The following description was taken from the R01 version of this FOA:
It is estimated that in 2016 over 50% of the more than 35 million HIV-infected people in the world will be over 50 years of age. Highly effective antiretroviral therapy developed in the mid-1990s transformed human immunodeficiency virus (HIV) infection into a chronic illness. However, even those who achieve excellent long-term virologic control and immune recovery will experience higher rates of comorbidities at an earlier age than their non-HIV infected counterparts. Fifty to sixty percent of deaths among HIV-infected persons will occur from these non-AIDS causes.
A variety of co-morbid diseases and conditions may arise in persons with long-standing HIV infection, including insulin resistance, dyslipidemia, cardiovascular disease, renal impairment, metabolic bone disease, liver disease, HIV-Associated Neurocognitive Disorders (HAND) and others. People living with prolonged HIV infection exhibit many of the clinical characteristics commonly observed in the elderly, such as multiple co-morbidities, polypharmacy, physical and cognitive impairment, functional decline, alterations in body composition, and increased vulnerability to stressors. Little is known about the unique manifestation of symptom clustering among those with long-standing HIV infection and in this complex population, HIV infection may be undiagnosed.
Reduced functional capacity, as a result of these comorbidities, combined with premature aging due to HIV infection, increases vulnerability and reduces a person’s ability to recover from episodic chronic disease crises and to maintain function and meaningful engagement in daily life. In addition, social stigma and other cultural issues may discourage active seeking of solutions and motivation to manage symptoms and maintain functional capacity and social engagement. The growing population of older adults with HIV tend to have limited or inadequate social networks, particular within traditional family structures. As a result, older individuals with HIV will need to rely more heavily on community-based services to manage functional needs and symptoms.
The overall objective of this initiative is to encourage interdisciplinary research to identify and decrease symptom burden, improve functional capacity, interrupt the progression towards frailty and enhance health-related quality of life among people with prolonged HIV-infection and comorbidities. The initiative encompasses research in both domestic and international settings, especially among groups experiencing health disparities related to race, ethnicity, age, class or gender.
Proposed research must align with both the NIH overarching AIDS research priorities found at the following link: https://grants.nih.gov/grants/guide/notice-files/NOT-OD-15-137.html
Topics appropriate for this FOA include but are not limited to the following:
- Innovative strategies to ensure proper identification of symptoms and unique symptom clusters among HIV-infected patients presenting with complex conditions
- Interventions that identify and address symptoms resulting from the interaction of HANA and premature aging
- Interventions aimed at increasing functional capacity and resilience and interrupting progression towards age-related symptoms of frailty among people with prolonged HIV infection
- Interventions that delineate and address the impact of decreased functional capacity on caregivers of PLWHA and identify/replicate unique solutions of caregivers of persons with HANA conditions and other comorbidities
Deadlines: standard dates and standard AIDS dates apply
- R01 – https://grants.nih.gov/grants/guide/pa-files/PA-18-143.html
- R21 – https://grants.nih.gov/grants/guide/pa-files/PA-18-161.html
Filed Under: Funding Opportunities