>> GOOD AFTERNOON, EVERYONE.
WE WILL NOW BEGIN OUR MEETING.
THANK YOU TO EVERYONE ON THE YO.
SO GOOD AFTERNOON.
AS YOU KNOW, MY NAME IS MARY
GLENSHAW, THE DESIGNATED FEDERAL
OFFICIAL OF THE OFFICE OF AIDS
RESEARCH ADVISORY COUNCIL.
WELL KOL AND THANK YOU AGAIN FOR
BEING HERE TODAY.
OUR COUNCIL IS GOVERNED BY THE
FEDERAL ADVISORY COMMITTEE ACT
AS AMENDED WHICH SETS FORTH
STANDARDS FOR THE FORMATION AND
USE OF ADVISORY COMMITTEES.
MY ROLE IS TO PREPARE MEETINGS,
ORGANIZE, ATTEND AND APPROVE ALL
COUNCIL AND SUBCOMMITTEE
MEETINGS.
I WILL ADJOURN ANY MEETING WHEN
IT'S DETERMINED TO BE IN THE
PUBLIC INTEREST, AND I'LL CHAIR
MEETINGS WHEN DIRECTED BY THE
OAR OR NIH DIRECTOR.
MS. CORETTA BYRD, WHO YOU ALL
ARE MEETING IN PERSON TODAY,
WILL FULFILL THESE DUTIES IN THE
EVENT THAT I'M ABSENT.
SO SOME GUIDELINES FOR TODAY.
FOLKS ON THE CALL AND IN PERSON,
PLEASE STAY MUTED UNLESS YOU'RE
SPEAKING.
FOR PEOPLE ON ZOOM, PLEASE KEEP
YOUR CAMERA ON FOR MOST OF THE
MEETING.
YOU CAN HIDE IF YOU NEED TO
LEAVE MOMENTARILY.
AND THEN PLEASE TURN IT BACK ON
WHEN YOU RETURN.
TO PARTICIPATE IN DISCUSSIONS,
WE WILL FACILITATE TWO SORT OF
ROUNDS OF DISCUSSION.
DR. TURNBULL WILL FACILITATE THE
ZOOM DISCUSSIONS AND I WILL
FACILITATE THE IN-PERSON
DISCUSSIONS AND WE'LL HAND OFF
TO AVOID SPEAKING OVER EACH
OTHER.
FOLKS ON THE ZOOM CALL, IF YOU
COULD PLEASE SEND MESSAGES
THROUGH ZOOM CHAT FOR THE
MEETING HOSTS ONLY, THAT WOULD
BE APPRECIATED.
IF YOU HAVE ANY CONCERNS, PLEASE
SEND ME AN EMAIL.
PLEASE REMEMBER THAT THIS IS
BEING VIDEOCAST LIVE AND IF
YOU'D LIKE TO SEE THE CLOSED
CAPTION FOR THE MEETING, PLEASE
CLICK ON THE CC ICON ON THE
BOTTOM RIGHT-HAND CORNER OF THE
VIDEOCAST SCREEN.
FOR OUR VOTING MEMBERS I'D LIKE
TO REMIND YOU OF OUR POLICIES
REGARDING CONFLICT OF INTEREST.
COUNCCOUNCILMEMBERS MAY NOT
PARTICIPATE IN THE REVIEW OR
DISCUSSION OF A SPECIFIC PROGRAM
OR PROJECT FOR WHICH THEY HAVE A
REAL OR APPARENT CONFLICT OF
INTEREST.
IF A PROGRAM OR PROJECT IS
DISCUSSED THAT PRESENTS A
CONFLICT FOR YOU, PLEASE EXCUSE
YOURSELF FROM THE MEETING.
TO DO THIS ON ZOOM, PLEASE
SIGNAL US AND WE WILL MOVE YOU
TO A PRIVATE ROOM.
IF THIS OCCURS IN PERSON, PLEASE
STEP OUT OF THE ROOM.
AND PLEASE RETURN WHEN THE
CONFLICT -- THE CONVERSATION
ABOUT THE CONFLICT IS OVER.
AFTER THE MEETING, KINDLY SIGN
THE CONFLICT OF INTEREST FORM
THAT WILL BE EMAILED TO YOU OR
WILL BE HANDED TO YOU HERE IN
PERSON.
AND I THINK THAT TAKES CARE OF
ALL THE HOUSEKEEPING ISSUES.
ARE THERE ANY CONFLICTS OF
INTEREST ANTICIPATED TODAY FOR
ANY OF YOU?
OKAY, GREAT.
SO THIS MEETING IS OPEN TO THE
GENERAL PUBLIC.
WE ACCEPT PUBLIC COMMENTS, AND
WE ARE NOW LIVE AND BEING
RECORDED.
I'LL TURN THE MEETING OVER TO
OUR CHAIR, DR. IVY TURNBULL.
DR. TURNBULL HAS BEEN A MEMBER
OF THE OARAC SINCE 2020, AND
THIS IS HER FIRST MEETING AS
CHAIR.
DR. TURNBULL, IF YOU COULD
KINDLY NOW BRING THE MEETING TO
ORDER.
THANK YOU.
>> THANK YOU, CAPTAIN GLENSHAW,
AND GOOD AFTERNOON, EVERYONE.
THE 63RD MEETING OF THE OFFICE
OF AIDS RESEARCH ADVISORY
COUNCIL IS NOW IN SESSION.
WELCOME, COUNCILMEMBERS, INVITED
SPEAKERS, NIH COLLEAGUES, AND
GUESTS.
COLLEAGUES, WE WILL NOW CONDUCT
ROLL CALL.
WHEN I CALL YOUR NAME, PLEASE
STATE YOUR POSITION AND
INSTITUTIONAL AFFILIATION.
STARTING WITH OARAC VOTING
MEMBERS.
DR. KATHLEEN COLLINS.
>> SORRY, TOOK ME A MINUTE TO
UNMUTE.
MY NAME IS KATHY COLLINS.
I AM PROFESSOR OF INTERNAL
MEDICINE AT THE UNIVERSITY OF
MICHIGAN, AND I RUN A RESEARCH
LAB THAT STUDIES HIV
PERSISTENCE.
I ALSO AM THE DIRECTOR OF THE
MICP AND ASSOCIATE DEAN OF
PHYSICIAN SCIENTIST EDUCATION
AND TRAINING.
>> DR. OMAR GALARRAGA.
>> GOOD MORNING.
I'M ASSOCIATE PROFESSOR AT THE
BROWN UNIVERSITY SCHOOL OF
PUBLIC HEALTH.
I'M ALSO THE DIRECTOR OF THE HSR
PH.D. PROGRAM AND MY RESEARCH IS
IN ECONOMIC ASPECTS OF HIV
PREVENTION AND TREATMENT WITH
PROJECTS IN MEXICO, SOUTH
AFRICA, KENYA, AND THE U.S.
HAPPY TO BE HERE.
THANK YOU.
>> DR. LUIS MO NTANER.
>> PROFESSOR AT THE WISTAR
INSTITUTE.
INTERNATIONAL CLINICAL TRIALS.
>> DR. MOJGAN NAGHAVI.
I GO BY MOJ.
I'M AT NORTHWESTERN UNIVERSITY
DEPARTMENT OF
MICROBIOLOGY-IMMUNOLOGY.
MY RESEARCH FOCUSES ON HIV HOST
IINTRACTION WITH A FOCUS ON HIV
TRAFFICS WITHIN INFECTED CELLS.
>> DR. ANNE NEILAN.
>> GOOD AFTERNOON.
MY NAME IS ANNE NEILAN.
I AM AN INFECTIOUS DISEASES
PHYSICIAN AT MASS GENERAL
HOSPITAL AND AN ASSISTANT
PROFESSOR OF PEDIATRICS AND OF
MEDICINE AT HARVARD MEDICAL
SCHOOL, AND MY CLINICAL AND
RESEARCH INTERESTS FOCUS ON ADD
LE SEPTADOLESCENTS USING
COST-EFFECTIVENESS ANALYSIS AND
SIMULATION MODELING.
THANK YOU.
>> DR. JOHN SLEASMAN.
>> HI, PROFESSOR AND CHIEF OF
THE DIVISION OF ALLERGY AND
IMMUNOLOGY AT DUKE UNIVERSITY.
MY RESEARCH IS FOCUSED IN HIV
PATHOGENESIS IN CHILDREN AND
ADOLESCENTS.
>> OARAC EX-OFFICIOS.
COLONEL JULIE AKE.
>> I'M JULIE AKE, INFECTIOUS
DISEASES PHYSICIAN, AND I DIRECT
THE U.S. MILITARY HIV RESEARCH
PROGRAM, WHICH IS AT THE WALTER
REED ARMY INSTITUTE OF RESEARCH.
>> DR. ROBERT EISINGER.
>> HE'LL BE JOINING LATER.
THANKS.
>> OKAY.
DR. VICTORIA DAVEY.
>> HI, I'M VICKY DAVEY WITH THE
U.S. DEPARTMENT OF VETERANS
AFFAIRS, INFECTIOUS DISEASES
EPIDEMIOLOGY.
THANK YOU.
>> DR. CARL DIEFFENBACH.
>> HI, EVERYBODY.
I'M CARL DIEFFENBACH, DIRECTOR
OF THE DIVISION OF AIDS IN
NIAID.
>> DR. ROHAN HAZRA.
>> GOOD AFTERNOON.
I'M ROHAN HAZRA.
I'M A PEDIATRIC INFECTIOUS
DISEASE PHYSICIAN BY TRAINING
AND THE DIRECTOR OF THE DIVISION
OF EXTRAMURAL RESEARCH AT NICHD,
THE CHILD HEALTH INSTITUTE, HERE
AT NIH.
>> REAR ADMIRAL JONATHAN MI MER.
>> HE CAN'T JOIN US TODAY.
>> DR. FRANCIS ALI-OSMAN.
>> I WORK ON BRAIN TUMOR THERAPY
AND MECHANISMS OF RESISTANCE.
I'M REPRESENTING THE NATIONAL
CANCER ADVISORY BOARD.
>> DR. MONICA GANDHI.
>> HI, MY NAME IS DR. MONICA
GANDHI.
I AM PROFESSOR OF MEDICINE AND
THE DIRECTOR OF THE UCSF CENTER
FOR AIDS RESEARCH AT UCSF, AND I
AM HERE AS EX-OFFICIO FROM ARAC.
THANK YOU.
>> DR. MELANIE OTT.
>> GOOD MORNING, EVERYBODY.
MY NAME IS MELANIE OTT.
I'M DIRECTING THE GLADSTONE
INSTITUTE OF VIROLOGY.
I'M ALSO PROFESSOR OF MEDICINE
AT UCSF.
MY RESEARCH IS FOCUSED ON HIV
CURE AND I'M REPRESENTING NIDA.
THANK YOU.
>> OARAC LEADERSHIP AND
SPEAKERS.
DR. BILL KAPOGIANNIS.
>> GOOD MORNING, EVERYONE, AND
WELCOME.
BILL KAPOGIANNIS.
I'M AN ADULT AND PEDIATRIC
INFECTIOUS DISEASE PHYSICIAN BY
TRAINING, AND NOW CURRENTLY THE
ACTING DIRECTOR OF THE NIH
OFFICE OF AIDS RESEARCH.
>> REAR ADMIRAL TIMOTHY HOLTZ.
>> MY NAME IS TIMOTHY HOLTZ,
INTERNIST AND INFECTIOUS DISEASE
EPIDEMIOLOGIST AND DEPUTY
DIRECTOR OF OAR.
>> CAPTAIN MARY GLENSHAW.
>> GOOD MORNING, EVERYONE.
MARY GLENSHAW.
I'M AN EPIDEMIOLOGIST BY
TRAINING AND SENIOR SCIENCE
ADVISOR AT THE OAR.
THANKS.
>> MISS RAHEL ABEBE.
>> RAHEL, YOU'RE ON MUTE.
>> GOOD AFTERNOON, EVERYONE.
MY NAME IS RAHEL ABEBE.
I'M A PUBLIC HEALTH ANALYST IN
OAR.
THANK YOU.
>> DR. GEETANJALI BONSAL.
>> GOOD AFTERNOON, EVERYONE.
SENIOR SCIENCE ADVISOR AND
HEALTH SCIENCE ADMINISTRATOR
HERE AT OFFICE OF AIDS
RESEARCHMENT
>> DR. ELIZABETH BARR.
>> HI, I'M ELIZABETH BARR.
I'M A SOCIAL SCIENCE -- SOCIAL
SCIENTIST AT THE OFFICE OF
RESEARCH ON WOMEN'S HEALTH.
MY BACKGROUND IS IN
COMMUNITY-LED HIV TREATMENT
RESEARCH
>> MISS CORETTA BYRD.
>> GOOD MORNING AND GOOD
AFTERNOON.
MY NAME IS CORETTA BYRD.
I'M A HEALTH SCIENTIST POLICY
ANALYST AT THE OFFICE OF AIDS
RESEARCH.
THANK YOU.
>> DR. JANINE CLAYTON.
>> GOOD AFTERNOON, EVERYONE.
I'M JANINE CLAYTON, THE NIH
ASSOCIATE DIRECTOR FOR RESEARCH
ON WOMEN'S HEALTH AND IN THAT
CAPACITY, I AM ALSO THE DIRECTOR
OF THE OFFICE OF RESEARCH ON
WOMEN'S HEALTH.
THANK YOU.
>> MR. ROBERT CRAIG.
>> GOOD AFTERNOON.
MY NAME IS ROBERT CRAIG, I OOM A
HEALTH SCIENTIST IN THE OFFICE
OF AIDS RESEARCH AND LEAD THE
ANALYTICS TEAM FOR OAR.
>> DR. SEBLE KASSAYE.
>> INFECTIOUS DISEASE PHYSICIAN
AT GEORGETOWN UNIVERSITY,
EPIDEMIOLOGIST ALSO BY TRAINING
AND I WORK WITH COHORTS LOOKING
AT LONG TERM OUTCOMES AMONG
PEOPLE WITH HIV.
>> DR. LESLIE MARSHALL.
>> GOOD AFTERNOON.
I'M LESLIE MARSHALL, AND I'M
SENIOR SCIENCE ADVISOR ON THE
SCIENCE TEAM AT THE NIH OAR, AND
I'M A MOLECULAR VIROLOGIST BY
TRAINING.
>> DR. DIANNE ROUSH.
>> I'M DIANNE ROUSH, DIRECTOR OF
THE DIVISION OF AIDS RESEARCH AT
NIMH.
I AM HERE FOR MARGUERITA
LIGHTFOOT, OUR NIMH
REPRESENTATIVE ON OUR COUNCIL
WHO COULDN'T MAKE IT, SO I'M
GOING TO PRESENT FOR HER.
THANK YOU.
>> LASTLY, OUR INVITED GUESTS,
SOME OF WHOM MAY JOIN THE
MEETING LATER.
>> ACTUALLY DR. TURNBULL?
>> YES.
>> I BELIEVE ALL OF OUR GUESTS
WILL BE JOINING LATER.
>> OH, OKAY.
ALL RIGHT.
THANK YOU, DR. GLENSHAW, FOR THE
CLARIFICATION.
WE HAVE DR. HENRY MASUR, AND DR.
IS THERE ANYONE I DID NOT
ANNOUNCE?
OKAY.
THANK YOU THEN, EVERYONE.
