Aging Well with HIV through Alcohol Research and Risk Reduction and Education (AWAR3E) Center

About This Grant

AWAR3E Overall People with HIV (PWH) experience more “inflammaging” characterized by chronic inflammation, immune dysfunction, and debilitating geriatric syndromes than people without HIV (PWoH). Inflammaging has not been well characterized among people with HIV because no single cohort can adequately address this question. Thus, before we can effectively intervene on this health issue, we need to characterize inflammaging among people with HIV to identify appropriate biomarkers, outcomes, and treatments. We bring together four well characterized, complimentary HIV cohorts to study this question in the Aging Well with HIV through Alcohol Research and Risk Reduction and Education (AWAR3E) Center. We propose that inflammaging in people with HIV is reflected in novel biomarkers of inflammaging (methylation age, HIV-1 viral reservoirs, and Conserved Transcriptional Response to Adversity [CTRA]; Project 1: Biomarkers) and is associated with debilitating geriatric syndromes (falls/fractures, delirium/dementia, and physiologic frailty; Project 2: Geriatric Syndromes). We also explore two potential treatments to counteract inflammaging, long-acting ART (LAARs, e.g. injectable cabotegravir-rilpivirine) and glucagon-like peptide-1 receptor agonists (GLP-1RAs, e.g., semaglutide; Project 3: Treatments). We hypothesize that people with HIV, those with unhealthy alcohol use, and those socioeconomically disadvantaged are less likely to receive these treatments than those without these factors, but are more likely to benefit from each. We evaluate their safety and effectiveness overall and for people with unhealthy alcohol use and socioeconomic disadvantage using causal modeling. Finally, the AWAR3E Center will provide guidance and coordination of this work with an Administration and Data Core, Program Advisory Group, Steering Committee, Engagement and Dissemination Core, and Pilot Program focused on training the next generation of investigators and community representatives in alcohol-HIV/AIDS research to promote health. Insights gained, training provided, and strategic engagement and dissemination through the AWAR3E Center will facilitate future alcohol interventions tailored to people with HIV to mitigate inflammaging associated health outcomes.