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HIV and Aging

Wherever antiretroviral therapy (ART) is accessible, people are aging with HIV, with older individuals experiencing increasing rates of delays in diagnosis, decreased benefits from ART, and excess risk of HIV-associated non-AIDS conditions (HANA). Aging with HIV has unique challenges and must be studied in the context of continued immune dysfunction, ongoing inflammation, premature polypharmacy, and alcohol and substance use. The Yale-UPR will make study of HIV and Aging a priority target area for multidisciplinary research with establishment of an HIV and Aging Scientific Working Group (SWG). The HIV and Aging SWG will bring together HIV and non-HIV researchers whose expertise in basic science, translational, and clinical research will allow for an integrated approach to collaboratively address these important issues, with the goal of translating findings into effective interventions and by mentoring new investigators.

The group on HIV and Aging has identified five provocative questions (PQs) to focus initial research efforts:

  1. Impact of age on advanced disease among people living with HIV
  2. Association of polypharmacy with ART and HANA conditions
  3. Mechanisms of excess risk of HANA conditions
  4. Role of viral co-infections on HANA conditions, especially cancers
  5. Aging well with HIV

With the goal of facilitating significant and innovative research on aging and HIV, the SWG will evaluate and identify new provocative questions based on continual evaluation of ongoing research area of HIV. We also look forward to recruiting early, mid-career, and established investigators to work on PQs who have not previously conducted research on the interaction of HIV and aging.
The HIV and Aging SWG co-led by Drs. Amy Justice, a clinical epidemiologist and internationally recognized expert in aging and HI; Brinda Emu, an immunologist and HIV clinician; and Ivonne Jimenez, Chief of Medicine at University of Puerto Rico and an expert in the neurologic consequences of aging. In addition, SWG membership includes a core group of basic, translational, clinical and implementation scientists whose research interests and methodologies are diverse, to allow for essential exchange of ideas with cross-disciplinary and complementary expertise to attain a common goal of advancing science and improving health for patients aging with HIV.


  • Director

    C.N.H. Long Professor of Medicine (General Medicine) and Professor of Public Health (Health Policy)

    Research Interests
    • Aging
    • Chronic Disease
    • Health Policy
    • Internal Medicine
    • Medical Oncology
    • Veterans
    • HIV Infections
    Dr. Justice is a Clinical Epidemiologist who has developed multiple large national cohorts based on data from the Veterans Affairs Healthcare System Electronic Medical Record enhanced with National Death Index and CMS data, patient completed surveys, DNA and tissue repositories, and stored pathology samples. She has two decades of experience in the processes required to clean, validate, and standardize raw EMR data and in its analysis using standard statistical methods, machine learning techniques, and cross cohort validations. The oldest and best known of her projects is the Veterans Aging Cohort Study (VACS). VACS is an ongoing, longitudinal study of >170,000 United States veterans with and without HIV infection continuously funded by National Institutes of Health (NIH) since 1996. She has developed and validated widely used indices including a prognostic index, the VACS Index, and a patient reported symptom index, the HIV Symptom Index. She is the principal investigator of the National Cancer Institute provocative questions grant HIV and Aging Mechanisms for Hepatocellular Cancer, has published over 400 peer reviewed manuscripts, and has presented work at the United Nations, The International AIDS Society, The Royal Medical College in London, the White House, and Congress. She is a member of the National Cancer Institute Ad hoc Subcommittee on HIV and AIDS Malignancy and the HIV and Aging Working Group, NIH Office of AIDS Research. She has recently joined the International Advisory Boards of Lancet HIV and Journal of the International AIDS Society.
  • Co-director

    Associate Professor of Medicine (Infectious Diseases); Director, Cancer-ID Clinic, Internal Medicine; co-Leader, Cancer Microbiology Working Group, Yale Cancer Center

    Research Interests
    • Head and Neck Neoplasms
    • HIV
    • Immune System
    • Lymphoma
    • T-Lymphocytes
    • Thoracic Neoplasms
    • Immunocompromised Host
    • Hematologic Neoplasms
    • Infectious Disease Medicine
    • Immune Evasion
    • Immune Reconstitution
    Dr. Emu received her B.A. from Harvard University and her M.D. from Johns Hopkins University School of Medicine. She completed an Internal Medicine residency at Beth Israel Deaconess Medical Center and fellowship in Infectious Diseases at the University of California, San Francisco. She remained on faculty at UCSF from 2004 to 2009, studying immune correlates of protection in HIV-infected individuals. Dr Emu then worked as Medical Director in early clinical development at Genentech, Inc in South San Francisco (2009-2012). While at Genentech, she focused on development of novel therapeutic approaches to unmet needs in infectious diseases, inflammation, and oncology. Dr. Emu joined the Division of Infectious Diseases at Yale School of Medicine in 2013. Her laboratory studies the intersection of chronic viral infection and oncology, with a focus on HIV-associated malignancies.  Specifically, she studies the impact of HIV-associated immune dysfunction on carcinogenesis and tumor progression.
  • Dr. Ivonne Jimenez-Velazquez is a Professor at the University of Puerto Rico. She Completed Doctor of Medicine at the School of Medicine-UPR, she interned at the Regional Hospital of Caguas and three years of Internal Medicine in the University Hospital, being then an Instructor in the Department of Medicine. Her research Interests are Geriatrics, Clinical Research, Epidemiology, Biostatistics, Psychiatry. She has been a researcher or co-researcher in 12 scientific research studies.