AS A REMINDER, PER OUR CHARTER
AND LEGISLATION, THE OARAC
ADVISES THE OAR DIRECTOR ON
BROAD MATTERS RELATING TO HIV
RESEARCH POLICIES, PRIORITIES
AND EXTRA TEE JEJ PLANNING.
INCLUDING THE REVIEW OF NIH
HIV/AIDS PROGRAMS.
I WILL NOW PROVIDE A BRIEF
OVERVIEW OF TODAY'S AGENDA,
WHICH WILL INCLUDE A REPORT FROM
THE OAR DIRECTOR, A PRESENTATION
FROM THE DIRECTOR OF THE NIH
OFFICE OF RESEARCH ON WOMEN'S
HEALTH, AN UP TATE UPDATE ON THV
AND WOMEN'S SIGNATURE PROGRAM, A
PRESENTATION FROM ONE OF THE
PDIs OF THE NATIONAL MACS WHIS
COMBINED COHORT STUDY AND THE
STAR COHORT, AN UPDATE ON THE
NIH HIV AND AGING AND EARLY
CAREER INVESTIGATOR SIGNATURE
PROGRAMS, A PRESENTATION ON THE
NEW NIH OAR DATA HUB, UPDATES
FROM NIH ADVISORY COUNCILS, AND
FINALLY, UPDATES FROM THE OARAC
HIV CLINICAL GUIDELINES WORKING
GROUPS.
THE AGENDA ALSO INCLUDES TIME
FOR REGISTERED COMMENTS.
ANYONE LISTENING TODAY WH WHO
WISHES TO MAKE A PUBLIC COMMENT
SHOULD EMAIL CAPTAIN GLENSHAW AT
OARACINFO@NIH.GOV.
WITH YOUR NAME, AFFILIATION, AND
QUESTION OR COMMENTS.
PLEASE VISIT THE NIH OAR WEBSITE
OR THE FEDERAL REGISTER NOTICE
FOR MORE DETAILS.
NOW, I WILL INTRODUCE DR. BILL
KAPOGIANNIS.
BILL JOINED OAR AND IS SERVING
AS THE ACTING NIH ASSOCIATE
DIRECTOR IN AIDS RESEARCH AND
ACTING DIRECTOR OF OAR, WHILE A
NATIONAL SEARCH FOR A NEW
DIRECTOR IS CONDUCTED.
IN THIS ROLE, HE LEADS OAR IN
COORDINATING THE NIH HIV AGENDA
TO END HIV PANDEMIC AND IMPROVE
HEALTH OF PEOPLE WITH HIV.
PRIOR TO JOINING OAR, DR
DR. KAPOGIANNIS SERVED AT THE
EUNICE KENNEDY SHRIVER NATIONAL
INSTITUTE OF CHILD HEALTH AND
HUMAN DEVELOPMENT.
WHERE HE LED SEVERAL DOMESTIC
AND INTERNATIONAL RESEARCH
NETWORKS AND CONSORTIA, FOCUSED
ON INFECTIOUS DISEASE AND
COMPLICATIONS SUCH AS HIV AND
COVID-19 AFFECTING CHILDREN,
ADOLESCENTS, AND YOUNG ADULTS.
HE IS ALSO THE EXECUTIVE
SECRETARY AND EDITOR OF THE
GUIDELINES FOR THE PREVENTION
AND TREATMENT OF OPPORTUNISTIC
INFECTIONS IN CHILDREN WITH AND
EXPOSED TO HIV.
BILL IS A BOARD CERTIFIED
INFECTIOUS DISEASE SPECIALIST IN
PEDIATRICS AND INTERNAL
MEDICINE.
HE EARNED HIS M.D. FROM THE
UNIVERSITY OF ILLINOIS AT
CHICAGO COLLEGE OF MEDICINE,
WHERE HE ALSO COMPLETED
RESIDENCY IN INTERNAL MEDICINE
AT PEDIATRICS.
HE COMPLETED A COMBINED
FELLOWSHIP IN INFECTIOUS DISEASE
AND PEDIATRICS AT EMORY
UNIVERSITY SCHOOL OF MEDICINE IN
ATLANTA, GEORGIA.
DR. KAPOGIANNIS, I WILL TURN IT
OVER TO YOU.
>> THANK YOU, IVY, FOR THOSE
KIND WORDS, AND ONCE AGAIN, GOOD
MORNING AND GOOD AFTERNOON AND
WELCOME, EVERYBODY.
IT IS A GREAT PLEASURE TO
WELCOME YOU HERE, BOTH VIRTUALLY
AND IN PERSON.
AND JUST WANT TO GO OVER A
LITTLE BIT OF THE STRUCTURE OF
MY BRIEF TALK TODAY.
I'M GOING TO GIVE A BRIEF
INTRODUCTION TO ME AND SOME
POINTS ON A VISION, BOTH FOR THE
OFFICE AND THE COUNCIL, AND
AGAIN, REALLY HIGHLIGHT ALL OF
OUR MEMBERSHIP UPDATES, GO A
LITTLE BIT INTO THE FY 2025 NIH
HIV/AIDS PROFESSIONAL JUDGMENT
BUDGET, AND THEN HIGHLIGHT SOME
KEY OAR ACTIVITIES SINCE THE
MARCH OARAC MEETING.
TOUCH ON THE STRATEGIC PLANNING
DEVELOPMENT AND ALSO END WITH A
REALLY IMPORTANT TOPIC, WHICH IS
THE WOMEN AND HIV SESSION.
SO REALLY, I WANT TO TAKE A
MOMENT HERE TO REALLY
ACKNOWLEDGE THAT THERE IS A REAL
TRANSITION THAT HAS TAKEN PLACE,
AND I REALLY, REALLY OWE A DEBT
OF GRATITUDE, WE OWE A DEBT OF
GRATITUDE TO DR. MAUREEN
GOODENOW, WHO ON MARCH 26TH, HAS
TRANSITIONED TO ME, IN THIS
ROLE, AND SHE TRANSITIONED TO
HER NEW ROLE AS SENIOR ADVISOR
TO THE NIH OFFICE OF THE
DIRECTOR.
MAUREEN HAS LED OAR SINCE 2016.
NOTABLY SHE WAS THE FIRST WOMAN
TO DIRECT THE OFFICE.
HER ACCOMPLISHMENTS ARE MANY AND
I'LL JUST NAME A FEW HERE.
SHE COORDINATED A $250 MILLION
INCREASE IN NIH HIV RESEARCH
BUDGET OVER THE LAST FIVE YEARS,
IMPLEMENTED THE FIRST FIVE-YEAR
NIH STRATEGIC PLAN FOR HIV AND
HIV-RELATED RESEARCH, AND WORKED
AT THE WHITE HOUSE OFFICE OF
NATIONAL AIDS POLICY TO ENSURE
STRONG RESEARCH REPRESENTATION
IN THE REVISED 2022-25 NATIONAL
HIV/AIDS STRATEGY, OR NHAS.
I'M SURE YOU'LL JOIN ME IN
THANKING MAUREEN FOR ADVANCING
HIV RESEARCH DURING HER OAR
TENURE.
SO WITH THIS TRANSITION OF
LEADERSHIP, IT IS AN HONOR FOR
ME, AND I'M HUMBLED, TO SERVE AS
THE ACTING NIH ASSOCIATE
DIRECTOR OF AIDS RESEARCH AND
ACTING DIRECTOR OF OAR'S -- THE
OFFICE, WHILE A NATIONWIDE
SEARCH FOR A NEW DIRECTOR IS
CONDUCTED.
THE LAST 18 YEARS OF MY CAREER
HAVE BEEN COMMITTED TO HIV
RESEARCH IN DIFFERENT
CAPACITIES, AS IVY MENTIONED, AT
THE EUNICE KENNEDY SHRIVER, MY
HOME, THE NATIONAL INSTITUTE OF
CHILD HEALTH AND HUMAN DEVEL
DEVELOPMENT, MOSTLY AS
DR. TURNBULL ALLUDED TO, I'VE
FOCUSED A LOT ON ADOLESCENTS AND
YOUNG ADULTS WITH HIV THROUGH MY
WORK WITH THE ADOLESCENT TRIALS
NETWORK DOMESTICALLY, AND THEN
THROUGH THE PATCH CONSORTIUM IN
LMICs AND SUB-SAHARAN AFRICA
AND BRAZIL.
SO CLINICALLY, I'VE PRACTICED
SEEING ADD LE SENTSZ AND YOUNG
ADULTS WITH HIV AT JOHNS HOPKINS
IN BALTIMORE THROUGH MY
VOLUNTEER WORK.
AND OF COURSE AS MENTIONED, ALSO
MANY OF YOU KNOW ME THROUGH THE
PEDS OPPORTUNISTIC INFECTION
GUIDELINES AS THE EXECUTIVE
SECRETARY.
SO AS ACTING DIRECTOR, I AM
COMMITTED TO CONTINUE WORKING TO
DEVELOP THE NECESSARY TOOLS AND
INTERVENTIONS TO END HIV IN THE
U.S. AND GLOBALLY.
IN KEEPING WITH MY CLINICAL AND
NIH ROOTS, I'M ALSO COMMITTED TO
REDOUBLING OUR EFFORTS TO
ADDRESS HEALTH DISPARITIES AND
INEQUITIES IN MARGINALIZED AND
MINORITIZED COMMUNITIES
DISPROPORTIONATELY IMPACTED BY
HIV ACROSS THE U.S.
I'M GRATEFUL TO THE OAR'S
ADVISORY COUNCIL FOR THEIR
CONTRIBUTIONS AND VISION, AND I
LOOK FORWARD TO OUR CONTINUED
COLLABORATION.
NOW I'M GOING TO PIVOT A LITTLE
BIT TO TELL US ABOUT OUR
MEMBERSHIP UPDATES.
AS NOTED EARLIER IN TODAY'S
MEETING, WE WELCOME DR. IVY
TURNBULL AS THE INCOMING OARAC
CHAIR.
DR. TURNBULL SERVES AS THE
DEPUTY EXECUTIVE DIRECTOR OF THE
AIDS ALLIANCE FOR WOMEN,
INFANTS, CHILDREN, YOUTH AND
FAMILIES, AND THE FOUNDING
MEMBER AND CHAIR OF THE BOARD OF
DIRECTORS OF THE NATIONAL BLACK
WOMEN'S HIV/AIDS NETWORK.
THE PRE-EMINENT POLICY AND
ADVOCACY ORGANIZATION FOR BLACK
WOMEN AND GIRLS LIVING WITH AND
IMPACTED BY HIV AND OTHER HEALTH
DISPARITIES.
IVY, WE ARE VERY GRATEFUL FOR
YOU AGREEING TO SERVE AS THE
OARAC CHAIR.
WE ALSO WELCOME THE FOLLOWING
MEMBERS TO -- THE FOLLOWING
OARAC VOTING MEMBERS.
I'LL START OFF WITH DR. OMAR
GALARRAGA, WHO SERVES AS THE
DIRECTOR OF THE HEALTH SERVICES
RESEARCH DOCTORAL PROGRAM AT
BROWN UNIVERSITY, WHERE HE'S AN
ASSOCIATE PROFESSOR OF HEALTH
SERVICES POLICY AND PRACTICE AT
THE SCHOOL OF PUBLIC HEALTH.
HE BRINGS GLOBAL AND DOMESTIC
HEALTH ECONOMICS EXPERTISE TO
OARAC.
HIS RESEARCH INCLUDES BEHAVIORAL
AND OTHER HEALTH INTERVENTIONS
AND HEALTH SYSTEMS AND HEALTH
ECONOMICS EVALUATIONS.
ALSO WELCOME DR. LUIS MONTANER,
VI. INCLUDING HIV, CANCER, COVI,
AND OTHER EMERGING VIRAL
INFECTIONS, AND EXPLORES NEW
STRATEGIES TO BOOST THE
NATURALLY MEUN FUNATURALLY MEUNO
COMBAT THESE CONDITIONS.
DR. MOJGAN NAGHAVI AT THE
FEINBERG SCHOOL OF MEDICINE AT
NORTHWESTERN UNIVERSITY, BACK IN
MY HOMETOWN, CHICAGO.
HER RESEARCH LAB FOCUSES ON HIV
BIOLOGY DURING EARLY INFECTION
AND NEURODEGENERATION.
AND LAST BUT NOT LEAST IS MY
COLLEAGUE AND FRIEND GR ANNE
NEILAN, PEDIATRIC I.D. PHYSICIAN
WHO SERVES AS THE -- SERVES AS
ASSISTANT PROFESSOR OF MEDICINE
AND PEDIATRICS AT HARVARD
MEDICAL SCHOOL.
IN ADDITION TO CLINICAL CARE OF
ADOLESCENTS AND YOUNG ADULTS,
HER RESEARCH INCLUDES MODELING
THE HIV CASCADE TO ASSESS
CLINICAL IMPACT, COST AND
COST-EFFECTIVENESS.
AND THANK YOU, ANNE, FOR
AGREEING TO SERVE ADDITIONALLY
AS THE OARAC REPRESENTATIVE TO
THE NIAID AIDS RESEARCH ADVISORY
COMMITTEE OR THE ARAC.
SO NOW I'D RIEK TO START WITH AN
OVERVIEW OF A KEY OARAC ACTIVITY
SINCE THE LAST MEETING.
I'D LIKE TO CALL ATTENTION TO
THE COMPLETION OF THE 2025
HIV/AIDS PROFESSIONAL JUDGMENT
BUDGET OR THE P.J., AS WE
AFFECTIONATELY CALL IT, WHICH IS
AVAILABLE ON OAR'S WEBSITE.
THIS DOCUMENT HIGHLIGHTS
ACCOMPLISHMENTS ON HIV/AIDS
RESEARCH DURING THE PREVIOUS
YEAR AND ESTIMATES THE AMOUNT OF
ADDITIONAL FUNDS THAT ARE NEEDED
TO ADVANCE PROGRAMS IN PRIORITY
AREAS OF SCIENCE AS OUTLINED IN
THE FY 2021-25 NIH STRATEGIC
PLAN FOR NIH AND HIV-RELATED
RESEARCH.
IN THE LAST CALENDAR YEAR, OAR
HAS ACCELERATED THE DEVELOPMENT
OF THE FY 2024 AND 2025 PJs TO
ALIGN BETTER WITH THE
GOVERNMENT -- THE U.S.
GOVERNMENT BUDGET PROCESS.
THE FY 2025 P.J. BUDGET
HIGHLIGHTS KEY INVESTMENT
OPPORTUNITIES ACROSS FOUR AREAS.
THOSE ARE, BASIC RESEARCH TO
PROMOTE DISCOVERY AND ADVANCE
HIV SCIENCE, THE DEVELOPMENT AND
ASSESSMENT OF MO VEL
INTERVENTIONS INCLUDING CLINICAL
TRIALS ACROSS THE LIFESPAN,
TRANSLATION, IMPLEMENTATION AND
DISSEMINATION OF HIV RESEARCH
DISCOVERIES TO OPTIMIZE PUBLIC
HEALTH IMPACT, AND AN
INFRASTRUCTURE AND WORKFORCE
DEVELOPMENT TO ENHANCE RESEARCH
CAPACITY AND INCREASE DIVERSITY.
THIS P.J. REQUESTS A
$659 MILLION INCREASE FOR A
TOTAL PROPOSED BUDGET OF
$3.953 BILLION FOR FY 2025, AN
INCREASE OF 20% OVER THE FY 2023
ENACTED BUDGET.
