# KNUST aging and human immunodeficiency virus outcomes—Study protocol

## TL;DR

This study aims to improve healthcare for older HIV-positive people in Ghana by examining geriatric health issues and developing an integrated care model.

## Contribution

The study introduces a protocol to address the lack of geriatric healthcare for aging HIV-positive individuals in sub-Saharan Africa.

## Key findings

- A significant proportion of HIV-positive individuals in Ghana are over 50 years old.
- Geriatric syndromes are under-recognized in older HIV-positive people due to limited geriatric healthcare access.
- The KAHO study will collect both qualitative and quantitative data to inform integrated HIV and geriatric healthcare models.

## Abstract

Globally, 7 million people with HIV (PWH) aged over 50 years exist. 5 million of them live in sub-Saharan Africa, the epicenter of the HIV epidemic. In Ghana, every 1 in 6 PWH is aged over 50 years. However, access to geriatric health care is grossly limited in Ghana and the sub-Saharan Africa region. This has resulted in a lack of focus on geriatric syndromes, a multi-factorial clinical condition common in older PWH, that do not fit discrete disease categories. Consequently, this gap threatens the life expectancy for aging PWH, necessitating the need to promptly fill it. The KNUST Aging and HIV Outcomes (KAHO) study will help identify priorities and opportunities for developing an effective integrated model of HIV and geriatric healthcare in Ghana.

The KAHO study will recruit 151 PWH aged 50 years and older at the Infectious Disease Unit (IDU) of the University Hospital, Kwame Nkrumah University of Science and Technology (KNUST). The study will be conducted over a 2-year period and participants will be seen at months 0, 6 and 12. Participants at each visit will be taken through assessments and questionnaires on geriatric health, cognition, social vulnerability, HIV-related conditions and they will provide biospecimens for laboratory testing. We will also conduct semi-structured qualitative interviews of PWH, healthcare providers, policy makers and study research assistants. Quantitative data will be analyzed using one sample proportion test and linear regression models appropriately. The Levesque’s framework will be used as a guide to analyze qualitative data.