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Jacques Normand, Ph.D. 
Director, AIDS Research Program 
NIDA 
The Johns Hopkins University 
Baltimore, Maryland 
November 5, 2014
Objectives 
2
3 
NIDA HIV/AIDS FY13 Program Profile 
17% 
16% 
1% 
3% 4% 2% 
55% 
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 
4
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) 
• 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
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
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 & Tx 
Adherence & 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
Enhancing Seek, Test, Treat, & Retain Strategies for 
Substance Using Adolescents and Young Adults 
• 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. 
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 
17
18 
WWW.DRUGABUSE.GOV/AIDS

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NIDA's AIDS Research Program

  • 1. Jacques Normand, Ph.D. Director, AIDS Research Program NIDA The Johns Hopkins University Baltimore, Maryland November 5, 2014
  • 3. 3 NIDA HIV/AIDS FY13 Program Profile 17% 16% 1% 3% 4% 2% 55% 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 4
  • 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. Enhancing Seek, Test, Treat, & Retain Strategies for Substance Using Adolescents and Young Adults • 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. 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 17