SO NOW TO PIVOT, I'D LIKE TO
BRIEFLY HIGHLIGHT THREE
SIGNIFICANT OAR ENGAGEMENTS
SINCE MARCH.
EARLY LAST MONTH I REPRESENTED
NIH IN AN IN-PERSON BRIEFING AT
THE U.S. CAPITOL VISITORS CENTER
THAT YOU CAN SEE PICTURES THERE.
THE BRIEFING WAS ORGANIZED BY
THE RESEARCH WORKING GROUP OF
THE FEDERAL AIDS POLICY
PARTNERSHIP, OR FAPP.
IN THAT BRIEFING IN PRERECORDED
REMARKS, REPRESENTATIVE BARBARA
LEE SPOKE HIGHLY OF THE NIH HIV
RESEARCH SUPPORTING LONG TERM
UNITED STATES COMPETITIVENESS ON
A GLOBAL SCALE.
OTHER INVITED SPEAKERS INCLUDED
MR. HAROLD PHILLIPS, DIRECTOR OF
THE OFFICE OF NATIONAL AIDS
POLICY, AS WELL AS
REPRESENTATIVES FROM THE HIV
VACCINE TRIALS NETWORK AND VC
CENTER FOR AIDS RESEARCH AND THE
MILITARY HIV RESEARCH PROGRAM.
SO NOW I WANT TO PIVOT A LITTLE
BIT ON MORE ACTIVITIES HERE AND
THIS IS TO ACKNOWLEDGE AND
REMEUND MREMIND ME THAT THE OARY
DIRECTOR REAR ADMIRAL TIMOTHY
HOLTZ REPRESENTED THE NIH AT A
VIRTUAL BRIEFING FOR SENATE AND
APPROPRIATIONS STAFF AT HHS AS
ASPR AS THEY'RE KNOWN ON ENDING
THE HIV EPIDEMIC OR EHE SPENDING
PLAN FOR 2023.
THERE WERE ALSO PRESENTATIONS
FROM THE OFFICE OF THE
ASSISTANCE SECRETARY FOR HEALTH,
CDC, HRSA AND THE INDIAN HEALTH
SERVICE.
THE SLIDE HERE THAT YOU SEE
SHOWS A BRE BREAKDOWN OF THE
$26 MILLION ALLOCATED TO NIH FOR
EHE ACTIVITIES IN FY 2023.
WE PLAN TO SPEND $5.6 MILLION OF
THOSE DOLLARS TO SUPPORT THE
FINAL YEAR OF FY 2022 EHE
PROJECT, FOCUSING ON HIV-RELATED
HEALTH EQUITY RESEARCH.
THE REMAINING $20.4 MILLION OF
THOSE WILL SUPPORT NEW TWO-YEAR
IMPLEMENTATION RESEARCH PROJECTS
AWARDED THROUGH THE CENTERS FOR
AIDS RESEARCH, AND AIDS RESEARCH
CENTERS IN THE FOLLOWING AREAS.
THE FOCUS AREAS ARE SEEN IN THAT
SECOND COLUMN, WHICH INCLUDE
SYNDEMIC APPROACHES, LEVERAGING
PHARMACIES, TO DECENTRALIZE CARE
AND PREVENTION, LINKAGE TO CARE
AND INCARCERATION, AND ALSO HIV
CLUSTER DETECTION AND RESPONSE.
THESE ACTIVITIES CONTINUE TO
EMPHASIZE PARTNERING RESEARCHERS
FROM HISTORICALLY BLACK COLLEGES
AND UNIVERSITIES AND MINORITY
SERVING INSTITUTIONS.
NOW THE NEXT SLIDE.
DR. HOLTZ ALSO PARTICIPATED AT
THE 76TH FULL COUNCIL MEETING OF
THE PRESIDENTIAL ADVISORY
COUNCIL ON HIV/AIDS, ALSO KNOWN
AS PACHA IN MARCH AND PROVIDED
REMARKS ON FEDERAL UPDATES ON
EHE.
ADDITIONALLY OUR OAR SENIOR
SCIENCE ADVISOR, CAPTAIN
DR. MARY GLENSHAW, ATTENDED SITE
VISITS WITH HHS ASSISTANT
SECRETARY DR. RACHEL LEVINE AND
PACHA LEADERSHIP, INCLUDING TWO
COMMUNITY CLINKING WITH NIH CLIH
FUNDING.
TOLL DATE, NIH EHE FUNDING HAS
BEEN AWARDED OVER 200 -- IT'S
ACTUALLY 201 HIGHLY MERITORIOUS
EHE PROJECTS, INCLUDING 66
PROJECTS FROM FY 22 WITH A FOCUS
ON STRATEGIC PARTNERSHIPS ACROSS
JURISDICTIONS WITH HIGH HIV
BURDEN IN THE U.S.
THE FY 2023 AWARDS ARE EXPECTED
THIS SUMMER.
NOW MOVING TO THE NIH HIV
STRATEGIC PLANNING.
SHIFTING GEARS HERE, THIS IS --
STRATEGIC PLANNING IS AN
IMPORTANT ELEMENT OF OUR
LEGISLATIVE MANDATE.
WE'RE CURRENTLY -- COVERING
FISCAL YEARS 2021 THROUGH 2025.
AS A REMINDER, FISCAL YEAR 2025
ENDS IN SEPTEMBER OF 2025, AND
THUS, WE WILL SOON START WORKING
ON THE NEXT ITERATION OF THE
STRATEGIC PLAN.
THE PLAN CONTAINS STRATEGIC
GOALS AND SCIENTIFIC PRIORITIES
THAT WERE DEVELOPED WITH INPUT
FROM MULTIPLE SOURCES.
THOSE INCLUDE PORTFOLIO
ANALYSIS, REQUESTS FOR
INFORMATION, LISTENING SESSIONS
THAT INCLUDED COMMUNITY AND
PARTNER ENGAGEMENT, AND INTERNAL
AND EXTERNAL ADVISORY GROUPS
SUCH AS THE NIH AIDS EXECUTIVE
COMMITTEE, AND THE OARAC.
DEVELOPING THE NEXT STRATEGIC
PLAN PROVIDES AN OPPORTUNITY TO
REVIEW HIV RESEARCH PRIORITIES
ACROSS THE NIH TO ENSURE THAT
RESOURCES ARE OPTIMALLY ALIGNED
TO THE NEEDS OF THE RESEARCH
AGENDA AND COMMUNITY.
SO AS YOU CAN SEE, WHICH IS
DEPICTED ON THE SCHEMATIC THERE
IN THE LOWER LEVEL BUBBLE ON THE
STRATEGIC PLAN DIAGRAM.
THE NIH HIV RESEARCH STRATEGY IN
TURN INFORMS THE DEVELOPMENT AND
IMPLEMENTATION OF OUR
LEGISLATIVELY MANDATED DOCUMENTS
SUCH AS THE CONGRESSIONAL BUDGET
JUSTIFICATION OR THE C.J., WHICH
IS THE UPPER BUBBLE AT THE TOP,
AND THEN THE PROFESSIONAL
JUSTIFICATION BUDGET, THE P.J.,
THE LOWER RIGHT BUBBLE.
SO OARAC INPUT WILL BE ESSENTIAL
IN THE DEVELOPMENT OF OUR NEXT
PLAN.
WE ANTICIPATE ESTABLISHING
WORKING GROUPS LATER THIS YEAR
AND WILL HAVE MUCH MORE
DISCUSSION ON THIS TOPIC AT
FUTURE OARAC MEETINGS AND LOOK
FORWARD TO ENGAGING WITH YOU.
NOW MOVING TO OUR SIGNATURE
PROGRAMS, THESE WERE FORMED TO
COORDINATE NIH-WIDE ACTIVITIES
IN MULTIDISCIPLINARY AND
CROSS-CUTTING AREAS.
THESE FOUR PROGRAMS THAT YOU SEE
HERE HIGHLIGHTED ARE HIV AND
AGING, HIV AND WOMEN, TECHNOLOGY
FOR HIV RESEARCH, AND EARLY
CAREER INVESTIGATORS.
THEY PLAY A SIGNIFICANT ROLE IN
GUIDING CURRENT AND FUTURE
ACTIVITIES OF OAR AND NIH.
WE WILL HEAR MORE DETAILED
REPORTS ON THE HIV AND AGING AND
ECI SIGNATURE PROGRAMS LATER
TODAY.
TODAY'S AGENDA BEGIN WITH A
FOCUS ON HIV AND WOMEN, AND I'D
LIKE TO BRIEFLY PROVIDE SOME
THOUGHTS ABOUT HIV AND WOMEN AND
OUR SIGNATURE PROGRAM BEFORE WE
HEAR FROM OUR SPEAKERS.
SO NIH'S -- NIH OAR'S HIV AND
WOMEN SIGNATURE PROGRAM IS A
PARTNERSHIP WITH THE DPCPSI'S
OFFICE OF RESEARCH ON WOMEN'S
HEALTH.
IT HAS TWO MAIN OBJECTIVES.
ONE IS TO PROMOTE THE NIH VISION
FOR WOMEN'S HEALTH WHERE ALL
WOMEN RECEIVE EVIDENCE-BASED
TAILORED HIV PREVENTION, CARE
AND TREATMENT.
THE OTHER IS TO SUPPORT WOMEN IN
SCIENCE CAREERS SO THEY CAN
ACHIEVE THEIR FULL POTENTIAL.
TO SET THE STAGE, WHY THE FOCUS
AND WHY IS THIS A PROBLEM WE
SHOULD BE LOOKING MORE INTO?
OUR SPEAKERS TODAY WILL GO INTO
MORE DETAILS BUT I WANTED TO
JUST ARTICULATE HERE WITH THIS
SLIDE SOME OF THE EPIDEMIOLOGY.
IN 2021, GLOBALLY, 54% OF ALL
PEOPLE WITH HIV WERE WOMEN AND
GIRLS, TRANSLATING TO ABOUT
20 MILLION.
AND ALMOST 50% OF ALL NEW
INFECTIONS WERE IN WOMEN.
AN ESTIMATED 20% OF TRANSGENDER
WOMEN LIVING WITH HIV IN 2021
AND THEN NOTABLY TRANS WOMEN
WERE 14 TIMES MORE LIKELY TO
ACQUIRE HIV COMPARED TO
CISGENDER WOMEN.
IN TERMS OF NIH RESOURCES OVER
THE PAST FIVE YEARS,
APPROXIMATELY 15 TO 19% OF HIV
FUNDING HAS BEEN CODED AS
RELATED TO WOMEN'S HEALTH.
WE ARE CURRENTLY ANALYZING THIS
PORTFOLIO TO BEST CAPTURE THIS
INVESTMENT AND UNDERSTAND IT,
AND REALLY ONE CAN ARGUE THERE'S
ROOM FOR GROWTH HERE.
SO TO IDENTIFY GAPS AND
PRIORITIES AT THE INTERSECTION
OF WOMEN'S HEALTH AND HIV, WE
RECENTLY SUSTAIN ESTABLISHED THE
HIV AND WOMEN'S WORKING GROUP.
THE WORKING GROUP LAUNCHED A NEW
WEBPAGE ON THE O.A.R. WEBSITE.
YOU CAN SEE THE CODE ON THE
SLIDE AND REACH IF YOU'D LIKE,
TO KEEP THE PUBLIC AWARE AND
INFORMED OF UPCOMING ACTIVITIES,
AND THESE ACTIVITIES INCLUDE A
WORKSHOP ON THE CURRENT AND
FUTURE DIRECTIONS OF HIV AND
WOMEN'S RESEARCH IN CONJUNCTION
WITH THE U.S. CHA CONFERENCE IN
SEPTEMBER, AND AN NIH HIV AND
WOMEN VIRTUAL WORKSHOP IN
MARCH 2024, AND YOU'LL HEAR MORE
ABOUT THESE EVENTS LATER ON IN
THE PROGRAM.
SO NOW JUST TO LOOK AT THE DAY
AHEAD AND OUR AGENDA, THE REST
OF THE AGENDA INCLUDES A FOCUS
ON HIV AND WOMEN WITH
PERSPECTIVES FROM ORWH DIRECTOR
DR. JANINE CLAYTON, ADDITIONAL
DETAILS THEN WILL BE PROVIDED ON
THE HIV AND WOMEN SIGNATURE
PROGRAM FROM DRS. ELIZABETH BARR
OF ORWH AND LESLIE MARSHALL OF
OAR.
AND THEN FINALLY, RECENT
FINDINGS FROM THE WHIS COHORT
WILL BE PRESENTED BY DR. SEBLE
KASSAYE, THANK YOU FOR JOINING
US FROM GEORGETOWN UNIVERSITY IN
PERSON HERE.
THEN WE'LL HEAR UPDATES FROM OUR
EARLY CAREER INVESTIGATORS AND
HIV AND AGING SIGNATURE
PROGRAMS, FOLLOWED BY A
PRESENTATION ON THE NIH O.A.R.
DATA HUB, A NEW RESOURCE
AVAILABLE ON THE O.A.R. WEBSITE
THAT PROVIDES INFORMATION ON THE
NIH HIV/AIDS RESEARCH PORTFOLIO.
AND LASTLY, WE'LL HEAR FROM OUR
ADVISORY COUNCIL REPRESENTATIVES
AND FROM THE CLINICAL GUIDELINES
WORKING GROUPS OF OARAC.
SO THE NEXT OARAC MEETING IS
GOING TO BE ON THURSDAY, OCTOBE.
WE REALLY APPRECIATE AND THANK
YOU FOR CONTINUING TO MAKE THESE
MEETINGS A PRIORITY AND LOOK
FORWARD TO SEEING YOU THEN AT
THE NEXT MEETING.
JUST WANTED TO TAKE A BRIEF
MOMENT TO HIGHLIGHT THE NATIONAL
HIV TESTING DAY BEFORE CLOSING.
THIS NEXT WEEK ON JUNE 27TH.
THIS YEAR'S THEME: TAKE THE
TEST AND TAKE THE NEXT STEP,
EMPHASIZES THE POINT THAT WHEN A
PERSON KNOWS THEIR STATUS, THEY
CAN CHOOSE HOW TO STAY HEALTHY.
O.A.R. IS IN THE EARLY STAGES OF
PLANNING A VIRTUAL WORKSHOP WITH
THE NIH AIDS EXECUTIVE
COMMITTEE, AND THE WORKSHOP IS
ENTITLED COMMUNITY VOICES,
FORGING THE PATH FORWARD FOR HIV
SELF-TESTING AND PERSONALIZED
VIRAL LOAD MONITORING.
THIS WILL BE HELD NOVEMBER 1ST
AND 2ND.
ADDITIONAL DETAILS WILL BE
PROVIDED AT OUR NEXT OARAC
MEETING.
SO WITH THAT, I'M GOING TO SAY
AS A REMINDER, THERE ARE MANY
WAYS TO STAY CONNECTED WITH
O.A.R. AND ALL OF OUR
ACTIVITIES, AND I THANK YOU,
MADAM CHAIR, IVY, BACK TO YOU.
>> THANK YOU, BILL, FOR SUCH A
GREAT UPDATE.
WE'RE GOING TO HOLD QUESTIONS
UNTIL THE OPEN DISCUSSION PER
PERIOD.
WE WILL NOW HEAR FROM DR. JANINE
CLAYTON, ASSOCIATE DIRECTOR FOR
RESEARCH ON WOMEN'S HEALTH AND
DIRECTOR OF THE OFFICE OF
RESEARCH ON WOMEN'S HEALTH AT
NIH.
