The Division of AIDS Research (DAR) supports research to reduce the incidence of HIV/AIDS worldwide and to decrease the burden of living with HIV/AIDS. DAR-supported research encompasses a broad range of studies that includes basic and clinical neuroscience of HIV infection to understand and alleviate the consequences of HIV infection of the central nervous system (CNS), and basic and applied behavioral science to prevent new HIV infections and limit morbidity and mortality among those infected. DAR places a high priority on interdisciplinary research across multiple populations, including racial and ethnic minorities, over the lifespan.
The portfolio on the basic neuroscience of HIV infection includes research to: elucidate the mechanisms underlying HIV-induced neuropathogenesis; understand the motor and cognitive impairments that result from HIV infection of the CNS; develop novel treatments to prevent or mitigate the neurobehavioral complications of HIV infection; and, minimize the neurotoxicities induced by long-term use of antiretroviral therapy. Critical approaches to this effort require molecular, cellular, and genetic studies to delineate the pathophysiologic mechanisms that lead to disrupted neuronal function, and to identify potential targets for therapeutic intervention. In addition, eradication of the virus from HIV-infected individuals to achieve a cure or a functional cure is a high priority.
The behavioral science research agenda emphasizes developing and testing behavioral interventions that can be effectively integrated with biomedical approaches to significantly impact the epidemic. The behavioral science agenda targets prevention of both transmission and acquisition of HIV, adherence to intervention components to reduce the burden of disease, and studies that address the behavioral consequences of HIV/AIDS. A strong component of integrating behavioral and biomedical approaches is expanding collaboration with other NIH institutes and federal agencies to leverage resources and broaden the impact of this research.
Areas of High Priority
- Expand approaches to integrate behavioral science with effective biomedical strategies for HIV prevention.
- Advance the development and testing of interventions delivered beyond the individual level, by incorporating appropriate context into intervention development and testing.
- Increase intervention potency and long-term maintenance of effects, with an emphasis on targeting high-risk vulnerable populations.
- Develop strategies to increase HIV-testing and improve linkage to care and timely treatment initiation.
- Develop and test interventions to improve HIV treatment outcomes through optimal treatment adherence and sustained engagement in care.
- Support implementation science and operations research to enhance dissemination strategies and public health impact of effective interventions.
- Examine evolving pathophysiologic mechanisms of HIV-associated neurocognitive disorders (HAND) in the setting of long-term antiretroviral therapy, and development of novel therapeutic approaches to mitigate CNS complications of HIV infection.
- Support the use of state-of-the-art genetic approaches to identify and validate viral and host genetic factors that influence the pathophysiology of HAND.
- Define and characterize HIV persistence in the CNS in the context of suppressive highly active antiretroviral therapy, and foster translational research to enable therapeutic eradication of HIV-1 from the brain.
Dianne M. Rausch, Ph.D.
5601 Fishers Lane, Room 8D20
Rockville, MD 20852