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ARRA Investments in HIV/AIDS

Public Health Burden
The Centers for Disease Control and Prevention has estimated that approximately 56,300 people were newly infected with HIV in 2006 in the United States1. NIH is committed to investing in research that will result in a decline in the incidence and progression of HIV infection.  Effective interventions are needed to prevent or reduce the transmission of HIV/AIDs.  In addition, new treatment approaches are needed to mitigate the progression of AIDS and its complications.  HIV-associated dementia is a neurological complication of HIV infection. It is most commonly seen in people with advanced cases of AIDS, despite treatment with antiretroviral medications. Symptoms include confusion, memory loss, behavioral changes, hallucinations, movement problems, and mental disorders such as depression and anxiety disorders. Some HIV/AIDS treatments may also cause these symptoms.

Preventing or Reducing the Transmission of HIV/AIDS
Preventing HIV infection is NIH’s highest priority for HIV-related research.  Some ARRA funded grants that address these issues include:
  • A study to develop and test a brief intervention to reduce high risk behaviors among men recently diagnosed with HIV. There are currently no interventions targeted for this population, who are at high risk for transmitting the infection as they adjust their behaviors to knowledge of their HIV status. Intervening shortly after diagnosis may maximize the benefits of changing risk behaviors and reducing HIV transmission.2
  • A multi-site project to evaluate the effectiveness of a mass media campaign directed to urban African American youth in preventing HIV/AIDS. The researchers will also assess the impact of a community-based, small-group training on safe sex skills in this same study population. This study will reveal the combined and separate effects of health messages received from the media versus from peers in promoting safe sex behaviors among teens.3
  • One project to assess the role of social and family networks in HIV risk behaviors among formerly imprisoned Latino men. Latinos are overrepresented in both HIV+ and prison populations, and being in prison is a major risk factor for HIV infection. Understanding this population’s specific needs and acknowledging the importance of social and family networks may lead to improvements in targeted interventions.4
  • Another project to examine the processes involved in implementing a behavioral intervention shown to be effective at reducing sexually transmitted infections at public health clinics and other community-based organizations. In addition to reducing behaviors that may transmit HIV, this study will help other efforts to translate evidence-based interventions into clinical practice.5
Treatment Adherence
Like other chronic diseases, closely following a treatment schedule is important for managing the symptoms of HIV, preventing medication resistance, and reducing use of costly health care services such as hospitalization or urgent care. Treatment adherence is a focus of ARRA funded studies, such as:
  • A randomized clinical trial to test whether automated text message reminders sent to a person’s cell phone may improve adherence to complex medication schedules.6
  • A project to examine the characteristics of multidisciplinary HIV care teams—which may include health care providers specializing in HIV care, nurses, social workers, and others involved providing HIV-related care or services—and how they affect patients’ adherence to highly active antiretroviral therapy  (HAART). Such research may help HIV care clinics to develop optimal service guidelines and measures of treatment outcome.7
  • A study to evaluate the impact of an interactive computerized counseling tool narrated in Spanish on medication and clinic visit adherence and treatment outcomes among Latino patients in an urban HIV clinic. Such patient-centered communication tools may be useful for promoting health practices in other populations and for other diseases as well.8
Addressing HIV-associated Neuropsychiatric Dysfunction
Understanding the biological processes that contribute to HIV-associated dementia can help to inform efforts to develop more effective tools for diagnosis, treatment, and prevention. Some ARRA funded grants with this research goal include:
  • A project to study how the interaction and regulation of molecules secreted by HIV-infected immune cells may create an environment in the brain that contributes to HIV-associated neurological disorders. Greater understanding of these processes may lead to targeted therapies.9
  • Another project to examine how HAART, the recommended treatment strategy for HIV+ patients, may impair cognition due to the toxicity of many medications. In addition to revealing potential targets for reducing or eliminating toxicity, the study may also help in identifying toxicity in future HIV/AIDS medications.10

  1. CDC. HIV Incidence [online]. 2008. Available from URL:
  2. 1R01MH078731-01A2 -- Brief Care-based HIV Prevention for Newly Diagnosed Men -- Sikkema, Kathleen J (NC)
  3. 3U01MH066785-05S2, -- A Multilevel HIV-Prevention Strategy for High-Risk Youth -- Brown, Larry K (RI); 3 U01 MH066794-05S2 -- A Multilevel HIV-Prevention Strategy for High-Risk Youth -- Vanable, Peter A (NY); 3 U01 MH066802-05S1 -- A Multilevel HIV-Prevention Strategy for High-Risk Youth -- Valois, Robert F (SC); 3 U01 MH066807-05S2 -- A Multilevel HIV-Prevention Strategy for High-Risk Youth -- Diclemente, Ralph J (GA); 3 U01 MH066809-05S2 -- A Multilevel HIV-Prevention Strategy for High-Risk Youth -- Romer, Daniel (PA)
  4. 1RC1MH088636-01 -- Network determinants of risk among formerly incarcerated Latino men -- Munoz-Laboy, Miguel A (NY)
  5. 1R01MH085502-01 -- Influences on the translation of an evidence-based HIV/STI intervention into practice -- Dolcini, M. Margaret (OR)
  6. 1RC1MH088341-01 -- Adherence Improvement and Measurement- AIM- System. Challenge Topic 10-MH-101 -- Kahn, James O (CA)
  7. 1R21MH085553-01A1 -- Optimizing Multidisciplinary HIV Care Team for Maximal HAART Adherence -- Horberg, Michael Alan (CA)
  8. 1RC1MH088307-01 -- A Spanish-Language Intervention to Enhance Routine HIV Patient Care Delivery -- Kurth, Ann E (NY)
  9. 1R01MH083516-01 -- Modulation of Cystatins and Cathepsins in HIV-1 Neuropathogenesis -- Melendez, Loyda M (PR)
  10. 1R01MH083517-01 -- Novel Pathways of HAARTmediated Neuronal Toxicity in the Central Nervous System -- Jordan-Sciutto, Kelly L (PA)

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