DR. CLAYTON IS A KEY ARCHITECT
OF THE NIH POLICY REQUIRING
SCIENTISTS TO CONSIDER SET AS A
LOGICAL VARIABLE ACROSS THE
RESEARCH SPECTRUM.
DR. CLAYTON, PLEASE BEGIN WHEN
YOU'RE READY.
>> THANK YOU SO MUCH,
DR. TURNBULL.
IT'S MY PLEASURE TO BE HERE
TODAY AND TO TALK A LITTLE BIT
ABOUT THE NIH OFFICE OF RESEARCH
ON WOMEN'S HEALTH AND HOW MUCH
OUR PRIORITIES INTERSECT WITH
THE OFFICE OF AIDS RESEARCH.
WE HAVE SEVERAL SHARED GOALS.
AT THE OUTSET, INCLUSION OF
WOMEN IN EVERYTHING WE DO,
PARTNERSHIPS ACROSS NIH, ACROSS
STAKEHOLDERS, ACROSS SECTORS,
AND ADDRESSING AREAS THAT ARE
GAPS IN OUR FUNDING.
I WANT TO TELL YOU A LITTLE BIT
ABOUT THE MISSION AND VISION OF
ORWH.
WE WERE FOUNDED OUT OF ADVOCACY,
WOMEN AND MEN IN CONGRESS
ESSENTIALLY DEMANDED THAT NIH
CREATE AN OFFICE OF RESEARCH ON
WOMEN'S HEALTH TO ADDRESS THE
FACT THAT WOMEN WERE NOT BEING
ROUTINELY INCLUDED IN NIH
SUPPORTED CLINICAL RESEARCH AND
THE FINDINGS WERE BEING APPLIED
TO WOMEN.
SO OUR MISSION IS TO EXPAND
WOMEN'S HEALTH RESEARCH TO MAKE
SURE THAT WOMEN IN
UNDERREPRESENTED RACIAL AND
ETHNIC MINORITY GROUPS ARE
INCLUDED IN NIH SUPPORTED
CLINICAL RESEARCH AND ADVANCE
WOMEN IN STEM CAREERS.
WE IMAGINE A WORLD WHERE ALL
WOMEN RECEIVE EVIDENCE-BASED
TREATMENT AND CARE.
IMAGINE A WORLD WHERE SEX AND
GENDER FACTORS ARE INTEGRATED
ACROSS THE HEALTH RESEARCH
CONTINUUM, AND A WORLD WHERE ALL
WOMEN IN SCIENCE REACH THEIR
FULL POTENTIAL.
THIS IS THE WAY WE THINK ABOUT
EXECUTING AND IMPLEMENTING THAT
VISION.
WE SEEK TO INCORPORATE SEX AND
GENDER CONSIDERATIONS ACROSS THE
ENTIRE RESEARCH CONTINUUM,
RANGING FROM BASIC AND
LABORATORY STUDIES THROUGH
TRANSLATION TO CLINICAL AND
APPLIED.
WE ALSO WANT TO ADDRESS SEX AS A
BIOLOGICAL VARIABLE ACROSS TYPES
OF RESEARCH FROM THE
PRE-CLINICAL INTO THE CLINICAL
SPACE, INTENTIONALLY INTEGRATING
CONSIDERATIONS OF SEX AND
GENDER, MAKING SURE THAT WE
INCLUDE SEX AND GENDER IN OUR
RESULTS REPORTING FROM RESEARCH
SO THOSE FINDINGS CAN INFORM
FUTURE STUDIES.
WE BELIEVE THAT INCORPORATING
SEX AND GENDER ACROSS THIS
RESEARCH CONTINUUM ADVANCES
RIGOR, BY DEFINITION, DISCOVERY,
INNOVATION, AND EQUITY.
ORWH AND O.A.R. HAVE A HISTORY
OF WORKING TOGETHER.
IT WAS MY PLEASURE TO WORK
CLOSELY WITH THE FORMER DIRECTOR
OF O.A.R., DR. MAUREEN GOODENOW,
IN COMMEMORATING 40 YEARS OF
ACCOMPLISHMENTS AND ADVANCES IN
WOMEN IN HIV/AIDS RESEARCH HERE
AT NIH FAIRLY RECENTLY, AND WE
HAVE A NEW PARTNERSHIP AS YOU
HEARD AND WE'RE LOOKING FORWARD
TO GROWING THIS AS WE MOVE
FORWARD.
WE KNOW, FOR EXAMPLE, THAT WOMEN
FACE MEEK CONSIDERATIONS NR HIV
RESEARCH.
PREGNANCY IN PEOPLE WITH HIV IS
LINKED TO 2 TO 10 TIMES
INCREASED RISK OF DEATH, AND
MULTI-MORBIDITY IS MORE COMMON
IN WOMEN WITH HIV, INCLUDING
INCREASED PREVALENCE OF NON-AIDS
COMORBIDITIES.
SOMETIMES OF DISEASE OFTEN
DIFFER FROM MEN, AND WE NEED TO
PAY ATTENTION TO THE ROLE OF
EXOGENOUS HORMONE THERAPY,
ESPECIALLY IN POPULATIONS OF
WOMEN.
THERE ARE ALSO BEHAVIORAL AND
SOCIAL SCIENCE CONCERNS.
WE KNOW THAT INTERSECTIONAL
STIGMA CAN IMPACT PREVENTION,
TREATMENT AND OUTCOMES, AND THAT
INTERPERSONAL AND GENDER BASED
VIOLENCE INCREASE THE RISK OF
HIV ACQUISITION.
WE WERE RECENTLY PLEASED TO HEAR
THE U.S. GOVERNMENT'S FIRST EVER
GOVERNMENT-WIDE NATIONAL ACTION
PLAN ON GENDER-BASED VIOLENCE.
THERE'S ALSO UNIQUE MENTAL
HEALTH BURDEN FOR WOMEN WITH
HIV, AND WE NEED TO INCORPORATE
CONSIDERATIONS OF
GENDER-AFFIRMING CARE AS WELL.
AT ORWH, WE TAKE A LIFE COURSE
PERSPECTIVE, MEANING WE THINK
ABOUT THE ENTIRE LIFE COURSE OF
A WOMAN AND THE FACT THAT YOU
MUST CONSIDER EVERYTHING THAT
CAME BEFORE WHEN YOU CONSIDER
THE HEALTH OF WOMEN, WHETHER
THAT'S A STRESS TESS OF
PREGNANCY, OR THE ONSET OF
PERIMENOPAUSE OR MENOPAUSE, OR
THE POST-MENOPAUSAL TRANSITION.
REPRODUCTIVE AGING AND MENOPAUSE
WAS SO IMPORTANT THAT WE DEVOTED
THIS YE YEAR'S VIVIAN PINN
SYMPOSIUM TO MENOPAUSE.
WE NOTE THAT THE AGE OF
MENOPAUSE IS ACTUALLY SLIGHTLY
LOWER FOR WOMEN WITH HIV.
AT THE VIVIAN PINN SYMPOSIUM,
DR. SARAH LUBY TALKED ABOUT
WOMEN WITH HIV IN THE CONTEXT OF
MENOPAUSE.
SHE SHARED THAT THEY'RE MORE
LIKELY TO EXPERIENCE DEPRESSIVE
SYMPTOMS AS WELL AS ANXIETY.
ALSO, WOMEN WITH HIV HAVE MORE
FREQUENT AND SEVERE HOT FLASHES
AND WE KNOW THAT THIS CAN IMPACT
QUALITY OF LIFE.
WOMEN WITH HIV ALSO CAN HAVE
DIFFICULTY DISTINGUISHING
MENOPAUSAL SYMPTOMS FROM
SYMPTOMS OF HIV, AND THESE ARE
JUST SOME OF THE AREAS THAT ARE
OF CONCERN RELATED TO
REPRODUCTIVE AGING AND ITS
INTERSECTION WITH HIV.
WE KNOW THE SEVERITY OF
UROGENITAL SYMPTOMS, FOR
EXAMPLE, NEEDS MORE ATTENTION AS
WELL AS EVALUATING MENOPAUSAL
HORMONE THERAPY USE IN WOMEN
WITH HIV.
SO HOW DOES ORWH SUPPORT HIV
RESEARCH?
WE WANT TO ALWAYS ADDRESS THE
MOST AFFECTED POPULATIONS,
INITIATE RESEARCH THAT
INCORPORATES SEX AS A BIOLOGICAL
VARIABLE OR SABV FROM THE STUDY
DESIGN AND SUPPORT RESEARCH THAT
STUDIES THE INTERSECTION OF SEX
AND GENDER FACTORS.
AND ONE OF THE WAYS THAT WE DO
THIS IS THROUGH OUR
U3 INTERDISCIPLINARY RESEARCH
PROGRAM THAT WAS CREATED BY ORWH
TO DRAW ATTENTION TO THE LACK OF
RESEARCH ON PERSISTENT
DISPARITIES IN WOMEN'S HEALTH
AND HEALTHCARE, AND TO SUPPORT
RESEARCH AND EVIDENCE-BASED
PROGRAMS TO ADDRESS THESE GAPS.
SO U3 STANDS FOR UNDERSTUDIED,
UNDERREPRESENTED AND
UNDERREPORTED POPULATIONS, SO WE
SEEK TO BRING THOSE POPULATIONS
IN FOCUS, ATTENDING TO THOSE
THAT HAVE BEEN EXCLUDED
HISTORICALLY OR ARE OFTEN
OVERLOOKED.
THIS CAN INCORPORATE RURAL
POPULATIONS, WOMEN FROM
MARGINALIZED RACIAL AND ETHNIC
GROUPS, AND OTHER DEMOGRAPHICS.
AND HERE IS A MAP OF THE CURRENT
AND PREVIOUSLY SUPPORTED ORWH UR
WEBSITE, AND YOU CAN SEE THAT
THEY DO SCATTER THE COUNTRY AND
YOU CAN SORT THIS BY THE
U3 POPULATION.
I'M JUST GOING TO HIGHLIGHT A
FEW FOR YOU HERE.
AT THE UNIVERSITY OF TEXAS, THE
TARGET POPULATION IS RURAL,
AFRICAN AMERICAN AND BLACK WOMEN
AT HIGH RISK FOR HIV.
THIS STUDY IS LOOKING AT
INCREASING HIV/STI HOME TESTING,
LICKAGES TO CARE, AND LINKAGES
TO PREP VIA A DIGITAL
INTERVENTION IN A PARTICULAR
GEOGRAPHIC HOT SPOT.
THE SECOND IS IN BALTIMORE AT
JOHNS HOPKINS LOOKING AT RACIAL
AND ETHNIC MINORITY FEMALE
ADOLESCENTS AND YOUNG ADULTS,
LOOKING AT THE VAGINAL
MICROBIOME, INFLAMMATION AND STI
AND HIV RISK.
THE THIRD EXAMPLE IS AROUND ANAL
CANCER RISK IN HIV-POSITIVE,
LOW-SOCIOECONOMIC STATUS AFRICAN
AMERICAN OR BLACK AND
HISPANIC/LATINO WOMEN.
THESE ARE JUST THREE EXAMPLES OF
SOME OF THE U3 PROGRAMS THAT WE
ARE SUPPORTING NOW THROUGH THE
U3 EFFORT IN COLLABORATION WITH
MULTIPLE INSTITUTES AND CENTERS
AND OFFICES.
CHRONIC DISEASE IS ALSO AN
IMPORTANT ISSUE FOR WOMEN ACROSS
THE LIFESPAN, INCLUDING WOMEN
WITH HIV, AND WE RECENTLY, IN
PARTNERSHIP WITH SEVERAL
INSTITUTES, CENTERS AND OFFICES,
INCLUDING O.A.R., ISSUED AN
UNDERSTANDING CHRONIC CONDITIONS
UNDERSTUDIED AMONG WOMEN FUNDING
OPPORTUNITY IN AN R01 AND R21.
DISEASES THAT ARE MORE COMMON IN
WOMEN, HAVE HIGHER MORBIDITY IN
WOMEN AND JUST A FEW OF THEM ARE
DEPICTED HERE ON THE SLIDE.
AND THE NEXT DUE DATE IS
JUNE 20TH NEXT YEAR.
OUR SPECIALIZED CENTERS OF
RESEARCH EXCELLENCE, OR SCORE
PROGRAM, IS A U54, WHICH
REPRESENTS A COOPERATIVE
AGREEMENT THAT EXPANDED FROM THE
P50 THAT WE FUNDED IN THE PAST.
THIS IS NIH'S ONLY
DISEASE-AGNOSTIC SEX DIFFERENCES
CENTER LEVEL PROGRAM AND IT
ADDRESSES SEX DIFFERENCES IN THE
CONTEXT OF DISEASES THAT ARE
IMPORTANT TO INFORM AND IMPROVE
THE HEALTH OF WOMEN.
WE IN THE SCORE PROGRAM, THERE
ARE THREE HIGHLY INTEGRATED
SYNERGISTIC RESEARCH PROJECTS.
THERE'S AN ADMINISTRATIVE CORE,
A CAREER ENHANCEMENT CORE AS
WELL.
AND WE HELP TO EXPAND EFFORTS
LIKE SABV THROUGH THE SCORE, AS
WELL AS EFFECT EXAMPLES, AND
I'LL GIVE A FEW FOR YOU HERE.
SOME OF THE SCORE SCIENTIST
MODEL WAYS TO OBTAIN THE FULL
BENEFIT OF SEX AWARE STUDIES,
EITHER THROUGH SEX STRATIFIED
RANDOMIZATION OR POWERED
ANALYSIS FOR SEX-DEPENDENT
EFFECTS, OR DEMONSTRATING
SEX-DISAGGREGATED RESULTS
REPORTING AS JUST A FEW
EXAMPLES.
WE ENCOURAGE COLLABORATION
ACROSS THE SCORE PROGRAMS AND WE
ALSO HOPE TO LEVERAGE THE SCORE
SUCCESSES IN DISSEMINATING
WIDESPREAD ADOPTION OF
APPLICATION OF SEX AS A
BIOLOGICAL VARIABLE ACROSS
VARIOUS DISEASES, STUDY AND
DISCIPLINES.
HERE ARE A COUPLE OF THE SCORE
INVESTIGATORS WHO ARE ADDRESSING
RESEARCH RELEVANT TO HIV/AIDS.
HERE A NEUROHYPOTHALAMIC
PITUITARY ADRENAL AXIS STUDY
THAT IS LOOKING AT THE
UNDERSTANDING BETWEEN BIOLOGICAL
AGING AND THE PROGNOSIS OF WOMEN
WITH HIV, SO WE'VE GOT THAT
REPRODUCTIVE AGING GOING ON AT
THE SAME TIME, AND IT'S SEEKING
TO CHARACTERIZE THE LINK BETWEEN
IMMUNOSENESCENCE AND ENDOCRINE
SENESCENCE.
