This study proposes to (i) Characterize HIV-related and -unrelated risk factors for cardiopulmonary non-communicable diseases in a novel Rural-to-Urban (R2U) African cohort; (ii) Characterize the impact of air pollution and moderating effects of HIV on cardiopulmonary outcomes among R2U migrants; and, (iii) Assess HIV and cardiopulmonary non-communicable diseases (CP- NCDs) health services utilization patterns among R2U migrants. To our knowledge, this would be the first population-based, longitudinal cohort study of the HIV, CP-NCDs, and urbanization syndemic in Africa. Our unique ability to leverage a rural-to-urban cohort, the excellent research infrastructure, and novel Aims will generate vital data needed for designing new research, interventions, and policies to combat the evolving HIV and CP-NCDs epidemic.