre- and post-aerobics DPOAEs. The minute-by-minute peak noise levels varied between 90.5 and 99.7 dBA. The overall mean noise level for the aerobics classes was 87.1 dBA (range = 83.4–90.7 dBA). Mean post-aerobic DPOAE levels were lower at most frequencies with a statistically significant 1.4 dB decrease at 6000 Hz. Results of this project, even with limited statistical significance, should be viewed cautiously. Learning outcomes: The reader will be able to (1) identify the approximate dB SPL measured during aerobics classes, (2) describe what effects, if any, these levels had on DPOAEs, and (3) discuss what specific frequency had a significant decrease in DPOAE level after an aerobics class.

Importance Hearing impairment is common in adults, but few studies have addressed it in the US Hispanic/Latino population. Objective To determine the prevalence of hearing impairment among US Hispanic/Latino adults of diverse backgrounds and determine associations with potential risk factors. Design, Setting, and Participants The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a population-based sample of Hispanics/Latinos in four US communities (Bronx, New York; Chicago, Illinois; Miami, Florida; and San Diego, California). Examinations were conducted from 2008 through 2011. The HCHS/SOL examined 16 415 self-identified Hispanic/Latino persons aged 18 to 74 years recruited from randomly selected households using a stratified 2-stage area probability sample design based on census block groups and households within block groups. Main Outcomes and Measures Hearing thresholds were measured by pure-tone audiometry. Hearing impairment was defined as a pure-tone average (PTA) of thresholds at 0.5, 1, 2, and 4 kHz greater than 25 dB hearing level. Bilateral hearing impairment required a PTA greater than 25 dB hearing level in both ears. Multivariable analyses included adjustments for sociodemographic and lifestyle variables, body mass index, and medical conditions. Results The prevalence of hearing impairment was 15.06% (SE, 0.44%) overall, and 8.24% (SE, 0.33%) had bilateral hearing impairment. The prevalence of hearing impairment was higher among people 45 years and older, ranging by Hispanic/Latino background from 29.35% to 41.20% among men and 17.89% to 32.11% among women. The multivariable-adjusted odds of hearing impairment was greater for participants of Puerto Rican background compared with Mexican background (odds ratio [OR], 1.57 [95% CI, 1.10-2.25]). The odds of hearing impairment were lower with more education (OR, 0.71 [95% CI, 0.59-0.86] for at least high school) and higher income (OR, 0.58 [95% CI, 0.36-0.92] for >$75 000 vs ≤$10 000). Noise exposure (OR, 1.35 [95% CI, 1.07-1.70]), diabetes (OR, 1.57 [95% CI, 1.27-1.94]), and prediabetes (OR, 1.37 [95% CI, 1.12-1.67]) were associated with hearing impairment. Conclusions and Relevance Hearing impairment is a common problem for older Hispanics/Latinos in these communities and is associated with socioeconomic factors, noise exposure, and abnormal glucose metabolism. Longitudinal studies are needed to determine whether these factors are involved in the etiology of hearing impairment and to identify ways to prevent or delay age-related changes in hearing.

Importance Age-related hearing loss affects quality of life. Data on hearing loss among aging human immunodeficiency virus–seropositive (HIV+) adults are limited. Objective To evaluate pure-tone hearing thresholds among HIV+ and HIV-seronegative (HIV−) adults and to determine whether HIV disease variables and antiretroviral therapy are associated with pure-tone threshold levels. Design, Setting, and Participants A total of 262 men (117 HIV+) from the Baltimore, Maryland/Washington, DC, site of the Multicenter AIDS Cohort Study and 134 women (105 HIV+) from the Washington, DC, site of the Women’s Interagency HIV Study participated. Pure-tone air conduction thresholds were collected in a sound-treated room for each ear at frequencies from 250 through 8000 Hz. Linear mixed regression models tested the effect of HIV on hearing after adjustment for age, sex, race, and noise exposure history. Main Outcomes and Measures Low-frequency pure-tone average (LPTA) at 250, 500, 1000, and 2000 Hz and high-frequency PTA (HPTA) at 3000, 4000, 6000, and 8000 Hz. Differential HIV effects for LPTA and HPTA and better/worse ear were also examined. CD4 + and CD8 + T-cell counts, log 10 plasma HIV RNA concentrations, receipt of AIDS diagnosis, and cumulative duration of antiretroviral therapy were included in the models for HIV+ participants only. Results HPTA and LPTA were significantly higher (18%: estimated ratio, 1.18 [95% CI, 1.02-1.36]; P = .02; and 12%: estimated ratio, 1.12 [95% CI, 1.00-1.26]; P = .05, respectively) for HIV+ participants compared with HIV− participants for the better ear. The direction of the effect was consistent across both the better and worse ears. There were no significant associations between HIV disease variables or treatment variables and LPTA or HPTA. Conclusions and Relevance The HIV+ adults had significantly poorer lower-frequency and higher-frequency hearing than HIV− adults. High-frequency hearing loss is consistent with an accelerated aging (presbycusis); low-frequency hearing loss in middle age is unexpected. Because some vowels and consonants have predominantly low-frequency acoustic energy, poor low-frequency hearing may impair communication in HIV+ individuals.