THE SECOND IN THIS SCORE IS
LOOKING AT HIV AND
ANTIRETROVIRAL THERAPY, AND
ESTROGEN DEFICIENCY-INDUCED
INFLAMMATORY EVENTS, AND
DETERMINE WHETHER THEY COLLIDE
IN AN ADDITIVE OR SYNERGISTIC
MANNER RELATED TO INFLAMMATION
IN THE CONTEXT OF BONE LOSS,
WHICH WE KNOW IS INCREASED IN
HIV, AND IN TERMS OF
CARDIOVASCULAR RISK IN WOMEN
WITH HIV, ANALYZING THE IMPACT
OF HIV-RELATED CHANGES ON THE
REGENERATIVE CAPACITY,
ENDOTHELIAL FUNCTION AND
ARTERIAL STIFFNESS ON PREVALENT
CORONARY AND CAROTID ARTERIAL
DISEASE.
SO JUST AN EXAMPLE OF THREE
INTEGRATED PROGRAMS IN OUR SCORE
PROGRAM.
WE ALSO INITIATED, SEVERAL YEARS
AGO, NIH'S FIRST EVER
R01 FOCUSED ON THE INTERSECTION
OF SEX AND GENDER INFLUENCES ON
HEALTH AND DISEASE WITH OUR ICO
PARTNERS, AND HAVE SUPPORTED TO
DATE 17 AWARDS WITH 11ICO 11 ICO
PARTNERS.
THIS ADDRESSES THE FIRST GOAL OF
THE NIH WIDE STRATEGIC PLAN.
I CALL THAT THE ULTIMATE GOAL OF
THE PLAN.
THE NEXT RECEIPT DATE IS IN
NOVEMBER AND HERE ARE SOME
EXAMPLES OF FUNDED INVESTIGATORS
UNDER OUR SEX AND GENDER R01.
ALBERTO BOSQUE IS LOOKING AT
HORMONAL CONTROL OF HIV LATENCY,
EILEEN SKULLY IS LOOKING AT THE
SEX AND GENDER OF THE
IMMUNOPATHOGENESIS OF HIV AND
MICHELLE YBARRA IS LOOKING AT
HARNESSING A PROGRAM FOR
TRANSGENDER GIRLS.
WE'RE ALSO ADDRESSING THE NEED
TO SUPPORT CAREERS IN HIV
RESEARCH.
AND HAVE CREATED AN R25 FOCUSED
ON GALVANIZING HEALTH EQUITY
THROUGH NOVEL AND DIVERSE
EDUCATIONAL RESOURCES TO HELP
MEET THE NEED FOR
GENDER-SPECIFIC TRAINING IN
SCIENCE, MEDICINE AND ALLIED
HEALTH PROFESSIONS.
NEXT AIDS APPLICATION DUE DATE
IS SEPTEMBER, AND THIS IS GOING
TO SUPPORT THE DEVELOPMENT OF
GENDER-FOCUSED CURRICULA AND
INCLUDING FOR THE EXTRAMURAL
COMMUNITY AND THE PUBLIC.
THROUGH A VARIETY OF OUR
PROGRAMS, WE TRY TO ENSURE THAT
WOMEN ARE SUPPORTED AND WOMEN'S
HEALTH RESEARCHERS, OUR BIRCWH
PROGRAM, WE'VE SUPPORTED OVER
700 SCHOLARS AND WE'RE
COLLABORATING WITH NINE HBCUs
TO SUPPORT WOMEN'S HEALTH
RESEARCHERS.
OUR TEAM SCIENCE LEADERSHIP
SCHOLAR PROGRAM IS OUR NEWEST
PROGRAM, SEEKING TO SUPPORT TEAM
SCIENCE LEADERSHIP IN A
CROSS-SECTIONAL -- SECTORAL,
EXCUSE ME, FASHION.
AND OUR CAREER CONTINUITY
AWARDS, WE CREATED THOSE WITH
THE NIH WORKING GROUP ON WOMEN
IN BIOMEDICAL CAREERS ON MAF OFF
OF NIH TO ALLOW K AND FIRST TIME
RPG AWARDEES TO -- DURING
CRITICAL LIFE EVENTS, AND
RETENTION ACTUALLY RE-ENTRY
PROGRAMS HERE, SUPPORT
INVESTIGATORS WHO'VE EXPERIENCED
THE NEED TO LEAVE RESEARCH AND
RE-ENTER, OR A DISCRIMINATORY OR
UNSAFE ENVIRONMENT, INCLUDING
SEXUAL HARASSMENT.
SO THOSE ARE SOME OF THE PROG
PROGRAMS, AND OUR SIGNATURE
PROGRAM FOR CAREERS IS OUR
BIRCWH PROGRAM.
I DO WANT TO HIGHLIGHT ALSO FOR
YOU THAT I HAVE THE PRIVILEGE OF
CO-CHAIRING THE NIH WORKING
GROUP ON WOMEN IN BIOMEDICAL
CAREERS WITH THE NIH DIRECTOR,
AND THROUGH THAT EFFORT, WE HAVE
FUNDED RESEARCH ON INTERVENTIONS
THAT ARE DESIGNED TO SUPPORT
WOMEN IN STEM, THE LANDMARK
BEING THE CAUSAL FACTORS AND
INTERVENTIONS RFA, THROUGH WHICH
14 GRANTS WERE SUPPORTED THAT
HAVE GENERATED OVER 100 PAPERS
THAT HAVE DEMONSTRATED WHICH
INTERVENTIONS WORK AND HOW TO
EXECUTE AND IMPLEMENT THOSE.
ONE OTHER ACTIVITY OF THE
WORKING GROUP IS THE WOMEN OF
COLOR RESEARCH NETWORK, WHICH IS
A LINKEDIN COMMUNITY AND HAS
FOUR REGIONAL CHAPTERS, AND IS
AVAILABLE TO SUPPORT WOMEN OF
COLOR IN RESEARCH AND ALL WHO
SUPPORT WOMEN OF COLOR IN
RESEARCH, AND WE HAVE ALMOST
2500 MEMBERS IN THAT COMMUNITY.
INTERSECTIONALITY IS SOMETHING
VERY IMPORTANT TO TEAM ORWH AND
WE'RE ALWAYS LOOKING FOR THE
CONTEXT OF HOW INTERSECTIONALITY
AFFECTS THE HEALTH OF WOMEN.
WE CREATED A DIVERSE VOICES
WEBINAR SERIES CALLED
INTERSECTIONALITY AND THE HEALTH
OF WOMEN, AND THE UPCOMING
SESSIONS ARE BOTH HIGHLY
RELEVANT TO HIV RESEARCH.
FOCUSING ON INTERSECTIONAL
APPROACHES TO SUBSTANCE USE AND
MISUSE.
DR. JAIMIE MEYER WILL BE FOE
KUTION ON HER CLINICAL RESEARCH
ON HIV PREVENTION AND TREATMENT
FOR WOMEN ADDRESSING SOCIAL AND
STRUCTURAL DETERMINANTS OF
HEALTH, AND DR. STEPHANIE
MEYERS-PANTELE WILL BE LOOKING
AT QUANTITATIVE AND QUANTITATIVE
AS WELL AS MIXED METHOD STUDIES
TO LOOK AT THE EFFECTIVE
INTERSECTIONAL STIGMA ON THE
HEALTH AND WELL-BEING OF
POPULATIONS DISPROPORTIONATELY
AFFECTED BY HIV, WOMEN WHO USE
DRUGS AND SEXUAL GENDER MINORITY
POPULATIONS AS WELL.
SO PLEASE JOIN US ON JULY 27TH.
AND YOU CAN JOIN IN ANY OF THE
ORWH EVENTS BY SIGNING UP ON OUR
WEBSITE TO RECEIVE OUR QUARTERLY
PUBLICATIONS OR GET EXPOSED TO
OUR E-LEARNING PROGRAMS.
SO WITH THAT, I WILL STOP
SHARING AND TURN IT BACK OVER TO
DR. TURNBULL.
>> THANK YOU, JANINE, FOR THIS
COMPREHENSIVE OVERVIEW OF
WOMEN'S HEALTH AND HIV.
THE NEXT PRESENTATION IS AN
UPDATE ON THE HIV NIH WOMEN'S
SIGNATURE PROGRAM.
WE WILL HEAR FROM DOCTORS
ELIZABETH BARR AND LESLIE
MARSHALL.
DR. BARR IS A PROGRAM OFFICER
FOR THE NIH OFFICE OF RESEARCH
ON WOMEN'S HEALTH.
AND DR. MARSHALL IS A SENIOR
SCIENCE ADD VAI SORE IN THE NIH
OFFICE OF AIDS RESEARCH.
AND LEADS THE CLINICAL RESEARCH
WORK STREAM.
DR. BARR AND DR. MARSHALL, OVER
TO YOU.
>> THANK YOU, DR. TURN BELL.
MY NAME IS LESLIE MY SHALL, I'M
A SENIOR SCIENCE ADVISOR AT THE
NIH OAR.
ALTHOUGH I'M DISAPPOINTED I
COULDN'T JOIN YOU IN PERSON
TODAY, I'M EXCITED TO BE HERE
WITH MY COLLEAGUE, DR. ELIZABETH
BARR, TO INTRODUCE THE O.A.R.
ORWH JOINT SIGNATURE PROGRAM
SUPPORTING RESEARCH FOR HIV AND
WOMEN AT THE NIH.
DURING TODAY'S TALK, WE WILL BE
REVIEWING PROGRAM RATIONALE,
OBJECTIVES, CURRENT ACTIVITIES,
AND ASPIRATIONAL PLANS FOR 2024
AND BEYOND.
AS DR. CLAYTON DESCRIBED, O.A.R.
AND ORWH HAVE BEEN ACTIVELY
ENGAGED IN SUPPORT OF RESEARCH
FOR WOMEN WITH AND IMPACTED BY
HIV.
IS AND WILL CONTINUE TO BE
CRITICAL TO ADVANCING RESEARCH
AT THE INTERSECTION OF HIV AND
WOMEN'S HEALTH.
OFTEN, THERE IS A LIMITED
AWARENESS OF NIH'S WOMEN'S
HEALTH PROGRAMS WITHIN THE HIV
RESEARCH COMMUNITY, INCLUDING
THE SEX AS A BIOLOGICAL VARIABLE
INCLUSION POLICIES, AS WELL AS
CONGRESSIONALLY MANDATED EFFORTS
ON MATERNAL MORBIDITY AND
MORTALITY, AND WOMEN'S HEALTH --
WOMEN'S MULTI-MORBIDITY BURDEN.
FROM THESE GAPS, THE OFFICE
IDENTIFIED OPPORTUNITIES FOR
IMPROVED PROGRAMMATIC
COORDINATION AND INFORMATION
DISSEMINATION ACROSS THE NIH.
MECHANISMS BEING UTILIZED
INCLUDE CROSS-PROMOTION THROUGH
SOCIAL MEDIA, EMAIL BLASTS, AND
THE OFFICE'S WEBSITES.
AS WELL AS O.D. SUPPORT FOR
FUNDING OPPORTUNITIES.
IMPORTANTLY, WE ALSO RECOGNIZE
THE NEED FOR CREATING A
DEDICATED SPACE FOR HIV AND
WOMEN'S HEALTH PROGRAMMATIC
STAFF TO SYNERGIZE.
IN THAT SPIRIT, O.A.R. AND ORWH
HAVE FORMED A PARTNERSHIP
THROUGH THE NIH HIV AND WOMEN
SIGNATURE PROGRAM.
THE CORNERSTONE IS AN
INTERSECTIONAL EQUITY-INFORMED
DATA-DRIVEN APPROACH TO RESEARCH
ON HIV AND WOMEN.
THE OBJECTIVES OF THIS JOINT
PROGRAM ARE TO PROMOTE THE NIH
VISION FOR WOMEN'S HEALTH, WHERE
ALL WOMEN, INCLUDING TRANSGENDER
WOMEN, GENDER DIVERSE PEOPLE,
AND INDIVIDUALS ASSIGNED FEMALE
AT BIRTH RECEIVE EVIDENCE-BASED,
GENDER-AFFIRMING, TAILORED HIV
PREVENTION, CARE, AND TREATMENT.
AND IT ALSO SUPPORTS WOMEN IN
SCIENCE CAREERS TO REACH THEIR
FULL POTENTIAL.
STRATEGIES TO ACHIEVE THESE
OBJECTIVES INCLUDE INCREASING
INFORMATION DISSEMINATION AND
NIH-WIDE COLLABORATION THROUGH
ESTABLISHMENT OF AN NIH HIV AND
WOMEN WORKING GROUP, AN HIV AND
WOMEN WEBPAGE AND A
COMPREHENSIVE EXTERNAL
ENGAGEMENT CALENDAR, INCLUDING
LISTENING SESSIONS, WORKSHOPS,
AND SYMPOSIA.
THE JOINT SIGNATURE PROGRAM
LAUNCHED IN FEBRUARY OF 2023 AT
THE INTERNATIONAL WORKSHOP ON
HIV AND WOMEN DURING THE O.A.R.
ORWH CO-SPONSORED SYMPOSIUM, HIV
AND WOMEN, CONSIDERATIONS FROM
ACROSS THE LIFESPAN.
THIS SYMPOSIUM FEATURED
PRESENTATIONS FROM EARLY CAREER
INVESTIGATORS AND REFLECTIONS
FROM ESTABLISHED INVESTIGATORS
ON PRIORITY TOPICS INCLUDING
AGING AND WOMEN'S
MULTI-MORBIDITY BURDEN, SOCIAL
AND STRUCTURAL CONSIDERATIONS
FOR WOMEN, AND ADOLESCENT GIRLS
AND YOUNG WOMEN.
THIS SYMPOSIUM ALSO PROVIDED AN
OPPORTUNITY TO HEAR FROM
COMMUNITY MEMBERS ON ISSUES
RELATED TO HIV AND WOMEN'S
HEALTH THAT ARE IMPORTANT TO
THEM.
YOU CAN READ MORE ABOUT THIS
EVENT, INCLUDING THE EXECUTIVE
SUMMARY, USING THE QR CODE SHOWN
HERE.
WE'D NOW LIKE TO REVIEW SOME
ONGOING ACTIVITIES.
IN APRIL 2022, THE SIGNATURE
PROGRAM LAUNCHED THE HIV AND
WOMEN WEBPAGE WHICH CAN BE
ACCESSED USING THE QR CODE SHOWN
HERE.
THE WEBPAGE AIMS TO SERVE AS AN
EASY TO NAVIGATE ONE-STOP SHOP
TO ACCESS RELEVANT INFORMATION
AND CURATED CONTENT FROM ACROSS
THE NIH AND FEDERAL GOVERNMENT.
THE WEBPAGE INCLUDES GENERAL
RESOURCES SUCH AS LINKS TO THE
NIH HIV AND WOMEN'S HEALTH
STRATEGIC PLANS, AND SEX AS A
BIOLOGICAL VARIABLE AND
INCLUSION POLICIES.
CLINICAL RESOURCES SUCH AS LINKS
TO RELEVANT CLINICAL GUIDELINES
AND NIH INFO, LINKS TO EXTERNAL
RESOURCES AND FUNDING TEUPTS
RELATED TO HIV AND WOMEN.
THE PAGE IS UPDATED REGULARLY
AND A COMPREHENSIVE SET OF LINKS
TO RELATED CONTENT FROM ACROSS
THE NIH INSTITUTES, OFFICES AND
CENTERS IS CURRENTLY UNDERWAY.
DR. BARR, OVER TO YOU.
>> BOTH OAR AND ORWH ARE
COORDINATING OFFICES LOCATED
WITHIN THE NIH OFFICE OF THE
DIRECTOR.
