FraGeriCare-WA: Frailty, geriatric syndromes and the care pathways of older people according to their HIV status in West Africa

A new challenge: ageing with HIV

Thanks to antiretroviral therapies, HIV has become a chronic condition. More and more people living with HIV are now reaching an advanced age. However, prolonged exposure to the virus and to treatment could accelerate certain ageing processes.

One of the major challenges is frailty, a common clinical syndrome among older people. It is characterised by a decline in physiological reserves and greater vulnerability to health events, leading to an increased risk of falls, functional impairment, hospitalisations and mortality.

FraGeriCare-WA offers a holistic approach, integrating the medical, social and organisational dimensions of ageing with HIV.

Despite its significance, frailty and geriatric syndromes remain poorly documented among older people living with HIV in sub-Saharan Africa. Existing research focuses mainly on specific medical aspects, without taking into account the full range of factors influencing the health of older people.

Preliminary work carried out in several West African countries has highlighted a number of important findings:

• data on geriatric health are rarely collected as a matter of routine in healthcare settings;
• around 10 per cent of patients receiving care for HIV are now aged 60 or over;
• tools for screening for geriatric syndromes are still not widely integrated into clinical care.

The objectives of the FraGeriCare project

The main objective of the FraGeriCare-WA project (ANRS 0496s) is to compare the prevalence of frailty among people aged 60 and over according to their HIV status (people living with HIV versus those who are not infected) in West Africa.

The project is structured around three main, complementary areas:

Clinical component

• To compare the prevalence of geriatric syndromes according to HIV status (cognitive impairment, functional dependence, depression, sensory impairments, mobility, pain, continence, malnutrition, etc.).
• To investigate comorbidities associated with ageing (diabetes, hypertension, cardiovascular disease, renal failure, osteoarticular conditions).
• To assess participants’ perceived health.
• To identify factors associated with frailty in older people.

Health systems strengthening component

• To assess the integration of geriatric screening tools into HIV care.
• To investigate access to care for non-HIV-related conditions.
• To describe medication practices, particularly polypharmacy and self-medication.
• To examine the feasibility of a care network tailored to older people living with HIV.

Socio-anthropological component

• To understand social representations of frailty and ageing.
• To study care pathways and coping strategies amongst older people.
• To analyse the role of carers and social networks in quality of life.
• To explore the relationships between patients, their loved ones and healthcare professionals.

An international study in West Africa

The project is being carried out in three countries:

• Burkina Faso (Bobo-Dioulasso)
• Côte d’Ivoire (Abidjan)
• Togo (Lomé)

It is based on an international scientific partnership bringing together, in particular, the Sourô Sanou University Hospital (Burkina Faso), the PAC-CI programme (PRISME Côte d’Ivoire), CARESP in Togo and Nantes University Hospital in France, with the support of ANRS MIE.

Implications and prospects

The FraGeriCare-WA project aims to generate essential data to anticipate the changing healthcare needs associated with ageing whilst living with HIV. The first participant was enrolled on 28 September 2026.

The results will, in particular, enable:

• improved early detection of frailty;
• the adaptation of care pathways to the needs of older people;
• the strengthening of the integration of geriatrics into HIV programmes;
• the informing of public health policies in West Africa.