Jacques Normand, Ph.D.

Director, AIDS Research ProgramNIDA

The Johns Hopkins UniversityBaltimore, MarylandNovember 5, 2014

Objectives

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NIDA HIV/AIDS FY13 Program Profile

17%

16%

1%

55%

3% 4% 2%

Behavioral and Social Science

Natural History & Epidemiology

Etiology & Pathogenesis

Vaccines

Therapeutics

Training Other

NIDA HIV/AIDS Budget by Research Area

Natural History and Epidemiology-------------- $44M

Etiology and Pathogenesis----------------------- $41M

Microbicides----------------------------------------- $0

Vaccines---------------------------------------------- $4M

Behavioral and Social Science----------------- $188M

Therapeutics----------------------------------------- $8M

Training, Infrastructure, and

Capacity Building------------------------------ $13M

Information Dissemination----------------------- $2M

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On Nov. 2013, Dr. Collins charge to OAR’s Advisory Council “Produce a report that outlines the highest

priority AIDS research in 3 areas”

• Prevention - including vaccines, microbicides, ARV-based prevention, behavioral research focused on risk reduction, stigma, and adherence

• Treatment - including advances in therapeutic interventions and research toward a cure

• Co-morbidities - neurologic, cardiovascular, oncologic, and accelerated aging

The document should also identify priorities that cut across the above mentioned areas with regard to basic science, training, and information dissemination.

OAR Priority Report (June, 2014)

• PreventionVaccines, microbicides, PrEP,

Integrated Strategies (combination)

• Treatment: Anti-retroviral Therapy

More efficient Tx

• The Prevention and Care Continua

STTR

• Cure Animal models, latency, reservoirs

• Co-infection, Co-morbidities, &complications TB, HCV, cardio, kidney,

neuro, & aging (in presence of HIV)

• Basic ScienceSystem Bio, Animal models

• Behavioral & Social Sciences Innovative methods, comparative

effectiveness

• Implementation ScienceAccess, uptake, retention, scale-up,

Sustainability

• Training, infrastructure, and Capacity-building

• Information Dissemination

Managing NIH HIV/AIDS ProgramProactively

• OAR approval of all FOAs

• Review of HIV/AIDS relatedness of Applications (CSR)

• Develop Trans-NIH definition of what is HIV/AIDS research

• Develop trans-NIH policy for proportional funding (Prorate)

Next step: Portfolio review to identify low priority grants

FY15 & FY16 Priorities

Promoting Retention in HIV Care

HIV Prevention in Vulnerable Populations in the U.S.—Emphasis on youth, the Homeless and Black/African American Women and Young Black/African American Men

Developing Comprehensive Interventions for Substance Using MSM

Implementation Science Research

Transformative Research

Prevention and Treatment of HCV in those with and at Risk for HIV

Enhancing Treatment as Prevention through Use of Incentives and Technology

Training, Infrastructure, and Capacity Building

FY15 Initiatives

Avant-Garde RFA (DP1)

A-START PAR (R03/$100K)

NIDA/ANRS Fellowship ($75K)

Advancing exceptional HIV/AIDS Research RFA (R01)

Extracellular Vesicles in HIV/AIDS and Substance Abuse RFA (R21, R01)

NIDA Drug Abuse and HIV Cohorts PAR (U01)

Technology-Based Interventions to Promote Engagement in Care & TxAdherence & For Substance Abusing Populations with HIV PA (R01,R34)

HIV, Drugs, & Vulnerable Pop PA (R21, R01)

AVENIR (AIDS) RFA (DP2)

FY15 Initiatives (Cont.)

Substance Use & Abuse, Risky Decision Making & HIV/AIDS PA (R03, R21, R01)

Centers for AIDS Research & Developmental Centers for AIDS Research PA (P30)

Drug Abuse Aspects of HIV/AIDS PA (R03, R21, R01)

Prevention & Tx of HCV in Those with and at Risk for HIV PAR (R21, R01, R34)

Long-Term Retention in Care for US Substance Using Pops PA (R01, R21, R34)

International Research Collaboration on Drug Abuse & Addiction Research (R21, R01)

Development and Testing of Novel Interventions to Improve HIV Prevention, Care, and Program Implementation PA (R34)

Note: NIDA has also joined many other ICS’ FOAs

FY16 Initiatives

Avant-Garde RFA (DP1)

A-START PAR (R03/$100K)

NIDA/ANRS Fellowship ($75K)

Advancing exceptional HIV/AIDS Research RFA (R01)

AVENIR (AIDS) RFA (DP2)

Substance Use & Abuse, Risky Decision Making & HIV/AIDS PA (R03, R21, R01)

Centers for AIDS Research & Developmental Centers for AIDS Research PA (P30)

FY16 Initiatives (Cont.)

Drug Abuse Aspects of HIV/AIDS PA (R03, R21, R01)

Prevention & Tx of HCV in Those with and at Risk for HIV PAR (R21, R01, R34)

Long-Term Retention in Care for US Substance Using Pops PA (R01, R21, R34)

International Research Collaboration on Drug Abuse & Addiction Research (R21, R01)

Development and Testing of Novel Interventions to Improve HIV Prevention, Care, and Program Implementation PA (R34)

Note: NIDA has also joined many other ICS’ FOAs

New FY16 Initiatives

Role of Polysubstance use in HIV Cure/Remission Research: Novel Approaches RFA (R03, R21, R01)

Integration of Infectious Diseases and Substance Abuse Treatment for HIV Positive Patients RFA (R01 & R34)

Enhancing Seek, Test, Treat, & Retain Strategies for Substance Using Adolescents and Young Adults RFA (R01)

Role of Polysubstance use in HIV

Cure/Remission Research: Novel Approaches

• Goals: Provide basic/clinical research

evidence on specific role of polySU that

may be most critical in HIV pathophysiology

• NIH Towards the cure—emphasis on virus

in primary peripheral sites (CD4+ and other

immune cells)

• This RFA will emphasize two critical areas:

– 1) Towards a cure in brain (in vivo

emphasis with in vitro components)

– 2) Towards a cure in substance using

populations (periphery)

• Critical research on reservoirs within

macrophage, microglia, and astrocytes

Integration of Infectious Diseases and

Substance Abuse Treatment for HIV Positive

Patients

Goals To develop and evaluate comprehensive integrated treatment

services for HIV and co-infections among substance abusers

Support implementation research to determine how to best provide comprehensive, integrated effective preventive and treatment interventions that are scalable, sustainable, and cost-effective in diverse populations

Note: This initiative can provide data on the beneficial health effects of drug treatment on other than HIV outcomes

• Target US youth age 14-25

• Prioritize intervention studies that recruit highest risk youth & address developmental, legal and service delivery issues

– Lead to improvements in serostatus knowledge, linkage to care/retention, & achievement of undetectable viral loads.

Enhancing Seek, Test, Treat, & Retain Strategies for Substance Using Adolescents and Young Adults

Estimated Cascade of Care among HIV+ Youth in the US (age 13-29)

Topics Under Consideration

Cascade of Care Retention Gap

Combination HIV Prevention Strategy

Alcohol, drug abuse, and HIV Functional collaboration with NIAAA

STTR/TasP

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