10 sites across the country awarded grants to design, implement, and evaluate interventions addressing HIV and aging in the U.S.
CHICAGO—NORC at the University of Chicago will lead a new national initiative with the New York State Department of Health / Health Research Inc (HRI) to support and evaluate interventions designed to improve the well-being of older adults with HIV.
The Emerging Strategies to Improve Health Outcomes for People Aging with HIV project—also known as the Ryan White HIV/AIDS Program Special Projects of National Significance Program Aging with HIV Initiative—will seek to strengthen the evidence base for emerging clinical and psychosocial services that comprehensively screen and manage co-occurring conditions, geriatric factors, and behavioral health needs among people aged 50 and older with HIV.
“The increasing number of people with HIV aged 50 years and older reflects tremendous advancement in HIV treatment and care,” said Rich Dunville, principal research scientist at NORC. “However, it also represents opportunities to integrate HIV care with care for aging-related issues. We are excited to support the implementation and evaluation of critical, innovative interventions to improve health outcomes among people aging with HIV.”
Thanks to effective antiretroviral therapy, life expectancy for people with HIV has improved dramatically. The unique needs of older adults with HIV, however, remain under-researched, even though they represent one of the largest and fastest-growing groups of people with HIV in the U.S. According to the CDC, more than half (53.3%) of the more than 1 million people living with HIV in the U.S. are age 50 and older.
People aging with HIV experience functional decline an average of 10–15 years earlier than people without HIV of similar age. They also are more likely than people with HIV under age 50 to have one or more HIV comorbidities, including neurocognitive disorders, cardiovascular disease, and cancer malignancies, and a greater likelihood of COVID-19 diagnosis and mortality.
“Persons with HIV face significant barriers to care, particularly as they age,” said Clemens Steinbock, director of the Center for Quality Improvement & Innovation, New York State Department of Health / HRI. “We are excited to provide coaching opportunities to the funded sites and actively support them to address these issues head on and improve client’s quality of care.”
Barriers to care can include social isolation, stigma, and lack of access to quality care.
Through the Aging with HIV Initiative, grant recipients will test interventions in specific populations ages 50 and older. Interventions being tested include:
- Creating a holistic, multi-faceted approach to care for older adults with HIV
- Leveraging existing geriatric assessments to mitigate falls and diagnose and treat frailty
- Expanding HIV dementia assessment and management in clinics
- Integrating additional assessments and referral processes into routine clinic workflows
- Improving collaborative care to assess risk and eliminate polypharmacy (the use of multiple medications for conditions)
“For Centro Ararat, this initiative represents the establishment of a new paradigm related to services for Puerto Rican patients living with HIV who are 50 years of age or older” said Dr. Iván Báez Santos, PsyD, mental health supervisor at Centro Ararat, a project site. “We are proud to be able to contribute to scientific knowledge and to the development of new service guidelines for this population.”
This work is funded through the Health Resources and Services Administration (HRSA), HIV/AIDS Bureau, Ryan White HIV/AIDS Program Part F Special Projects of National Significance (SPNS) and includes 10 grant recipients across the U.S.:
- Boston Medical Center Corporation, Boston, MA
- Centro Ararat, Inc., Ponce, PR
- Colorado Health Network, Inc., Denver, CO
- Empower U, Incorporated, Miami, FL
- Family Health Centers of San Diego, Inc., San Diego, CA
- Mount Sinai Beth Israel Medical Center, New York, NY
- University of Chicago, Chicago, IL
- University of Pittsburgh Medical Center Presbyterian Shadyside, Pittsburgh, PA
- Wake Forest University Health Sciences, Winston Salem, NC
- Yale University, New Haven, CT
The New York State Department of Health AIDS Institute, Center for Quality Improvement & Innovation will provide implementation expertise and technical assistance for the 10 grant recipient sites. NORC will lead the project’s evaluation activities.
About NORC at University of Chicago, Chicago, IL
NORC at the University of Chicago conducts research and analysis that decision-makers trust. As a nonpartisan research organization and a pioneer in measuring and understanding the world, we have studied almost every aspect of the human experience and every major news event for more than eight decades. Today, we partner with government, corporate, and nonprofit clients around the world to provide the objectivity and expertise necessary to inform the critical decisions facing society.
About New York State Department of Health / Health Research Inc (HRI), New York, NY
The New York State Department of Health / Health Research Inc (HRI) is funded by the Health Resources and Services Administration (HRSA) HIV/AIDS Bureau to develop and implement the HRSA Ryan White HIV/AIDS Center for Quality Improvement & Innovation (CQII). HRI serves as a national resource to provide technical assistance to Ryan White HIV/AIDS Program (RWHAP)-funded recipients and subrecipients to measurably strengthen local clinical quality management programs to impact HIV health outcomes. The AIDS Institute was recently funded in July 2020 to manage HRI, which is now housed at the Center for Program Development, Implementation, Research and Evaluation (CPDIRE), after operating the National Quality Center (NQC) since 2004.
SPNS Funding Statement
This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $13,017,161 with no percentage financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov. Visit TargetHIV.org/aging for more information.