AS SUCH, OUR MISSIONS ENTAIL
COORDINATION OF RESEARCH THAT IS
RELEVANT TO OUR OFFICE MISSIONS
ACROSS THE 27 INSTITUTES AND
CENTERS OF NIH.
FOR BOTH OFFICES, THE NIH
REVITALIZATION ACT OF 1993
ESTABLISHED NIH-WIDE
COORDINATING COMMITTEES, THE NIH
HIV/AIDS EXECUTIVE COMMITTEE, OR
NAEC, AND THE COORDINATING
COMMITTEE FOR RESEARCH ON
WOMEN'S HEALTH, CCRWH.
LAST YEAR, THE OAR AND ORWH
DIRECTORS ESTABLISHED A JOINT
WORKING GROUP OF THE
COORDINATING COMMITTEES TO
PROMOTE SIN RG IN EFFORTS SYNERS
RELATING TO WOMEN AND NIH.
THE NAEC-CCRWH WORKING GROUP ON
WOMEN AND HIV IS CHARGED TO
PROMOTE HEALTH AND WELL-BEING
FOR ALL WOMEN WITH OR AFFECTED
BY HIV AND TO SUPPORT CAREER
DEVELOPMENT FOR WOMEN IN HIV
RESEARCHMENT THE OVERARCHING
GOAL OF THE JOINT WORKING GROUP
IS TO MAXIMIZE COLLABORATION
ACROSS NIH TO PROMOTE MEANINGFUL
RESEARCH FOCUSED ON HIV AND
WOMEN.
TO ACCOMPLISH THIS GOAL, WE MEET
MONTHLY AND RECEIVE REGULAR
UPDATES ON ONGOING DEVELOPING
AND ASPIRATIONAL ACTIVITIES
RELATED TO WOMEN AND HIV.
STANDING TOPICS FOR OUR WORKING
GROUP MEETINGS ARE SHOWN ON THIS
SLIDE.
I'M HAPPY TO SHARE A BRIEF HIGH
LEVEL OVERVIEW OF THE JOINT
WORKING GROUP'S ONGOING
ACTIVITIES.
WE'VE BEEN WORKING WITH THE NIH
LIBRARY TO COMPLETE A LITERATURE
REVIEW TO ASSESS THE STATE OF
THE SCIENCE IN KEY AREAS AT THE
INTERSECTION OF WOMEN AND HIV.
INITIAL AREAS OF FOCUS ARE
SOCIAL AND STRUCTURAL VARIABLES
THAT IMPACT HIV PREVENTION,
TREATMENT, AND OUTCOMES.
AGING AND A LIFE COURSE
PERSPECTIVE.
MULTI-MORBIDITY, CO-MORBIDITY
AND POLYPHARMACY, CURE-RELATED
RESEARCH, DEMOGRAPHIC DIVERSITY,
AND TRAUMA-INFORMED
GENDER-AFFIRMING HIV CARE
RESEARCH AND TREATMENT.
IN PARALLEL, WE ARE COMPLETING A
PORTFOLIO ANALYSIS OF NIH
FUNDING AT THE INTERSECTION OF
HIV AND WOMEN TO CHARACTERIZE
THE FUNDING LANDSCAPE.
WE'LL BE LEADING A WORKSHOP AT
THIS YEAR'S U.S. CHA THAT WILL
REVIEW NIH EFFORTS RELATED TO
WOMEN AND HIV, DESCRIBE CURRENT
NIH PRIORITIES IN WOMEN IN HIV,
AND CORRECTICA CRITICALLY, INVIP
ATTENDEES TO PROVIDE INPUT ON
THESE PROVIDE ORTS AS WELL AS
FUTURE EFFORTS.
FINALLY, WE INVITE TO YOU SAVE
THE DATES FOR A VIRTUAL
SCIENTIFIC WORKSHOP WE WILL HOST
IN CONJUNCTION WITH NATIONAL
WOMEN AND GIRLS HIV AWARENESS
DAY IN MARCH 2024.
THIS VIRTUAL WORKSHOP WILL
REVIEW THE STATE OF THE SCIENCE
ON NIH AND WOMEN, INFORM AN NIH
HIV AND WOMEN RESEARCH AGENDA
AND PRIORITIES FOR PROGRAMMATIC
EFFORTS.
AS WE CLOSE OUT THIS
PRESENTATION, I WOULD LIKE TO
HIGHLIGHT OUR ASPIRATIONAL
PLANNING FOR THE NEXT FISCAL
YEAR AND BEYOND.
THE ONGOING ACTIVITIES THAT
DR. MARSHALL AND I HAVE JUST
DESCRIBED, WHICH ARE SHOWN
ACROSS THE TOP OF THIS SLIDE,
WILL INFORM OUR EFFORTS IN THE
COMING YEARS.
WE WILL USE THE DATA AND
FINDINGS OF THE PORTFOLIO
ANALYSIS AND LITERATURE REVIEW,
AS WELL AS THE INPUT AND
EXPERTISE OF THE NAEC-CCRWH
WORKING GROUP MEMBERS, TO SHAPE
OUR FUTURE ENGAGEMENTS AND
ACTIVITIES.
ACROSS THE BOTTOM OF THIS SLIDE
ARE THREE ASPIRATIONS FOR
UPCOMING YEARS, INCLUDING
IDENTIFYING FUNDING GAPS,
STRATEGIES AND OPPORTUNITIES,
HOSTING WORKSHOPS ON HIV AND
WOMEN, AND ENSURING THIS IS
INCORPORATED ACROSS OUR OFFICE'S
STRATEGIC PLANNING.
WE INVITE YOU TO STAY CONNECTED
AND INFORMED USING ANY OF THE
METHODS SHOWN ON THIS SLIDE AND
I THANK YOU FOR YOUR ATTENTION.
BACK TO YOU, DR. TURNBULL.
>> DR. TURNBULL, WE'RE NOT
HEARING YOU.
ONLINE.
>> I'M SORRY.
I DIDN'T UNMUTE MY LINE.
CAN YOU HEAR ME NOW?
>> YES.
>> OKAY, GREAT.
SO THANK YOU ONCE AGAIN, LESLIE
AND ELIZABETH, FOR YOUR
PRESENTATION.
WE WILL NOW HEAR FROM OUR GUEST
SPEAKER, DR. SEBLE KASSAYE.
SHE IS PRINCIPAL INVESTIGATOR OF
THE COMBINED COHORT STUDY AND
STAR COHORT.
OVER TO YOU, DR. KASSAYE.
>> THANK YOU, DR. TURNBULL, GOOD
AFTERNOON, EVERYONE.
THANK YOU TO THE OFFICE OF AIDS
RESEARCH FOR THE OPPORTUNITY TO
PRESENT TODAY.
AND FOR THE FOCUS ON HIV AMONG
WOMEN.
I'D LIKE TO ACKNOWLEDGE THE
FIRST GENERATION OF
INVESTIGATORS IN THIS AREA WHO
HAVE LAID THE FOUNDATION FOR
MUCH OF THE DATA I WILL BE
PRESENTING TODAY.
SO GLOBALLY AS WE'VE JUST HEARD
OVER HALF OF THE PERSONS
AFFECTED WITH HIV ARE WOMEN, AND
IN THE U.S. AND IN THE D.C.
REGIONS IN PARTICULAR, THE
EPIDEMIC IS HIGHLY MINORITIZED
WITH WOMEN OF COLOR BEING
HEAVILY AFFECTED BY HIV.
AND IN THIS, WE ALSO KNOW WE
HAVE REALLY MADE GREAT STRIDES
IN HAVING EFFECTIVE THERAPIES
THAT REALLY HAVE TURNED THE
OVERALL EPIDEMIC WITH
SIGNIFICANT IMPROVEMENTS IN
MORTALITY SINCE THE EARLY DAYS
OF THE EPIDEMIC, SUCH THAT A
YOUNG PERSON WHO'S NOW AFFECTED
WITH HIV SHOULD EX-SECRE EXPECTE
ALMOST THE SAME LIFESPAN AS
SOMEONE WHO IS UNINFECTED.
SIMILARLY, THESE EFFORTS HAVE
ALSO TRANSLATED INTO
IMPROVEMENTS IN TRANSMISSION,
AND HENCE IN THIS BACKDROP, THE
NIH CARE CONTINUUM REALLY
PROVIDES A CONSTRUCT FOR US TO
QUANTIFY OUR PROGRESS TOWARDS
PROVIDING CARE AND TREATMENT
SERVICES TO PERSONS WITH HIV.
SURVEILLANCE DATA DEMONSTRATE
EXCELLENT PROGRESS IN DIAGNOSIS
OF INDIVIDUALS WITH HIV LOCALLY,
NATIONALLY AND IN THE GLOBAL
ARENA.
HOWEVER, THERE ARE UNMET NEEDS
WHEN IT COMES TO LINKAGE TO CARE
AND VIRAL SUPPRESSION.
DELIVERY OF EFFECTIVE
ANTIRETROVIRALS IS KEY TO
PREVENTING HIV TRANSMISSION, AND
EFFORTS TO ELIMINATE PEDIATRIC
HIV IS A NOTABLE AREA OF GREAT
SUCCESS, INCLUDING FOR WOMEN.
THESE ARE DATA FROM A STUDY THAT
I DESIGNED WHILE WORKING AT THE
ELIZABETH GLAI SER PEDIATRIC
AIDS FOUNDATION.
THIS OBSERVATIONAL COHORT WAS
CONDUCTED TO DETERMINE PROGRAM
EFFECTIVENESS FOLLOWING THE
IMPLEMENTATION OF UNIVERSAL
TREATMENT FOR ALL PREGNANT WOMEN
WHERE HIV PREVALENCE FOR WOMEN
AT THE TIME WAS OVER 25%.
WE ENROLLED 650 WOMEN WITH HIV
AND 941 WOMEN WITHOUT HIV FROM
JUNE 2014 THROUGH 2016.
AND COMPLETED 24 MONTH FOLLOW-UP
BY SEPTEMBER 2018.
WE IDENTIFIED SEVERAL IMPORTANT
FINDINGS IN THIS STUDY.
THE MOTHER TO CHILD TRANSMISSION
RATE AT 24 MONTHS WAS 2.8%.
DESPITE THIS VERY POSITIVE
FINDING, WE DID IDENTIFY THAT
MORE NIH EXPOSED INFANTS DIED
DURING THE FOLLOW-UP PERIOD,
RESULTING IN 91-POINT 8%
COMPARED TO 96.3% IN UNEXPOSED
INFANTS.
THE STUDY DOES ESTABLISH THAT
THE PROGRAM WAS PERFORMING ON
PAR WITH THAT THE OTHER HIGH
PERFORMING COUNTRIES IN
SUB-SAHARAN AFRICA.
FROM HERE ON, I WILL FOCUS ON
DATA COLLECTED HERE IN THE U.S.
OBSERVATIONAL COHORTS HAVE BEEN
IMPORTANT TO ELUCIDATE THE
EFFECT OF HIV AMONG WOMEN.
THE WOMEN'S INTERAGENCY HIV
STUDY IS A NATIONAL MULTI-SITE
OBSERVATIONAL INTERVAL COHORT
THAT STARTED ENROLLMENT IN 1994.
THIS WAS COMBINED IN 2019, WITH
THE MULTICENTER AIDS COHORT
STUDY THAT PREDATED THE WIHS BY
ABOUT A DECADE.
THE WIHS COHORT HAS CONTRIBUTE
TODAY IMPORTANT FINDINGS RELATED
TO HIV AMONG WOMEN.
SOME OF WHICH HAVE ALREADY BEEN
MENTIONED IN EARLIER
PRESENTATIONS.
THE D.C. WIHS WAS ONE OF THE
ORIGINAL STUDY SITES SET OF BUT
MY PREDECESSOR DR. MARY YOUNG AS
A MULTISITE COLLABORATION WITH A
RECRUITMENT STRATEGY DESIGNED TO
ENSURE ADEQUATE REPRESENTATION
OF THE AFFECTED POPULATION.
WE UNDERTOOK A STUDY TO
DETERMINE VIRAL SUPPRESSION
OUTCOMES AMONG WOMEN.
OUR INITIAL D.C. FOCUSED
ANALYSIS USE DATA THROUGH 2012.
AS YOU CAN SEE, WHEN WE LOOKED
CROSS-SECTIONALLY, WE IDENTIFIED
INCREASING VIRAL SUPPRESSION
OVER TIME WITH THE MOST RECENT
TIME POINT DEMONSTRATING ABOUT
60% OF WOMEN WITH VIRAL
SUPPRESSION.
AND THIS WAS QUITE GOOD ACTUALLY
BASED ON SURVEILLANCE DATA THAT
WERE BEING REPORTED AT THE TIME.
HOWEVER, WHEN WE LOOKED
LONGITUDALLY USED A GROUP BASED
PROBABILITY MODELING APPROACH WE
IDENTIFIED THERE WERE THREE
DISTINCT PATTERNS OF VIREMIA.
APPROXIMATELY 28% FELL INTO A
GROUP OF LOW PROP PROBABILITY OF
VIREMIA SO THEY WERE DOING VERY
WELL.
36.3% WERE IN A GROUP WITH
INTERMEDIATE PROBABILITY OF
VIREMIA, AND A THIRD GROUP, 36%,
HAD A HIGH PROBABILITY OF VIE
VIREMIA, INCLUDING IN THE RECENT
YEARS.
12 YEA EVEN WHEN ADJUSTED FOR
CD4 COUNT, ART USE, ADHERENCE,
AND HOUSING, THE FACTORS WE
IDENTIFIED AS ASSOCIATED WITH
BELONGING IN THE HIGH
PROBABILITY OF VIREMIA GROUP
WERE AFRICAN AMERICAN RACE,
YOUNGER AGE, LOWER EDUCATION,
MODERATE OR HIGHER ALCOHOL USE,
AND THE PRESENCE OF DEPRESSIVE
SYMPTOMS.
WE EXPANDED THIS ANALYSIS TO
LOOK COHORT-WIDE TO DETERMINE
WHETHER THE PHENOMENON WE
DESCRIBED WERE UNIQUE.
WE SIMILARLY IDENTIFIED THREE
DISTINCT GROUPS USING THE
GROUP-BASED TRAJECTORY APPROACH
WITH THE CONVERGENCE IN
PROBABILITY OF VIREMIA AMONG THE
LOW AND INTERMEDIATE PROBABILITY
OF VIREMIA GROUPS BY 2009.
WE SEE THAT THE SLOPE OF THE
DECLINE IN THE PROBABILITY OF
VIREMIA WAS LONGER AMONG
INDIVIDUALS IN THE HIGH
PROBABILITY OF VIREMIA GROUP.
WE THEN FOCUSED ON THE TIME
BETWEEN 2015 TO '17,
ANTICIPATING THAT THE MOVE TO
UNIVERSAL TREATMENT BASED ON
RECOMMENDATIONS AND GUIDELINES
STARTING IN 2012, MAY HAVE TAKEN
TIME TO IMPLEMENT.
WHEN WE LOOKED
CROSS-SECTIONALLY, APPROXIMATELY
83% OF WOMEN ACHIEVED VIRAL IS
SUPPRESSION IN 2017 BUT WHEN WE
LOOKED OVER THE PERIOD OF THREE
YEARS, ONLY 71% DEMONSTRATED
DURABLE VIRAL SUPPRESSION.
