Direct and indirect impacts of HIV and ART among older people in community settin

描述：由美国国立卫生研究院艾滋病研究办公室委托的一个工作组确定了抗逆转录病毒治疗（ART）的多重发病率、功能、影响、免疫衰老、炎症和对女性护理人员的关注，这些领域存在着迫切的研究需求。工作组确定的主要限制之一是现有研究中缺乏适当的比较人群，从而限制了从收集到的“西方”人群中老年人的数据推断，这些老年人由于不同的暴露和风险行为。强调需要利用和加强现有的队列。拟议的研究解决了其中的许多问题。世界卫生组织的全球老龄化和成人健康研究（SAGE）在其老年人福利研究（WOPS）子研究中，目前正在收集撒哈拉以南非洲（乌干达和南非）两个低收入农村/城市周边环境中约1300名社区居住老年人的队列数据，以了解艾滋病毒/艾滋病对老年人的直接和间接影响。一半的答复者是艾滋病毒阳性，其中约一半目前正在接受抗逆转录病毒治疗。另一半是HIV阴性的，但他们的家庭间接受到了HIV/AIDS的影响。在乌干达纳入了一个“对照”队列，其中的老年人既没有感染艾滋病毒或艾滋病，也没有受其影响。在这项提议开始之前，该队列已经接受了两次访谈，并且在这笔赠款的资助下，将在整个研究过程中提供为期7年的数据——感染和/或受艾滋病毒影响的老年人长期社区居住队列，以及生活在同一地区没有艾滋病毒的老年人的可比队列。全面的健康措施和包括免疫功能和衰老过程在内的一系列生物标志物，为研究两个非临床非洲人群（南非和乌干达）中艾滋病毒/艾滋病的复杂性提供了前所未有的机会。拟议研究的数据将对了解美国类似的老年艾滋病毒/艾滋病人群的健康和福祉具有直接意义，特别是那些来自较低社会经济阶层和少数民族的人群。该研究的数据将使用与其他国际老龄化研究（包括SAGE和美国健康与退休家庭研究）相当的测量方法。该研究的所有匿名微数据将按照国际标准与所有元数据一起存档，并提供给研究人员。

DESCRIPTION: A working group commissioned by the Office of AIDS Research of the NIH identified multi-morbidity, functioning, impacts of anti-retroviral therapy (ART), immune senescence, inflammation and a focus on women caregivers among the areas where critical needs for research exist. One of the major limitations identified by the working group, was the lack of appropriate comparison populations in existing studies, thereby limiting the inferences from data collected on older adults in "Western" populations due to different exposures and risk behavior. The need to leverage and build on existing cohorts was emphasized. The proposed study addresses many of these issues. The World Health Organization's Study on Global AGEing and Adult Health (SAGE), in its Well-Being of Older People Study (WOPS) sub-study, is currently collecting data on a cohort of about 1300 community dwelling respondents older adults in two low-income rural/periurban settings in sub-Saharan Africa (Uganda and South Africa) to understand the direct and indirect impact of HIV/AIDS on older adults. Half the respondents are HIV- positive and of these about half are currently on ART. The other half of the cohort is HIV- negative, but have been indirectly affected by HIV/AIDS in their families. A "control" cohort is included in Uganda, with older adults neither infected nor affected by HIV or AIDS. The cohort will already have been interviewed twice before the start of this proposal and with funding from this grant, will provide data for a seven year period over the full course of the study - the longet community dwelling cohort of older adults infected and/or affected by HIV, with a comparable cohort of older adults living in the same areas without HIV. Comprehensive measures of health and the inclusion of an array of biomarkers, including those of immune function and the ageing process, provide an unprecedented opportunity to study the complex nature of HV/AIDS in two non- clinical African populations (South Africa and Uganda). Data from the proposed study will have direct implications for understanding the health and well-being of similar older adult populations with HIV/AIDS in the US, especially those from lower socioeconomic classes and minority populations. Data from the study will use measures that are comparable to other international studies of aging, including SAGE and the US Health and Retirement family of studies. All anonymized microdata from the study will be archived according to international standards along with all metadata and made available to researchers.