HIV CO-INFECTIONS IN UGANDA

背景：随着我国艾滋病综合护理项目的建立和规模的扩大

Background: With the establishment and scale up of comprehensive HIV care programs in sub- Saharan Africa (SSA) and the related reduction in mortality. There is an increasing number of older people living with HIV (OPLWH). The scale up of ART has resulted in reduction in morbidity and mortality with a subsequent increased longevity, by restoring the immune function following suppression of viral load replication. However, despite this increased life expectancy, living long- term with HIV and ART is associated with an earlier onset of clinical aging, chronic conditions including geriatric syndromes in particular frailty, and neurocognitive impairment. Aim: We plan to train a fellow in the research area of OPLWH as a steppingstone to the fellow’s career development path, to the HIV-care and research program at IDI to build scalable tools for care of OPLWH for HIV-care and research program, and pilot and evaluate a potential fellowship program that can be scaled up in collaboration with the IDI to a full fellowship accredited by the Makerere University. Specific objectives 1. To train a research fellow to conduct research in OPLWH in Uganda. 2. To adapt and validate instruments for geriatric assessment, specifically scalable screening tools for frailty, physical function and sarcopenia for OPLWH in Uganda. 3.To evaluate the fellowship, we will conduct a modified Kirkpatrick evaluation. Methods: We plan to train a research fellow to conduct research in OPLWH with emphasis on piloting and testing tools for clinical care of OPLWH focusing on frailty, physical and cognitive function. Additionally, the program proposes to adapt and validate instruments for geriatric assessment of OPLWH, specifically scalable screening tools for frailty, physical function and sarcopenia for OPLWH in Uganda. We will also will evaluate the feasibility of self-collection through tablets using simplified validated tools for cognitive function, Quality of Life, Instrumental Activities of Daily Living (IADL), history of falls, screening for depression, and incontinence. Finally, to evaluate the fellowship, we will conduct a modified Kirkpatrick evaluation. Solicit mentors ‘experience, lessons learnt and identify gaps that should be addressed in the planned training program (D71 and D43 in research in HIV and geriatric medicine by Drs. Castelnuovo and Byakika)