Comprehensive Alcohol-HIV/AIDS Research Center (P60 Clinical Trial Optional) Re-issue
Kendal Bryant, Ph.D.
September 07, 2023
Purpose
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) supports a broad-based Alcohol Research Centers program to foster and conduct interdisciplinary, collaborative research on the effects of varied patterns of alcohol use and associated alcohol use disorders and the broad impact of alcohol on health and disease at the individual, group, and societal levels. This NOFO uses the NIH Comprehensive Research Center (P60) mechanism to support research center grants to conduct a range of basic and behavioral cross-cutting, intervention, and translational research in alcohol and HIV/AIDS.
Background
NIAAA seeks applications aimed to address the impact of alcohol use on the most important challenges for ending HIV/AIDS pandemic. These priority areas include: 1) Reducing incidence of HIV/AIDS including testing vaccine efficacy and delivery of effective infection preventive interventions; 2) Developing and testing the next generation of HIV therapies among alcohol and other substance users; 3) Research toward a cure – and an increased understanding of viral reservoirs and viral dynamics influenced by different patterns of alcohol use; 4) Addressing the impact of comorbidities, coinfections, and complications (including alcohol-related comorbidities such as depression, anxiety, pain, trauma, other substances, and potentially interactive medications) in the context of an aging population of individuals living with HIV; 5) cross-cutting integrative areas of basic biological and behavioral research on fundamental issues that underpin the development of high priority HIV prevention and treatment strategies; 6) research to reduce health disparities, and research training of workforce required to conduct high priority HIV/AIDS and alcohol related research. Of particular importance is the training of early-stage investigators.
Scope/Objectives
Given the significant overlap between alcohol use-associated susceptibility of infections and chronic conditions in multiple organ/systems and HIV-related comorbid conditions, research topics for the center core components may advance cross-cutting research ( https://www.oar.nih.gov/hiv-policy-and-research/research-priorities-overview/cross-cutting-research).
Basic/mechanistic studies identified as cross-cutting research are to provide the underlying foundation for all HIV research areas and include studies on HIV virology; acquisition, transmission, and susceptibility; and investigations of HIV-related immunology and host-viral interactions. Research on the viral, cellular, molecular, genetic, and immune mechanisms of pathogenesis is essential to better understand HIV acquisition, prevention, and disease progression, and the mechanisms leading to the pathogenesis of HIV-associated comorbidities, coinfections, and complications and a potential cure. Efforts must be made to ensure linkages to NIH-supported HIV cohorts, biorepositories, and other relevant databases and to potentially integrate animal studies into the discovery pipeline.
Additional Special Areas of Interest have been identified through discussions with communities of people with HIV/AIDS, practitioners, and organizational researchers. These high priority areas of research may augment other cross-cutting activities. The Office of AIDS Research (OAR) has identified several areas of particular interest that should also be considered in the context of the Comprehensive Center research activities. In response to the input received from Listening Sessions held from August 2021 through December 2022, OAR will continue to expand the efforts of multiple existing “Signature Programs” that foster collaborative research that are relevant to PWH who drink alcohol. Within each of these areas a range of alcohol-related issues could be addressed. These Programs include 1) HIV and Aging, 2) HIV and Women, and 3) Application of New Technologies of Discovery for HIV (primarily focused on biorepositories, biomarkers, and synthetic/systems biology)
Public Health Relevance/Objective: Ending the Epidemic
The U.S. Department of Health and Human Services (HHS) launched the Ending the HIV Epidemic in the U.S. (EHE) initiative in 2019. The initiative aims to reduce new HIV infections in the U.S. by 90% by 2030 by scaling up key HIV prevention and treatment strategies. This ambitious goal to end the HIV epidemic in the United States by 2030 is through the application of nearly four decades of investments in scientific research that have yielded prevention and treatment breakthroughs that now make it possible to control HIV infection. However, the role of alcohol use, and alcohol-related mental health and other substance use problems as well as environmental consequences of alcohol exposure (e.g., homelessness) exist at an individual, group, and societal level. These complex alcohol-related interconnected problems in living continue to impede this ambitious goal to End the Epidemic. Improved alcohol-focused assessment and course of HIV infection, a further understanding of impaired decision making, distribution of alcohol-related services and the implementation of effective HIV and alcohol-focused interventions at multiple levels can facilitate the achievement of EHE goals to substantially reduce new HIV infections.