HIV after 40 is nested in the Agincourt Health and Socio-Demographic Surveillance System (AHDSS) in rural, northeast South Africa. We draw on a novel integrated multi-method dataset which includes five data sources including:


(1) AHDSS annual census - Longitudinal household data collection began in 1992 and now follows over 150,000 people in 31 villages


(2) HIV/NCD Survey - The Hanakekela Study is a nested cross-sectional survey conducted in 2010-2011. It surveyed 5,080 individuals, of whom 2,080 are aged 40 – 93. The study team collected HIV and Non-Communicable Disease biometric data, and included a behavioral survey on sexual behavior and other health practices.


The Izindaba za Badala Study – a longitudinal qualitative study conducted in two waves including:


3) IZB Life History Interviews

2013: 60 nested life history interviews with people with and without HIV aged 40-84 who participated in the Hanakekela Study

2018: 25 in-depth follow-up interviews


(4) IZB Community Focus Group Interviews

2013: 9 community focus group interviews with a total of 77 respondents

2018: 10 community focus group interviews with a total of 84 participants


(5) IZB Key informant Interviews:

2013: 9 health workers interviews in 3 local health clinics.

2020: cancelled due to Covid-19 epidemic.



Ethical approvals:

The project received IRB approvals from the University of Colorado Boulder, the University of Michigan, Princeton University, the University of Witwatersrand Human Research Ethics Committee, and the Department of Health, Mpumalanga Provincial Government, South Africa.