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

项目总结 赞比亚实施卫生科学培训教育网络的目标(顶峰) D43(NIH/FIC D43TWO12492)补充部分将用于建设赞比亚当地在艾滋病毒和老龄化方面的研究能力 以及生成与污名对生活质量(QOL)和与衰老相关的影响相关的新数据 条件。补充补充的天顶家长奖目标是发展赞比亚的短、中、 UTH的长期实施科学能力，以满足关键和弱势群体未得到满足的需求 为实现可持续的疫情控制，联合国人口基金将继续努力。 经过20年的大规模扩大抗逆转录病毒治疗(ART)并取得成功 艾滋病病毒携带者(PLWH)对抗逆转录病毒治疗的维持和保留、预期寿命 收入国家(LMIC)正在增加。老年人存活率的增加和新的感染 而总体艾滋病毒发病率的下降，特别是在年轻群体中，导致了分布的转变 将艾滋病毒流行率的影响扩大到老年群体。赞比亚以人口为基础的艾滋病毒影响评估结果 (ZAMPHIA)2021年调查，由马里兰大学巴尔的摩分校(UMB)和赞比亚卫生部进行 调查显示，50-54岁成年人中艾滋病毒的流行率(29%)几乎是一般成年人的三倍 15岁及以上人口(11%)。老龄化与非传染性疾病(NCD)的风险增加有关 以及身体和认知功能的下降。了解老年人相关疾病的负担 公共卫生保健对于卫生保健资源的分配和干预措施的设计都至关重要 缓解日益增多的老年人中与老龄化有关的状况。 在赞比亚大学教学医院(UTH)实施这项研究的顶峰实习生/研究PI 将在导师团队的支持下实现两个目标：1)表征身体功能，认知 赞比亚PLWH与年龄和性别匹配的成年人之间的功能和非传染性疾病患病率比较 和2)评估老年人的艾滋病毒状况和生活质量之间的关系，以及艾滋病毒- 赞比亚艾滋病毒携带者中的相关耻辱和生活质量。建议的天顶实习生/研究PI， 将在研究协调、实施和数据方面接受MPI的现场指导 管理/分析以及克里斯汀·斯塔福德博士关于艾滋病毒和老龄化的虚拟和面对面支持， 生活质量和艾滋病毒相关污名评估的管理。来自UMB部门的培训 流行病学和公共卫生与克劳德·D·佩珀身体和认知功能管理中心 关于老龄化的评估和课程/讲习班将补充指导。 研究数据将有助于了解赞比亚老年PLWH目前的疾病负担； 告知与环境相适应的干预发展，以预防或减轻老龄化相关的发病率和 在赞比亚，公共卫生部门和普通人群的死亡率都很高，并建立了与老龄化有关的研究能力。

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.