ArticleThe lancet. Healthy longevity2025
The prevalence, incidence, and sociodemographic risk factors of HIV among older adults in sub-Saharan Africa (AWI-Gen): a multicentre, longitudinal cohort study.
Article in The lancet. Healthy longevity, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed.
- Sex-specific bone architectural deficits among older adults living with HIV: a cross-sectional study from Zimbabwe.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2026Article
- Associations between extreme weather events, mobility, and resource insecurities with HIV vulnerabilities among older adults in Moshi, Tanzania: Cross-sectional findings.International journal of STD & AIDS · 2026Article
- High HIV incidence density among middle-aged and older populations in Luzhou, China: evidence from retrospective cohort study, 2018-2023.BMC infectious diseases · 2026Article
- Parkinsonism in people with virally suppressed HIV.The lancet. HIV · 2026Review
- Spatial modeling of HIV prevalence in Malawi using generalized additive models.Frontiers in epidemiology · 2026Article
- Age-Related Variations in Clinical and Biochemical Profiles of People Living With HIV.AIDS research and treatment · 2026Article
- Left behind? A longitudinal analysis of need for preexposure prophylaxis services among middle-aged and older adults in South Africa.AIDS (London, England) · 2025Article
- Intersecting epidemics: immune dysregulation associated with HIV and tuberculosis syndemic contribute to increased risk of hypertensive disease in Sub-Saharan Africa.Frontiers in cardiovascular medicine · 2025Review
- Mapping the intersection of HIV and Alzheimer's disease: a bibliometric analysis of emerging research trends.Frontiers in neurology · 2025Article
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16 authors.
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Abstract
backgroundSub-Saharan Africa's ageing population includes a rising number of adults aged 50 years and older living with HIV. Although antiretroviral therapy (ART) has extended life expectancy, data on HIV incidence and treatment outcomes among older adults remain scarce. To inform targeted public health interventions, we aimed to examine the prevalence and incidence of HIV, as well as sociodemographic determinants associated with HIV acquisition and treatment outcomes, among older adults in sub-Saharan Africa.
methodsAWI-Gen is a multicentre, longitudinal cohort study. We assessed data from random community-based samples of adults aged 40-60 years collected between Aug 5, 2013, and Aug 19, 2016 (wave 1) and of adults aged 40 years and older collected between Jan 24, 2019, and Nov 23, 2022 (wave 2) from Nairobi (Kenya) and from Soweto, Agincourt, and Dikgale Mamabolo Mothiba (South Africa). Sociodemographic data were collected through interviewer-administered questionnaires and structured interviews. The primary outcome was HIV status at both wave 1 and wave 2, classified as either HIV-positive or HIV-negative. We evaluated the prevalence and incidence of HIV, ART coverage, and self-reported HIV awareness and used logistic regression to examine risk factors associated with HIV acquisition and treatment outcomes.
findingsAmong 7919 participants in wave 1 who were recruited and followed up, 6505 (82·1%) participants were aged 40-60 years, of whom 5730 (88·1%) contributed HIV-related data. 3148 (54·9%) participants were women and 2582 (45·1%) were men. In wave 2, 4520 participants from wave 1 were followed up with an additional 579 participants recruited. 5076 (99·5%) participants were aged 40 years and older, of whom 4931 (97·1%) contributed HIV-related data. 2767 (56·1%) participants were women and 2164 (43·9%) were men. Overall, 1271 (22·2%) of 5730 participants in wave 1 and 1073 (21·8%) of 4931 participants in wave 2 were living with HIV, with regional variability (χ
interpretationThe findings emphasise the complex interplay of age, education, gender, and location in shaping HIV risk. Although ART coverage has improved, older adults face considerable barriers to HIV prevention, including educational disparities and gender inequities, particularly in rural settings. Tailored interventions targeting older populations are essential to address these gaps because the risk of HIV acquisition, albeit generally lower than in younger populations, remains noteworthy.
fundingNational Human Genome Research Institute, the National Institute of Environmental Health Sciences of the US National Institutes of Health, and the Department of Science and Innovation, South Africa.
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