# Project 3 - Impairment and multimorbidity among people aging with HIV and ART in South Africa

> **NIH NIH P01** · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · 2024 · $269,689

## Abstract

Project 3: Impairment and multimorbidity among people aging with HIV and ART in South Africa –
Abstract
 The benefits and side effects of antiretroviral therapy (ART) are fundamentally changing the age
composition and multimorbidities of people living with HIV (PLHIV) in South Africa, which has the largest
number of both PLHIV and people receiving ART globally. Aging PLHIV are likely to suffer from substantial
cognitive impairment and dementia, physical impairment, and multimorbidities. These impairments and
morbidities are likely distinct from those that people without HIV suffer from – because of the long-term effects
of HIV infection; the side effects of long-term ART; and the psychosocial, behavioral, and structural
characteristics of PLHIV. The research in Project 3 of the Health, Aging and Dementia in South Africa: A
Longitudinal Study (HAALSI) proposal will fill a knowledge gap that is critical for health, aging, and social
policy in South Africa: the population-level frequencies, types, and drivers of cognitive impairment and
dementia, physical impairment, and multimorbidity among PLHIV in HIV hyperendemic communities in South
and Southern Africa. To do this, we will build on the previous HAALSI HIV renewal project, and the successful
partnership between the MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) and
the Harvard Center for Population and Development Studies. First, we will quantify the national prevalence of
cognitive and physical impairment across the HIV care continuum in South Africa using established cognitive
batteries and physical function tests in the HAALSI National survey. We will also quantify the changes in
cognitive and physical impairment across the age course and the HIV care continuum using the longitudinal
the HAALSI Agincourt cohort. Second, we will identify the distinct multimorbidity profiles of people aging with
HIV and ART in South Africa, using clustering analyses of biomarker, anthropometric, and cognitive and
psychological data on a range of diseases and conditions, including HIV, hypertension, diabetes, obesity,
hypercholesterolemia and hypertriglyceridemia, depression, and cognitive impairment and dementia. Third, we
will utilize quasi-experimental methods to establish the long-term effects of HIV and ART as well as the
psychosocial, behavioral, and structural characteristics of older PLHIV on cognitive impairment including
dementia; physical impairment; and chronic multimorbidity in South Africa. Our research will provide the
evidence that is critically needed to design policies and programs that will ensure healthy and dignified aging
among the large and growing population of older adults with HIV in South Africa and the broader Southern
African region.

## Key facts

- **NIH application ID:** 10843310
- **Project number:** 5P01AG041710-10
- **Recipient organization:** HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH
- **Principal Investigator:** Till Barnighausen
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $269,689
- **Award type:** 5
- **Project period:** 2013-09-15 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10843310

## Citation

> US National Institutes of Health, RePORTER application 10843310, Project 3 - Impairment and multimorbidity among people aging with HIV and ART in South Africa (5P01AG041710-10). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10843310. Licensed CC0.

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