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

项目摘要 赞比亚卫生科学培训实施教育网络（ZENITH） D43（NIH/FIC D43TWO12492）补充将建立赞比亚当地在艾滋病毒和老龄化方面的研究能力 以及产生有关污名对生活质量（QOL）和衰老相关影响的新数据。 条件补充补充的ZENITH父母奖的目标是发展赞比亚短，中， 在UTH的长期实施科学能力，以解决关键和弱势群体的未满足的需求 实现可持续的流行病控制。 在抗逆转录病毒疗法（ART）沿着二十年的大规模推广以及成功的 维持和保留抗逆转录病毒疗法，中低等年龄段艾滋病毒感染者的预期寿命， 低收入国家（LMIC）的增长。老年人中存活率增加与新感染相结合 艾滋病总体发病率的下降，特别是在较年轻的年龄组中， 艾滋病毒感染率向老年人群体蔓延。赞比亚基于人口的艾滋病毒影响评估的结果 （ZAMPHIA）2021年调查，由马里兰州巴尔的摩大学（UMB）和赞比亚卫生部进行 显示，50 - 54岁成年人的艾滋病毒感染率（29%）几乎是普通成年人的三倍 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。了解与老龄化有关的疾病的负担 PLWH对于医疗资源分配和干预措施的设计至关重要， 在不断增加的老年人中缓解与老龄化有关的状况。 ZENITH培训生/研究PI在赞比亚大学教学医院（UTH）实施本研究 将由一个导师团队支持，以实现两个目标：1）表征身体功能，认知 与年龄和性别匹配的成年人相比， 艾滋病毒和2）估计艾滋病毒状况与老年人生活质量之间的关系，以及艾滋病毒- 赞比亚老年艾滋病毒感染者的相关污名和生活质量。拟定的ZENITH培训生/研究PI， 将在研究协调、实施和数据方面接受MPI的实地指导 管理/分析以及克里斯汀斯塔福德博士在艾滋病毒和老龄化方面的虚拟和亲自支持， 管理QOL和HIV相关污名评估。来自UMB部门的培训 流行病学和公共卫生和克劳德D。Pepper管理身体和认知功能中心 关于老龄问题的评估和课程/讲习班将对辅导提供补充。 研究数据将有助于了解赞比亚老年艾滋病毒携带者和艾滋病患者目前的疾病负担; 告知背景适当的干预措施的发展，以预防或减轻与衰老有关的发病率， 在赞比亚提高艾滋病毒携带者和一般人口的死亡率，并建立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.