AS YOU CAN SEE IN THE RIGHT
UPPER FIGURE, 41% OF WOMEN IN
THE HIGH PROBABILITY OF VIREMIA
GROUP REMAINED VIREMIC IN THE
MOST RECENT TIME PERIOD,
SUGGESTING THAT THERE IS
SOMETHING UNIQUE ABOUT THIS
GROUP THAT WE NEED TO UNDERSTAND
IF OUR GOAL IS TO ACHIEVE
UNIVERSAL DURABLE VIRAL
SUPPRESSION.
IN ADDITION TO THE FACTORS WE
PREVIOUSLY IDENTIFIED ASSOCIATED
WITH HIGH PROBABILITY OF VIREMIA
AMONG THE PARTICIPANTS, UNSTABLE
HOUSING, DEPRESSIVE SYMPTOMS,
DRUG USE, AND MODERATE OR
GREATER ALCOHOL USE WAS
ASSOCIATED WITH VIREMIA.
WE PLAN TO REPEAT THESE ANALYSES
NOW INCLUDING MEN TO LOOK FOR X
DIFFERENCES AND ALSO TO LOOK AT
GEOGRAPHIC VARIATIONS WITH THE
MORE RECENT ADDITION OF SOUTHERN
U.S. SITES THAT WERE NOT A PART
OF OUR EARLIER ANALYSES.
THE FINDINGS FROM THE
GROUP-BASED TRAJECTORY ANALYSIS
HELPED US BETTER CHARACTERIZE
THE LIKELIHOOD OF VIRAL
SUPPRESSION AND WAS THE BASIS
FOR THE NEXT SET OF STUDIES THAT
WE UNDERTOOK.
IN A PROJECT WE CALLED BOTTLING
SUCCESS, FUNDING THROUGH
SUPPLEMENTAL FUNDS FOR NIMHD, WE
SOUGHT TO IDENTIFY THE SOCIAL,
BEHAVIORAL, STRUCTURAL AND
CLINICAL BASIS FOR VIRAL
SUPPRESSION USING THE SOCIAL
COGNITIVE THEORETICAL FRAMEWORK.
OUR GOAL WAS TO IDENTIFY
MODIFIABLE ELEMENTS THAT WOULD
IMPROVE LONG TERM VIRAL
SUPPRESSION.
THE UNDERLYING PREMISE OF THE
FRAMEWORK IS THAT INTERACTIONS
BETWEEN INDIVIDUAL AND
INTERPERSONAL FACTORS LEAD TO
MANIFESTED BEHAVIORS, THUS
INFLUENCING BIOLOGIC OUTCOMES.
KEY TO THIS FRAMEWORK IS A
CONCEPT OF SELF-EFFICACY THAT IS
SHAPED BY SOCIAL STRUCTURES AND
ENVIRONMENTAL EXPOSURES.
COGNITION AND BEHAVIOR CAN BE
INFLUENCED AND SHAPED, LEADING
TO IMPROVEMENTS IN
SELF-EFFICACY.
AND THEREBY THE DESIRED
BEHAVIORS ON HEALTH OUTCOMES.
SO WE SOUGHT TO QUANTIFY AND
DETERMINE WHETHER TREATMENT
SELF-EFFICACY IS ASSOCIATED WITH
VIRAL SUPPRESSION.
WE ALSO INCLUDED MEASURES OF
PERSONAL SOCIAL INVENTORY,
PERCEIVED STRESS, AND
PROVIDER-PATIENT INTERACTIONS
THAT MAY INFLUENCE
HEALTH-SEEKING BEHAVIORS.
IN THIS MANUSCRIPT LED BY
DR. BLARE SPENCE, AN INFECTIOUS
DISEASES PHYSICIAN AND EARLY
STAGE INVESTIGATOR IN MY GROUP,
WE ANALYZED DATA FROM THE DC
WIHS WOMEN WITH HIV, JUST OVER
TWO THIRDS OF WHOM HAD DURABLE
VIRAL SUPPRESSION BETWEEN 2015
AND 2018.
IN THIS ANALYSIS WE FOUND THAT
HIGHER TREATMENT SELF-EFFICACY
WAS ASSOCIATED WITH VIRAL
SUPPRESSION, WHILE USE OF
ILLICIT DRUGS WAS ASSOCIATED
WITH VIREMIA.
WE DID NOT FIND A -- WHICH MAY
BE DRIVEN BY THE HIGH PREVALENCE
OF HIV IN OUR REGION AND
POTENTIALLY SHIFTING SOCIETAL
ISSUES -- CONCEPTS AROUND STIGMA
IN OUR REGION.
DR. KATE MICHELLE WHO JOINED MY
GROUP AS A POSTDOCTORAL FELLOW
AND WHO IS NOW IN THE D.C.
HEALTH DEPARTMENT FOCUSED ON
MATERNAL HEALTH MADE GREAT
HEADWAY IN ANALYZING DATA WE
COLLECTED RELATED TO TRUST.
WHEN WE LOOKED AT PROVIDER TRUST
IN VIRAL OUTCOMES, HIGH PROVIDER
TRUST WAS ASSOCIATED WITH
GREATER ART ADHERENCE AND LOWER
HEALTHCARE SERVICE DISTRUST.
SOMEWHAT DISTURBING WAS OUR
FINDING AMONG WOMEN WHO HAD
COMPLETED THE TRUST
QUESTIONNAIRES IN 2006 AND THEN
AGAIN IN 2017-18.
28% OF THESE WOMEN REPORTED A
DECREASE IN TRUST IN THE
INTERVENING DECADE, WHILE
ANOTHER 25% REPORTED AN INCREASE
IN TRUST.
THIS IS AN IMPORTANT FINDING IN
OUR CONTINUED UNDERSTANDING OF
HOW WOMEN RELATE TO THE
HEALTHCARE SYSTEM IS PIVOTAL, AS
WE STRIVE TO ACHIEVE AND
MAINTAIN DURABLE VIRAL
SUPPRESSION OUTCOMES.
THIS COMPONENT OF THE STUDY I
FIND PARTICULARLY INTERESTING.
IT WAS A COLLABORATION THAT WE
HAD WITH OUR COLLEAGUES AT THE
D.C. HEALTH DEPARTMENT, WHERE
WE SENT A WEB-BASED SURVEY TO
ALL D.C. -LICENSED PHYSICIANS
AND MID LEVEL PROVIDERS TO
ASSESS HIV KNOWLEDGE AND
ATTITUDES, INCLUDING A VALIDATED
HIV STIGMA QUESTIONNAIRE.
OVER A ONE-MONTH PERIOD, WE
ENROLLED 436 PROVIDER WITH A
MEAN AGE OF 46 YEARS, 70% OF
WHOM ARE FEMALE, 62% WHITE, 19%
ASIAN, AND 12% BLACK.
44% WERE BASED IN AN ACADEMIC
MEDICAL CENTER, WHILE 45% WERE
IN NON-PROCEDURAL SPECIALTIES.
ALTHOUGH THE CITY REQUIRED
CONTINUING MEDICAL EDUCATION
RELATED TO HIV FOR THE PRECEDING
FIVE YEARS BEFORE THE STUDY
PERIOD, WE IDENTIFIED GAPS IN
COMFORT WITH TALKING ABOUT HIV
RISK, ASSESSING DRUG USE, AND
DISCUSSING SEXUAL PRACTICES.
NOTABLY, WE FOUND THAT LOWER HIV
STIGMA WAS ASSOCIATED WITH
GREATER HIV KNOWLEDGE AND
COMFORT WITH COUNSELING.
THE FINDINGS FROM THESE SERIES
OF SURVEYS PROVIDE DATA
SUPPORTING THE NEED TO DEVELOP
INTERVENTIONS TO INCREASE
TREATMENT SELF-EFFICACY,
IMPROPER AND SUPPORT PATIENT AND
PROVIDER INTERACTIONS AND
EFFECTIVELY ADDRESS DRUG AND
ALCOHOL USE.
STUDIES TO DETERMINE WHICH AND
WHAT COMBINATION OF THESE
INTERVENTIONS WOULD IMPROVE
VIRAL OUTCOMES ARE NEEDED.
I'LL SWITCH GEARS TO DISCUSS
VERY BRIEFLY A COUPLE OF STUDIES
THAT WE HAVE DONE RELATED TO
COMORBIDITIES IN THE SETTING OF
HIV.
WE KNOW FROM CLINIC-BASED AND
OBSERVATIONAL COHORTS INCLUDING
THE WIHS THAT NON-AIDS
COMORBIDITIES EMERGE EARLIER
AMONG PERSONS WITH HIV.
DR. MATT LEVY, EPIDEMIOLOGIST
WHO TRAINED AT GEORGE
WASHINGTON, USED DATA FROM THE
LONGITUDINAL CAROTID ULTRASOUND
IMAGING THAT WAS CONDUCTED AMONG
700 WIHS PARTICIPANTS WITH A
MEDIAN AGE OF 47 OVER AN
APPROXIMATELY SEVEN-YEAR TIME
SPAN.
HIS GOAL WAS TO DETERMINE THE
ASSOCIATION BETWEEN MENTAL
HEALTH CHARACTERISTICS AND
SUBCLINICAL ATHEROSCLEROSIS,
MAKIMAKE EXCELLENT USE OF --
INCLUDING NIMH.
THE PARENT STUDY CONDUCTED
THROUGH R01 FUNDING TO
DR. ROBERT KAPLAN IN THE BRONX
IDENTIFIED HIGHER SUBCLINI
SUBCLINICAL@THROW SCLEROSIS
AMONG WOMEN WITH HIV TO
COMPARABLE WOMEN WITHOUT HIV,
14% VE VERSUS THE%.
DR. LEVY IDENTIFIED HIGH
PSYCHOSOCIAL RISK PRIMARILY
DRIVEN BY DEPRESSIVE SYMPTOMS
WAS ASSOCIATED WITH PREVALENT
PLAQUE.
USING THE LONG TEUJAL DATA,
DR. LEVY IDENTIFIED@THROW
SCLEROSIS WAS HIGHER AMONG WOMEN
WITH SIGNIFICANT DEPRESSIVE
SYMPTOMS, 17%, COMPARED TO 7 TO
10% OF THOSE WITH NO OR
SOMETIMES DEPRESSIVE SYMPTOMS.
COLLEAGUES ARE NOW CONDUCTING
MULTI-OMIC STUDIES SUPPORTED BY
SUPPLEMENTAL FUNDING SUPPO
SUPPORTED -- PREMATURE@THROW
SCLEROSIS IN THIS COHORT.
CERVICAL CANCER WAS IDENTIFIED
EARLY ON AS AN AIDS-ASSOCIATED
DISEASE.
THE WIHS PLATFORM HAS BEEN USED
TO STUDY CERVICAL DYSPLASIA AND
INFORM CURRENT DAY PRACTICE
GUIDELINES.
WITH SUPPORT FROM NCI AS THE
CO-FUNDING INSTITUTE.
CERVICAL CANCER REMAINS AN
IMPORTANT CAUSE OF CANCER DEATHS
NATIONALLY AND GLOBALLY.
MY COLLEAGUE AT GEORGETOWN NOTED
A NUMBER OF WOMEN WITH MODERATE
CERVICAL DYSPLASIA LIMITED TO
THE UPPER TWO THIRDS OF THE
MUCOSAL SURFACE HAD RESOLUTION
OF THEIR LESIONS WITHOUT
INTERVENTION.
SHE WONDERED WHETHER THE
STANDARD PRACTICE PROCEDURES TO
REMOVE THE PRECANCEROUS CELLS
THAT COULD LEAD TO CERVICAL
INCOMPETENCE, THEREBY INCREASING
RISK FOR PREGNANCY
COMPLICATIONS, WERE INDEED
WARRANTED IN AN ERA OF MORE
EFFECTIVE ANTIRETROVIRALS.
WE FOUND AND IDENTIFIED A SUBSET
OF WOMEN -- INTERESTING FINDINGS
INCLUDE HIGH RATES OF DISEASE
REGRESSION AMONG 62% OF THESE
WOMEN.
ONLY 13% HAD DISEASE
PROGRESSION, OVER A DECADE OF
FOLLOW-UP, WITH NONE DEVELOPING
CANCER.
WOMEN'S IMMUNE STATUS AS
MEASURED BY CD4 WAS ASSOCIATED
WITH DISEASE PROGRESSION WITH
LOWER CD4 ASSOCIATED WITH HIGHER
ODDS OF PROGRESSION TO -- 3.
WE ARE NOW STUDYING THE ROLE OF
HPV IN THE MICROBIOME ON THE
OBSERVED DISEASE PATTERNS, AND
IMPROVEMENTS IN OUR BIOMARKERS
TO ASSESS RISK FOR CERVICAL
CANCER AND REFINE MANAGEMENT
STRATEGIES WITH THE ROLLOUT OF
HPV VACCINATION REMAINS PAIR
MOUNT AND SOMETHING THAT WE HOPE
TO STUDY IN THE STAR COHORT THAT
IS SUPPORTED BY NICHD.
I'LL BRIEFLY TALK ABOUT SOME OF
OUR PREP STUDIES.
ALMOST HALF A MILLION OF THE
1.2 MILLION PERSONS WHO ARE
THOUGHT TO BENEFIT FROM PREP IN
THE U.S. ARE WOMEN.
HOWEVER, PREP UPTAKE AND THE
ROLLOUT OF PREP FOR WOMEN HAS
BEEN QUITE POOR, WITH ONLY 10%
OF WOMEN WHO WOULD BENEFIT FROM
THE MEDICATION HAVING RECEIVED
PREP.
WE ANALYZED DATA FROM THE WIHS
TO DETERMINE PREP ELIGIBILITY
AND UPTAKE AMONG 716 WOMEN.
BETWEEN 2014 TO '19, WE FOUND
ANYWHERE FROM 10 TO 15% OF WOMEN
WERE ELIGIBLE FOR PREP BASED ON
CDC ELIGIBILITY CRITERIA AT EACH
TIME POINT.
WHEN WE LOOKED LONGITUDINALLY,
36% OF WOMEN WOULD HAVE BEEN
ELIGIBLE FOR PREP.
THE FIGURE ON THE RIGHT IS A
HEAT MAP THAT WE DEVELOPED.
EACH ROW REPRESENTS A WOMAN, AND
THE PREP ELIGIBILITY AND
TREATMENT IS SHOWN IN THE
DIFFERENT COLORS OVER A
FIVE-YEAR SPAN IN THE COLUMNS.
THE 64% OF WOMEN WHO ARE NOT
ELIGIBLE FOR PREP AND DID NOT
RECEIVE PREP ARE SHOWN IN BLUE.
TIME POINTS IN RED REPRESENT
TIMES WHEN WOMEN DID MEET
ELIGIBILITY TRY TIER YA CRITERIE
NOT PRESCRIBED PREP.
THE FEW SPECS OF GREEN SHOW
LIMITED UPTAKE AMONG THOSE WHO
MET ELIGIBILITY CRITERIA.
ONLY 3% OF THE WOMEN REPORTED
EVER USING PREP AND AS YOU CAN
SEE, PREP USE WAS NOT
PERSISTENT.
CIRCLING BACK TO OUR PROVIDER
SURVEYS.
WE TRIED TO UNDERSTAND THE
POTENTIAL ROLE OF PRIMARY CARE
PROVIDERS IN THE PREP ROLLOUT
FOR WOMEN.
ONLY HALF OF THOSE WHO COMPLETED
THE SURVEYS RESPONDED THAT THEY
ROUTINELY ASKED ABOUT SEX
PRACTICES.
