Grant: Team Grant - HIV/AIDS and comorbidities

People living with HIV are worrying about their memory, and with good reason. Even with good control of the infection, up to 50% may have cognitive or depressive symptoms. These changes in thinking and mood are usually mild, but they seem to matter in everyday life: they can affect functioning at work, the ability to stick to treatments, and the quality of life of both patients and their family and friends. The causes of these changes in brain health are not clear: Do they result from HIV-induced brain injury? Accelerated aging? Toxic effects of medication? Or the stress of living with a serious chronic illness? The answer may be "all of the above". We propose that poor brain health in HIV is due to multiple factors, and aim to characterize these in a representative sample of people with HIV drawn from 3 clinics in Montreal and Vancouver. Those showing signs of poor brain health will be assessed in detail, and all will be followed regularly over time to understand the biological, psychological and social factors that affect brain health, the impact of these symptoms on function and quality of life, and their evolution over time. Sub-groups will participate in specific studies using brain imaging and special blood tests to better understand the mechanisms that underlie this problem. We don't have to wait for these results to act, though: Everyone with symptoms will be helped to take steps to improve their brain health, and will have the chance to try one of three interventions that have shown promise in other neurological illnesses: physical activity, brain health self-management, or cognitive training. We will identify the elements of these programs that are most effective in improving brain health in people with HIV, and work to make them widely available. This project brings experts in neuroscience, epidemiology, and HIV together in a new team, to carry out innovative, action-oriented research aiming to make a real difference in brain health in HIV in Canada.