Jacques Normand, Ph.D. Director, AIDS Research Program NIDA

1. Jacques Normand, Ph.D.
Director, AIDS Research Program
NIDA
The Johns Hopkins University
Baltimore, Maryland
November 5, 2014

2. Objectives
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3. 3
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

4. 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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5. 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.

6. OAR Priority Report (June, 2014)
• Prevention
Vaccines, 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 Science
System Bio, Animal models
• Behavioral & Social Sciences
Innovative methods, comparative
effectiveness
• Implementation Science
Access, uptake, retention, scale-up,
Sustainability
• Training, infrastructure, and
Capacity-building
• Information Dissemination

7. Managing NIH HIV/AIDS Program
Proactively
• 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

8. 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

9. 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 & Tx
Adherence & For Substance Abusing Populations with HIV PA (R01,R34)
 HIV, Drugs, & Vulnerable Pop PA (R21, R01)
 AVENIR (AIDS) RFA (DP2)

10. 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

11. 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)

12. 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

13. 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)

14. 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

15. 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

16. • 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)

17. 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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