ZENITH D43 HIV & Aging Supplement - Prevalence of aging related conditions, stigma, and quality of life among older adults with and without HIV infection in Zambia

University Of Maryland Baltimore, Baltimore MD

Investigators

Abstract

PROJECT SUMMARY The goal of this Zambia Education Network for Implementation Science Training in Health (ZENITH) D43 (NIH/FIC D43TWO12492) supplement will be to build local Zambian research capacity in HIV and aging as well as generate new data related to the impact of stigma on both quality of life (QOL) and aging related conditions. The supplement complement's the ZENITH parent award goal to develop Zambian short, medium, and long-term implementation science capacity at UTH to address the unmet need of key and vulnerable populations towards attaining sustainable epidemic control. Following two decades of large-scale expansion of antiretroviral therapy (ART) along with successful maintenance and retention on ART, life expectancy among people living with HIV (PLWH) in low- and middle- income countries (LMIC) is increasing. Increased survival combined with new infections among older adults and declining overall HIV incidence particularly in younger age groups has resulted in a shift in the distribution of HIV prevalence to older age groups. The results of Zambia's Population-based HIV Impact Assessment (ZAMPHIA) 2021 survey, conducted by University of Maryland Baltimore (UMB) and Zambia Ministry of Health revealed that the prevalence of HIV among adults ages 50-54 (29%) is nearly three times the general adult population 15 and older (11%). Aging is associated with increased risk of noncommunicable diseases (NCD) and decline in physical and cognitive function. Understanding the burden of aging-related conditions among PLWH will be critical for both healthcare resource allocation and the design of interventions to prevent or mitigate aging-related conditions among the increasing population of older persons. The ZENITH trainee/study PI implementing this study at University Teaching Hospital (UTH) in Zambia will be supported by a team of mentors to carry out two aims: 1) Characterize physical function, cognitive function, and NCD prevalence, among PLWH in Zambia compared to age- and sex-matched adults without HIV and 2) To estimate the association between HIV status and quality of life among older adults, and HIV- related stigma and QOL among older adults living with HIV in Zambia. The proposed ZENITH trainee/study PI, will receive on-ground mentorship from MPIs in study coordination, implementation and data management/analysis and virtual and in-person support from Dr. Kristen Stafford on HIV and aging, administration of QOL and HIV-related stigma assessments. Training from the UMB Department of Epidemiology and Public Health and Claude D. Pepper Center on administering physical and cognitive function assessments and courses/workshops on aging will complement the mentorship. The study data will help understand the current burden of disease among older PLWH in Zambia; informing contextually appropriate intervention development to prevent or mitigate aging-related morbidity and mortality among both PLWH and general population and build aging related research capacity in Zambia.