Thursday, July 3, 2025 7/3/2025

Epidemiology and Impact of the HIV, NCD, and Urbanization Syndemic in Africa

Award Number: R01HL152813
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 02/02/2021
PERIOD OF PERFORMANCE END DATE: 01/31/2026

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Epidemiology and Impact of the HIV, NCD, and Urbanization Syndemic in Africa - Africa bears the vast majority (69%) of the world’s current HIV infections with 26 million persons living with HIV (PLHIV). Increased access to antiretroviral therapy (ART) in Africa has markedly extended the lives of PLHIV and is shifting morbidity and mortality among PLHIV toward non-communicable diseases (NCDs), including high burden cardiopulmonary NCDs (CP-NCDs) such as congestive heart failure, hypertension, asthma, and chronic obstructive pulmonary disease. In addition, Africa is experiencing rapid urbanization with its associated increases in air pollution and changes in lifestyle and the social, structural, and health service environment. This remarkable convergence of HIV, CP-NCDs, and urbanization has profound implications for the future of global health. Unfortunately, there is a paucity of data on the impact of urbanization and air pollution on CP- NCDs and the potential role of HIV as an effect modifier, e.g. PLHIV may be more susceptible to urban ills due to existing chronic inflammation despite suppressed HIV viremia or from sequelae of past tuberculosis or other pulmonary infections. In addition, little is known about HIV and CP-NCDs health service utilization patterns as people migrate to urban settings and how HIV and CP-NCD care might be better integrated. Finally, HIV and CP-NCDs research in Africa has primarily been cross-sectional and often without HIV-negative comparison groups, major limitations in understanding causal factors and accurately calculating attributable fractions for traditional and non-traditional risk factors. Longitudinal, population-level approaches are needed to better guide future research, programs, and policies. The Rakai Community Cohort Study (RCCS), established in 1994, is an open, population-based cohort in 40 communities in south-central Uganda with survey rounds conducted over ~18 month intervals (RCCS census population ~33,000 adults, HIV prevalence ~18%). RCCS communities are non-urban; however, the cohort experiences an out-migration of ~950 participants per round to two large urban centers (Kampala and Masaka) where RCCS has satellite offices. With this unique research infrastructure, RCCS offers a novel opportunity to conduct longitudinal, population-based research on the HIV, CP-NCDs, and urbanization syndemic within a comprehensive health determinants framework. This study proposes to (i) Characterize HIV-related and -unrelated risk factors for cardiopulmonary non-communicable diseases in a novel Rural-to-Urban (R2U) African cohort; (ii) Characterize the impact of air pollution and moderating effects of HIV on cardiopulmonary outcomes among R2U migrants; and, (iii) Assess HIV and CP- NCDs health services utilization patterns among R2U migrants. To our knowledge, this would be the first population-based, longitudinal cohort study of the HIV, CP-NCDs, and urbanization syndemic in Africa. Our unique ability to leverage a rural-to-urban cohort, the excellent research infrastructure, and novel Aims will generate vital data needed for designing new research, interventions, and policies to combat the evolving HIV and CP-NCDs epidemic.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $1,534,033 )
2025	2025	THE JOHNS HOPKINS UNIVERSITY	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	001	5	4/24/2025	NON-COMPETING CONTINUATION	$153,403
2025	2025	THE JOHNS HOPKINS UNIVERSITY	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	000	5	3/26/2025	NON-COMPETING CONTINUATION	$1,380,630
														Subtotal = $1,534,033

Issue Date FY: 2024 ( Subtotal = $1,551,103 )
2024	2024	THE JOHNS HOPKINS UNIVERSITY	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	002	4	8/9/2024	NON-COMPETING CONTINUATION	$0
2024	2024	THE JOHNS HOPKINS UNIVERSITY	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	001	4	6/12/2024	NON-COMPETING CONTINUATION	$1,551,103
2024	2023	THE JOHNS HOPKINS UNIVERSITY	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	000	3	1/9/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $1,551,103

Issue Date FY: 2023 ( Subtotal = $1,566,511 )
2023	2023	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	001	3	1/24/2023	NON-COMPETING CONTINUATION	$1,566,511
2023	2022	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	000	2	1/6/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $1,566,511

Issue Date FY: 2022 ( Subtotal = $1,599,493 )
2022	2022	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	000	2	12/14/2021	NON-COMPETING CONTINUATION	$1,439,542
2022	2022	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	001	2	6/15/2022	NON-COMPETING CONTINUATION	$159,951
														Subtotal = $1,599,493

Issue Date FY: 2021 ( Subtotal = $1,566,902 )
2021	2021	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	001	1	2/24/2021	NEW	$0
2021	2021	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	002	1	6/27/2021	NEW	$0
2021	2021	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	003	1	7/6/2021	NEW	$0
2021	2021	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	000	1	2/2/2021	NEW	$1,566,902
														Subtotal = $1,566,902

Grand Total All Awards = $7,818,042

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Epidemiology and Impact of the HIV, NCD, and Urbanization Syndemic in Africa

Award Number: R01HL152813

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 02/02/2021

PERIOD OF PERFORMANCE END DATE: 01/31/2026

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