The present study is part of a larger project that investigates the effect of caloric restriction on longevity in the rhesus monkey. The purpose of the present study was to document presbycusis and the effect of caloric restriction on presbycusis in monkeys. The control group had 35 monkeys allowed to eat freely and the caloric-restricted group (CR) had 33 monkeys with a 30% reduction in caloric intake. Monaural and binaural auditory brainstem response (ABR) and middle latency response (MLR) were obtained from 27 female and 41 male monkeys that were 11-23 years of age and had been in the study for 102, 42, or 36 months when tested. Significant findings were the following: (1) wave I amplitudes were larger for females and for younger monkeys, and amplitudes decreased in aging males but not in aging females; (2) wave IV amplitudes were larger for females than males, and amplitudes for CR females were larger than for female controls, whereas the amplitudes from control and CR males were not different; (3) wave Pa latencies were shorter for females, and shorter latencies were maintained for aging females but not for aging males; (4) interwave interval IV-Pa was shorter for females, and intervals lengthened for aging males but not aging females; (5) binaural wave IV amplitude decreased faster with age for control monkeys than for CR monkeys, and the L+R Pa amplitude decreased with age. Additional trends were identified for longitudinal monitoring as monkeys enter old age.

Thirty-one female rhesus monkeys were randomly assigned to three lead exposure conditions (none, birth to 1 year, and birth to 2 years). Blood lead levels were maintained at 35–40 μg/dl beginning shortly after birth and continuing for 1 or 2 years postnatally. Auditory function was assessed in these monkeys at least 1 year after exposure to lead. The outcome measures included tympanometry to assess middle ear function, otoacoustic emissions (OAEs) to assess cochlear function, and auditory brainstem-evoked responses (ABRs) to assess the auditory nerve and brainstem pathways. There were no significant differences among the three experimental groups for any of the tympanometric variables measured suggesting no effect of lead exposure on middle ear function. Suprathreshold and threshold distortion product OAEs (DPOAEs) were comparable among the three groups. Finally, the auditory-evoked response at levels from the auditory nerve to the cerebral cortex did not significantly differ as a function of lead exposure. The lead exposure in this study had little effect on auditory function.

Research on the effects of perinatal human immunodeficiency virus (HIV) exposure on hearing sensitivity is increasing. This is important because hearing loss can delay language and communication development in young children. The purpose of this project was to evaluate hearing sensitivity characteristics in HIV+ and HIV- children.

This study was designed to compare normal-hearing and hearing-impaired auditory brainstem response (ABR) thresholds using 1 msec rise-plateau-fall times with ABR thresholds using two-cycle rise-fall times and a one-cycle plateau. Because tone bursts of 500 Hz and 1000 Hz were selected for study, the respective two-cycle rise-fall times were 4 msec and 2 msec. This study also compared ABRs using repetition rates of 25.6/sec and 40/sec to determine if these two rates yield different ABR thresholds. Sixteen normal-hearing subjects and 13 subjects with mild-to-moderate sensorineural hearing loss participated in this study. The results revealed that increasing rise-fall time from 1 msec to 4 msec at 500 Hz, and from 1 msec to 2 msec at 1000 Hz, had little or no effect on the ABR threshold. Moreover, no differences in ABR thresholds were observed for the two repetition rates. Thus, these data suggest that differences in repetition rate do not account for the discrepancies in thresholds among studies. The predication of pure-tone thresholds in dB HL from ABR thresholds in dB nHL was assessed using correction factor and regression procedures. Both methods yielded a reasonable approximation of the degree and configuration of hearing loss. Approximately 85% of pure-tone thresholds were predicted within +/- 10 dB at 500 Hz and 1000 Hz. The present investigation suggests that either the 1 msec or 2-cycle-rise-fall times may be used for clinical purposes.

Background We measured the prevalence of hearing sensitivity among HIV+ and HIV- men and women and identified associated risks co-factors. Methods Audiometric testing was conducted among 262 men [median age 54.7 years; 117 (44.7% HIV+; median (25th, 75th): nadir CD4+: 296 (191, 400); viral load (VL): 40 (40.40))] from the Baltimore-DC site of the Multicenter AIDS Cohort Study and 134 women [median age 45.2 years; 105 (78.4% HIV+; median (25th, 75th): nadir CD4+: 249 (92, 367); VL: 80 (48,1270))] from the DC site of the Women’s Interagency HIV Study. Pure-tone hearing thresholds were obtained at 500, 1000, 2000, and 4000 Hz and HL was defined as a pure tone average (PTA) ≥ 20 dB hearing level in either ear. A linear mixed model with a random-subjects effect was used to account for two repeated measurements (one per ear) adjusted for age, gender, race, HIV status, and noise exposure. The HIV+ model included nadir CD4+, peak CD8+, VL, ever having AIDS, ever monotherapy (MT), ever combination therapy (CT) and ever HAART use. Results 84 (95.2% men, 4.8% women) HIV- and 90 (65.6% men, 34.4% women) HIV+ participants had HL in the poorer ear. Age was a statistically significant risk factor of HL, however HIV status and noise exposure were not. In the HIV+ model, nadir CD4+, peak CD8+, VL, ever having AIDS, and MT were not statistically significantly associated with HL. Although there was a higher PTA and a lower PTA with ever CT and HAART use neither was significantly associated with HL. Conclusions We found no impact of HIV status or treatment variables on HL. HIV-infected individuals who used HAART had a lower PTA, an indicator of better hearing sensitivity. However, due to cross-sectional design of this study, it is not known whether HAART use protects hearing sensitivity.