Filling a Critical Gap in HIV Knowledge and Care for HAND

The CIHR Centre for HAND and Brain Health will build and support a trans-disciplinary program of clinically relevant, patient-centred research that will address the intersections of aging, neurocognitive issues and related mental health consequences, and medical comorbidities of HIV. We will: (a) bring together critical mass of experts - including biomedical, clinical, behavioural researchers, health care providers, rehabilitation specialists, and members of the HIV community to build highly skilled, trans-disciplinary HAND team; (b) provide infrastructure, platform and building blocks to create an internationally competitive neuro-HIV/HAND program of research that will solve problems in care and treatment for HAND; (c) establish first comprehensive assessment in Canada of the prevalence, risk factors (comorbidities) and stability of HAND in a population of "older" people living with and aging with HIV and associated medical complications. Its major focus will be to study and better understand milder HAND conditions (ANI/MND) which persist in cART era; (d) identify optimal cognitive screening instruments for mild HAND that can be implemented in clinics, community-based agencies and on-line to support patient management options; (e) test out promising cognitive activation (brain fitness) exercises, physical exercise and mindfulness-based cognitive therapy to improve neurocognitive impairments and subjective cognitive complaints, and thereby improve everyday functioning/quality of life; (f) support novel, innovative projects that will lead to new insights into the socioeconomic, psychiatric and ethno-cultural factors that underlie risk and progression of HAND. The Centre will provide pilot funding for these project teams to lay groundwork for formal applications to CIHR; (g) ensure its findings and evidence-based tools reach clinicians and other front-line service providers who will put them into practice to improve health outcomes of people living with HIV and HAND.