Grant: Team Grant - HIV/AIDS Comorbidities Prevention and Healthy Living

Older people living with HIV worry about their memory, and with good reason. A third or more have problems with thinking or concentration, despite good control of their HIV infection. Rates of depression, anxiety and poor motivation are also high. Separately or together, these brain health problems affect function and quality of life. The causes of brain health symptoms in HIV are not fully understood, and we don't know whether brain health inevitably worsens over time. Our team has developed new ways to assess these problems in the clinic, identified the factors that relate to poor brain health in a large on-going cohort study, and provided preliminary information about whether these symptoms can be treated. Here, we build on this foundation to meet three broad aims: (1) Understand the factors that lead to poor brain health, focusing on viral, cerebrovascular, and social contributors; (2) Empower people living with HIV and the clinicians who care for them with practical tools to assess brain health and personalize treatment; (3) Act to help people living with HIV improve brain health through lifestyle changes. We will extend the existing cohort study to provide crucial information about whether brain health worsens over longer follow-up. We will add a second wave of participants, including more women, to help us provide personalized brain health recommendations suited to a wide range of people. We will implement the assessment tools that we have developed in our current study as easy-to-use apps. We will work closely with the HIV clinicians and community partners on our team to ensure these are user-friendly and clinic-ready. We will test an innovative, two-phase intervention to help people with brain health challenges pursue health goals tailored to their own priorities and risks, to improve their memory, mood and quality of life. This study will provide the knowledge and tools that people living with HIV need to take charge of their brain health now.