Kendall Bryant, Ph.D., Office of the Director, NIAAA

Purpose

This NIAAA-led NOFO calls for research proposals supported by the research grant mechanisms R01 and associated announcement R34 for intervention development. The NOFO seeks to expand the HIV/AIDS prevention toolkit among alcohol impacted populations with a range of patterns of episodic and long-term use and associated behavioral and biological risks for HIV acquisition. This includes integration of effective prevention and treatment interventions with an understanding of the overarching framework for reducing the incidence of new infections by facilitating cross-cutting informative research. The purpose is for the development of new interventions and implementation of these integrative preventive activities in diverse settings and populations.

Background

Patterns of alcohol use including Alcohol Use Disorders present clear barriers for diverse plans for ending the HIV pandemic in both domestic and international settings.  Advances in the HIV and alcohol research field include the development of new medications (including long-acting injectable medications) and behavioral strategies to prevent HIV transmission, reduce susceptibility to infection, and control alcohol use. In addition, new intervention designs (e.g., stepped care, multicomponent) have made it possible to develop and integrate new combinations of interventions into ongoing HIV efforts. It is estimated that these interventions can substantially reduce the incidence of new HIV infections in both domestic and international settings by 10-20% or more in at-risk with alcohol and alcohol-related cofactors (e.g., depression, anxiety, pain, other substance use).

Scope/Research Objective

Multiple areas for potential research collaboration and integration of the HIV prevention care continuum are identified. These include (but are not limited to) both ongoing and expanding activities related to the impact of alcohol on:

1. Pre-exposure Prophylaxis (PrEP) - ongoing
2. Treatment as Prevention (TasP) - ongoing
3. Combination and Adaptive Interventions – ongoing
4. Cross-cutting and Translational Pre-Intervention - expanding
5. Syndemic and Health Disparities Outcomes - expanding
6. Implementation and Operations – expanding

Summary

• Develop, test, and combine interventions to achieve NIH-CDC 2030 Ending the Epidemic targets
• Improve identification of “at-risk” individuals with measurable complex patterns of drinking in the context of comorbidities, situations, and settings
• Integrate alcohol and alcohol-related measurement into targeted cohorts, consortia, and community settings (at multiple levels) and improvement of analytic strategies
• Promote ending the epidemic and bridging research and implementation gaps through dissemination of information and training of a new generation of researchers

Justification

NIAAA HIV/AIDS research activities have been supported by NIH/OD, Office of AIDS Research, through the NIH Strategic Plan for HIV and HIV-Related Research FY2021-2025 and is relevant to other institute and agency national and international plans coordinated through Health and Human Services and other NIH institutes. This NOFO will balance NIAAA’s portfolio and complement other ongoing activities focused on the treatment of People Living with HIV/AIDS (PLWH) who may have additional Comorbidities, Coinfections, and Complications (CCC). These activities are currently funded under Cooperative Agreement (CHAART Consortiums) and Program Projects mechanisms.  In addition, this NOFO can be responsive to overall goal of the Office of Infectious Disease and HIV/AIDS Policy to reduce the incidence of new infections by 90% by 2030 in the U.S.

Diversity

The HIV Prevention and Alcohol Program at NIAAA is expected to engage a diverse group of scientists in biomedical research, which includes but is not limited to participation of individuals from underrepresented backgrounds (i.e. racial and ethnic minorities, persons with disabilities, or persons from disadvantaged backgrounds), women, early-stage and experienced investigators with a track record of funding, and investigators from various disciplines/departments and specialties. NOT OD 20-031 (Notice of NIH's Interest in Diversity).