Introducing the WHO ICOPE approach into HIV care: A perspective on healthy ageing in people living with HIV

Giovanni Guaraldi; Jovana Milic; Licia Gozzi; Severino Ambrosio; Elisabetta Delmonte; Irene Avanzini; Barbara Castelnuovo; Cristina Mussini

doi:10.1016/j.jarlif.2025.100047

Introducing the WHO ICOPE approach into HIV care: A perspective on healthy ageing in people living with HIV

JAR Life. 2025 Dec 31:15:100047. doi: 10.1016/j.jarlif.2025.100047. eCollection 2026.

Authors

Giovanni Guaraldi¹, Jovana Milic¹, Licia Gozzi¹, Severino Ambrosio¹, Elisabetta Delmonte¹, Irene Avanzini¹, Barbara Castelnuovo², Cristina Mussini¹

Affiliations

¹ University of Modena and Reggio Emilia, Italy.
² The Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda.

Abstract

Background: The ageing of people living with HIV (PWH) presents unique clinical and public health challenges that are not fully addressed by current care models.

Objective: This Perspective paper aims to explore the feasibility and added value of introducing the World Health Organization (WHO) Integrated Care for Older People (ICOPE) framework and guidelines into HIV care models, using the lens of intrinsic capacity (IC) and functional ability to reframe how age-related conditions are managed. In particular, we discuss how HIV services can adopt intrinsic capacity (IC) assessments and function-centered care as a scalable strategy to promote healthy ageing.

Methods: This is a narrative and conceptual Perspective based on literature review, expert consultation, and clinical case examples, including the Modena HIV Metabolic Clinic and experiences from resource-limited settings.

Results: The ICOPE approach offers a feasible, person-centred framework for identifying and managing early declines of IC across six domains. ICOPE facilitates timely interventions at the primary health care level. HIV care services and systems, already oriented towards longitudinal and multidisciplinary management, are uniquely positioned to pioneer ICOPE implementation.

Conclusion: HIV medicine may serve as a model for expanding the integration of the ICOPE approach across chronic diseases, especially in low-resource settings where primary care structures must address age-related vulnerability. Adopting ICOPE can promote healthy ageing in PWH and beyond.

Keywords: Frailty; HIV; Healthy ageing; ICOPE; Intrinsic capacity.