Ukraine HIV Research Training Program/Aging Supplement

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PROJECT SUMMARY/ABSTRACT Limited knowledge exists about aging among people living with HIV (PLWH) in the Eastern European and Central Asia (EECA) region including Ukraine which is experiencing armed conflict. The intersection of HIV-aging with aging-related noncommunicable diseases (NCDs) and physical performance, function and activity has never been estimated in Ukraine and the EECA, and not evaluated among PLWH who are living to older ages. This must be characterized in PLWH and repeatedly assessed across the HIV care continuum to ensure quality of life among PLWH who are reaching ages older than ever observed. This application is a supplement to the ongoing Fogarty HIV Research Training Grant. We will train one Early Stage Investigator (ESI) by accomplishing two Aims. Aim 1 includes advanced didactic training in HIV-aging and Gerontology via two well- established (one NIH-funded) programs in the US plus additional activities. Aim 2 includes collecting pilot data on key aging metrics in addition to sociodemographic and HIV variables including HIV viral load and CD4+ count. The ESI will assess physical performance, function and activity using 1) the WHO International Classification of Functioning, Disability and Health; 2) components of the Short Physical Performance Battery, including hand grip strength, 4-meter walk, and chair stands; and 3) the WHO Global Physical Activity Questionnaire. The ESI will also assess NCDs, including obesity; hypertension; blood lipid, glucose and HbA1c levels; diabetes, cardiovascular disease; and mental health NCDs including depression, post-traumatic stress disorder, and alcohol and substance use disorders. Our ESI training plan supports implementation of our pilot study, with the hypothesis is that the prevalence of lower physical performance, function and activity, will be observed among PLWH who have higher levels of NCDs. This will be exacerbated among PLWH who are poorly controlled, injection drug users, older, and men, and experience war related trauma. This innovative combination of advanced didactic plus hands-on research training in HIV-aging of one Ukrainian ESI is the first in Ukraine and the EECA. Among older PLWH we will use standardized and validated clinical approaches to assess HIV-aging in combination with NCDs and HIV-related factors. This training is achievable in one year. Pilot study results will inform development of interventions to 1) address chronological aging together with the HIV/NCD care continuum among PLWH in Ukraine, and 2) provide a foundation for prospective observational studies of aging processes in PLWH in Ukraine. This will build on the parent D43 and is in alignment with the theme of addressing the humanitarian crisis sparked by the war.