# Quality of Life and Aging with HIV in Rural Uganda

> **NIH NIH R01** · MASSACHUSETTS GENERAL HOSPITAL · 2020 · $1

## Abstract

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ABSTRACT
The United States government has contributed over $50 billion to expand antiretroviral therapy (ART) access
in sub-Saharan Africa. As people living with HIV (PLWH) in the region realize the medical benefits of these
initiatives, their AIDS-related mortality is declining and their life expectancy is increasing. Yet, these programs
typically apply a narrow focus on AIDS-related health, which overlooks the drivers of quality of life for this
population, and risks losing the tremendous gains achieved through investments in HIV care programs.
Consequently, there is a need to identify determinants of quality of life for older PLWH in sub-Saharan Africa,
and evaluate interventions to sustain wellbeing. To date, most studies of aging with HIV in the region have
been cross-sectional and have focused on single morbidity domains (e.g. hypertension). There is remarkably
little data about regional preferences for and determinants of quality of life for older PLWH. Our preliminary
data among older PLWH in Uganda demonstrate meaningfully different biomedical, social and HIV-specific risk
profiles, and outsized effects of HIV stigma on social functioning and wellbeing, compared to western settings.
Similarly, we and others have shown that alterations to family structures caused by deaths due to HIV might
undermine quality of life in the region. Thus, our scientific premise is that the social, biomedical, and HIV-
disease specific determinants of quality of life for older PLWH in rural sub-Saharan Africa will be different from
those in the United States. Our overarching goal is to elucidate the determinants of quality of life for older
PLWH in rural Uganda, and how HIV contributes to them, to ultimately develop effective interventions to
improve quality of life for this population. In the current proposal, we will address important gaps in the field by:
1) using qualitative methods to develop a conceptual framework for how HIV impacts quality of life among
older PLWH in Uganda, and inform measure selection for this proposal, 2) demonstrating how HIV infection
affects trajectories of functioning and quality of life in rural Uganda; and 3) identifying intervention targets and
assessing the acceptability and feasibility of interventions to address poor quality of life. Our proposal is
relevant to Office of AIDS Research high-priority topics and responds to multiple National Institute of Aging
topic areas through its focus on: 1) interactions between HIV, social determinants, functional status and
wellbeing; 2) relationships between HIV infection and cognitive functioning; and 3) geriatric approaches to
assessment of older adults with HIV. While addressing these high-priority areas of investigation, our study will
build research capacity by providing a platform for junior investigators at the Mbarara University of Science and
Technology, as part of a training initiative with Harvard Medical School (NIH D43 TW010128). Our study is
anticipated to have signif...

## Key facts

- **NIH application ID:** 9999389
- **Project number:** 5R01AG059504-02
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** MARK J SIEDNER
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $1
- **Award type:** 5
- **Project period:** 2019-09-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9999389

## Citation

> US National Institutes of Health, RePORTER application 9999389, Quality of Life and Aging with HIV in Rural Uganda (5R01AG059504-02). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/9999389. Licensed CC0.

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