ONLY A QUARTER REGULARLY ASK
ABOUT DRUG USE AND WE WERE SAD
TO SEE THAT TWRO 40% SAID THEYD
NOT ASK ABOUT DRUGS OR SEX, EVEN
IF GIVEN MORE TIME.
I HOPE I HAVE SHARED WITH YOU,
IN CLOSING, THAT THE
OBSERVATIONAL COHORTS THAT ARE
FUNDED THROUGH NIH AND THE
OFFICE OF AIDS RESEARCH AND
OTHER U.S. FUNDERS REALLY
PROVIDE GREAT OPPORTUNITY FOR US
TO GET INSIGHTS INTO THE
BIOLOGY, AS WELL AS
IMPLEMENTATION CHALLENGES
RELATED TO HIV AND WOMEN, AS
WELL AS SERVING AS AN IMPORTANT
PLATFORM FOR EDUCATING THE NEXT
GENERATION OF INVESTIGATORS.
THANK YOU.
DR. TURNBULL, TURNING BACK TO
YOU.
>> THANK YOU VERY MUCH.
AND THANK YOU TO ALL OF OUR
PRESENTERS.
WE WILL NOW HAVE TIME FOR OPEN
DISCUSSION.
THIS IS THE TIME TO ASK
QUESTIONS ABOUT THE
PRESENTATIONS WE'VE JUST HEARD.
DR. GLENSHAW AND I WILL MODERATE
THIS DISCUSSION SECTION STARTING
WITH MEMBERS ON THE ZOOM CALL.
ANY MEMBER WHO WISHES TO
PARTICIPATE ON THE ZOOM CALL,
PLEASE USE THE ZOOM RAISE YOUR
HAND FUNCTION.
DR. GLENSHAW, YOU'LL BE LOOKING
OUT FOR THE INDIVIDUALS OR THE
QUESTIONS THAT WE HAVE IN THE
ROOM.
OKAY.
ANY QUESTIONS?
DR. GANDHI.
>> THOSE WERE GREAT
PRESENTATIONS, AND I THINK THE
COMMITMENT THAT THE NIH HAS HAD,
SPECIFICALLY IN HIV RESEARCH TO
DEFINING SEX DIFFERENCES ARE
REALLY PROFOUND.
THE WIHS STUDY IS ACTUALLY THE
LARGEST SPECIFIC STUDY FOR WOMEN
AND HAS DEFINED MANY IMPORTANT
OBJECTIVES.
SO I GUESS MY QUESTION IS THAT
THE WIHS STUDY IS OBSERVATIONAL,
AND IS VERY CAREFUL ABOUT NOT
BEING ABLE TO PERFORM
INTERVENTIONAL RESEARCH.
HOWEVER, YOU KNOW, WE ARE SEEING
THAT, FOR EXAMPLE, WHAT SEBLE
JUST PRESENTED ABOUT THE REALLY
LOW RATES -- THAT YES, PREP RISK
GOES UP AND DOWN, RISK GOES UP
AND DOWN, BUT WE ALL KNOW THAT
THE OVERALL RATES OF UPTAKE OF
PREP AMONG WOMEN IN THE U.S. IS
VERY WOEFULLY INADEQUATE AND NOW
WE HAVE THIS TOOL THAT 9%
MORE -- AND SO HOW DO WE -- AND
THIS IS A QUESTION I GUESS FOR
THE PROGRAM, IS HOW DO WE TAKE
THE WIHS PLATFORM AND ADD ON
INTERVENTIONS?
AND I KNOW THAT THAT HASN'T BEEN
A PART OF THE WIHS PLATFORM, BUT
HOW DO WE TAKE THIS INCREDIBLE
PLATFORM WHERE PARTICIPANTS ARE
RECRUITED AND RETAINED AT REALLY
HIGH LEVELS, AND HAVE
INTERVENTIONS AT LEAST, YOU
KNOW, STEM OFF OF WIHS.
HAS ANYONE USED THIS PLATFORM
FOR INTERVENTION, OR THOUGHT
ABOUT THAT, OR HOW TO COMBINE
THOSE?
>> THANK YOU, DR. GANDHI.
SO I WILL COMMENT THAT THERE
HAVE BEEN INTERVENTIONS DONE
LOCALLY TO LOOK AT ALCOHOL
CESSATION, AND THERE ARE ALSO
EFFORTS ONGOING TO TRY TO LOOK
AT TO RECRUIT FROM THE WIHS TO
STUDY THINGS SUCH AS
INTERVENTIONS TO STUDY METABOLIC
SYNDROME THROUGH VARIOUS
INTERVENTIONS, AND THEN USING
THE PLATFORM, TO USE SAMPLES AND
DATA THAT WILL NOT ADDITIONALLY
NEED TO BE COLLECTED.
SO I DO THINK IT'S POSSIBLE TO
LEVERAGE THE COHORT FOR SUCH
INTERVENTIONS, AND REALLY WHAT I
DO THINK IS QUITE DISTINCT,
THOUGH, IS BY THIS NOT BEING A
CLINICAL TRIAL, IT DOES ALLOW US
TO REALLY KEEP AN EYE ON WHAT
THE POPULATION EFFECTS OF OUR
VARIOUS PROGRAMS CLINICALLY ARE
WHEN WE TRANSLATE IT INTO
PRACTICE.
SO I DO THINK THERE'S CONTINUED
NEED FOR HAVING SUCH A
POPULATION-BASED COHORT TO
ASSESS THE IMPACT THAT WOOR
HAVING WITH PROG WE'RE
HAVING WITH PROGRAMS.
SO I DO THINK IT CAN BE
LEVERAGED FOR INTERVENTION BUT I
DO THINK THERE'S DISTINCT VALUE
TO HAVING IT REMAIN
OBSERVATIONAL AS WELL.
>> I WOULD AGREE WITH YOU AND I
WOULD JUST URGE MORE LEVERAGING
OF THE PLATFORM FOR
INTERVENTIONS, ESPECIALLY WITH
OPENING OF THESE OTHER INSIGHTS.
>> DR. ALI OSMAN.
>> THANK YOU VERY MUCH.
AND THANKS TO THE THREE SPEAKERS
FOR VERY INSIGHTFUL
PRESENTATION.
MY QUESTION IS, I THINK IT'S
RELEVANT, ESPECIALLY DR. GANDHI
MENTIONING INTERVENTIONS, WHICH
I WOULD CONSIDER INCLUDES ALSO
THERAPEUTIC INTERVENTIONS.
AS I'M SURE YOU KNOW, CURRENTLY
THERE'S A SIGNIFICANT SHORTAGE
OF KEY ANTI-CANCER AGENTS,
INCLUDING MANY CHEMOTHERAPEUTICS
THAT ARE STABLES IN PROTOCOLS
FOR VARIOUS CANCERS.
YOU KNOW, CISPLATIN, AND SO ON.
THIS IS HAVING AN IMPACT ON THE
PRACTICE OF ONCOLOGY, CERTAINLY
ON CLINICAL TRIALS.
I DIDN'T HEAR ANY REFERENCE TO
THAT, BUT -- WHICH MAY BE GOOD
NEWS THAT YOU'RE NOT DEALING
WITH THIS PROBLEM, BUT ARE YOU
DEALING WITH IT OR IS THERE A
PROSPECT -- SHORTAGE IN DRUGS
MIGHT LIMIT SOME OF THE PROGRAMS
THAT YOU HAVE, PARTICULARLY
INTERVENTIONAL PROGRAMS?
AND I'M JUST CURIOUS WHETHER
THAT'S SOMETHING THAT YOU HAVE.
I'M REPRESENTING THE NATIONAL
CANCER ADVISORY BOARD, SO AT THE
NCI, THAT'S A MAJOR ISSUE THAT'S
BEING GRAPPLED WITH RIGHT NOW.
IS THIS SOMETHING THAT COULD
IMPACT SOME OF THE PROGRAMS THAT
YOU HAVE?
>> SO WE DO HAVE EXCELLENT
ACCESS TO ANTIRETROVIRAL
THERAPIES.
THEY ARE AVAILABLE.
HOWEVER, ACCESS WHEN IT COMES TO
REQUIRING PRIOR APPROVALS,
ESPECIALLY FOR THE MORE
EXPENSIVE INJECTABLE PRODUCTS
THAT MAY IMPROVE OUR ADHERENCE,
CAN BE CHALLENGING.
AND THE REIMBURSEMENT ALSO FOR
SOME OF THESE SERVICES,
ESPECIALLY WHEN IT COMES TO
PREVENTION, IS PARTICULARLY
CHALLENGING.
SO THESE ARE STRUCTURAL PROBLEMS
THAT WE DO HAVE TO DEAL WITH,
AND ARE NOT MEASURED WITHIN THE
WIHS, BUT CERTAINLY THESE SHOULD
BE MEASURED AND BE STUDIED.
>> SO IT'S NOT IMPACTING THE
HIV-ASSOCIATED CANCERS BECAUSE
YOU HAVE, YOU KNOW, SITUATIONS
WHERE SOME AGENTS ARE NEEDED TO
TREAT PATIENTS WHO MAY HAVE
CANCERS.
YOU DON'T SEE THAT PROBLEM?
>> I DO SEE THE NEED TO
SPECIFICALLY REQUEST PRIOR
APPROVAL FROM AN INSURANCE
COMPANY'S -- THAT CAN LEAD TO
SOME DELAYS.
ULTIMATELY, USUALLY WE ARE ABLE
TO ACCESS CARE.
FOR PEOPLE WHO NEED TO MAKE
SWITCHES.
>> THAT'S GREAT NEWS.
THANKS.
>> DR. GANDHI, DR. DIANNE ROUSH
FROM NIMH IS SHARING THAT THERE
ARE ACTUALLY NUMEROUS RFAs
THAT LEVERAGE THE MAX WIHS
CLINICAL COHORT FOR INTERVENTION
ACTIVITIES, WE'D BE HAPPY TO
SHARE THOSE.
>> THANK YOU.
>> ANY QUESTIONS FROM THE ROOM?
DR. MONTANER?
>> IT'S NOT SO MUCH A QUESTION
BUT PERHAPS SERVING AS ADVISORY,
GIVING YOU AT LEAST INSIGHTS.
YOU KNOW, IN MENTORING OVER 26
YEARS AND GETTING ENGAGED WITH
DIFFERENT CLINICAL EFFORTS, I
MEAN, THE TOPIC OF WOMEN AND HIV
HAVE BEEN WITH US EVER SINCE.
SO I REALLY WANT TO CONGRATULATE
THE OFFICE ON ITS INITIATIVE AND
ALL OF THE EFFORTS UNDERWAY.
I THINK THAT THEY'RE ON THE
RIGHT TRACK.
SO I WOULD JUST OFFER FOUR
SUGGESTIONS, MAYBE SOME QUICK
SUGGESTIONS FOR THE PROGRAM TO
CONSIDER.
THE FIRST ONE IS THERE'S ALWAYS
A RECURRENT GAP BETWEEN THE
EXECUTION OF THE RESEARCH WHEN
THE GRANT IS AWARDED AND THE
RECRUITMENT RESOURCES AVAILABLE
TO GET WOMEN INTO RESEARCH.
SO I THINK THAT YOU COULD ALTER
THE HUMAN SUBJECT SECTION BY
SPECIFICALLY REQUESTING TEXT ON
RESOURCES THAT ARE BEING PLANNED
FOR THE RETRUETTMENT OF WOMEN. .
AND ON THE BUDGET JUSTIFICATION,
ALSO REQUEST AS YOU DO FOR DATA
MANAGEMENT, A SPECIFIC COMMENT
ON USE OF RESOURCES FOR
RECRUITMENT OF DIVERSE
POPULATIONS, BECAUSE THERE'S A
GAP AT THE END THAT OFTEN
INVESTIGATORS SAY WE DON'T HAVE
THE MONEY TO COVER CHILD CARE,
WE DON'T HAVE THE MONEY TO HAVE
PEOPLE COME IN AT 7:00 A.M. OR
MEET WOMEN AT 7:00 P.M.
SO I THINK WE CAN DO SIMPLE
THINGS TO THE GRANT PROCESS TO
GET PEOPLE TO THINK ABOUT THAT
AHEAD OF TIME.
I THINK WITH REGARDS TO GETTING,
YOU KNOW, WOMEN INTO THE
WORKFORCE, I THINK THE RESEARCH
MINORITY NETWORK AND OTHER SUCH
NETWORKS THAT ARE BASED
PRIMARILY IN NON-R01-HEAVY
CENTERS, HAVE A LOT OF
INDIVIDUALS THAT EITHER HAVE
STARTED IN TEACHING AS ASSISTANT
PROFESSORS AND EVENTUALLY WANT
TO GET INTO RESEARCH, AND OUR
SYSTEM NOW WITH STUDY SECTIONS
PENALIZES WOMEN THAT DON'T FIT
THE NORM OF WHEN AN ASSISTANT
PROFESSOR WITH THREE YEARS AND
R01 BY 4 YEARS AND TWO R01s
FOR ASSISTANT PROFESSOR TENURE
AND NOW WE CAN REWARD YOU FOR
THAT.
THAT PATTERN DOESN'T HAPPEN IN
NON-R01 INSTITUTIONS.
AND OUR SYSTEM DOESN'T REALLY
ACKNOWLEDGE THAT.
IN OTHER WORDS, WE DON'T REALLY
TELL REVIEWERS, YOU NEED TO TAKE
THE TRAJECTORY OF THE ENGAGEMENT
AS IT STANDS NOW FOR YOUR
CANDIDATE AND NOT THE ENGAGEMENT
OVER THE LAST 15 YEARS.
SO WE EITHER NEED TO INTRODUCE
REVIEWER CRITERIA RE-EDUCATION
OR MAYBE USE THE RCMI -- YOU
KNOW, WE PUT A LOT OF MONEY INTO
PILOT PROJECTS AND THEY ALL GO
TO NEW INVESTIGATORS, NEW
PH.D.s, BUT THERE'S A LOT OF
POTENTIAL ON CANDIDATES THAT
HAVE NOT TAKEN THE TRADITIONAL
ROUTE AND WANT TO COME BACK, BUT
WHEN THEY DO THE PILOT AND THEY
GO TO STUDY SECTION, THEY GET
PENALIZED FOR THE GAP IN THEIR
CAREER.
SO ALTHOUGH YOU TRY TO STIMULATE
THEM, WE HAVE STUDY SECTIONS
THAT DON'T REALLY WANT TO
ACKNOWLEDGE THAT CAREER.
SO WE EITHER NEED TO CHANGE THE
RULES FOR THE STUDY SECTION OR
MAKE IT VERY INTENTIONAL THAT WE
HAVE A REINTEGRATION PROGRAM FOR
WOMEN AND IT'S NOT A PILOT
PROJECT IN THE SENSE OF A PH.D.,
NEW PH.D. YOUNG INVESTIGATOR.
I THINK THE R21 IS ANOTHER
INSTRUMENT THAT IS
UNDERUTILIZED.
CURRENTLY IT LANDS IN STUDY
SECTIONS AND IT GETS BASICALLY
REVIEWED LIKE AN R01.
I'VE BEEN IN STUDY SECTIONS FOR
20 YEARS AND I'VE NEVER SEEN AN
R21 WITHOUT PRELIMINARY DATA.
TO THE POINT WE TELL OUR YOUNG
INVESTIGATORS, DON'T EVEN BOTHER
TO WRITE AN R21, YOU'RE GOING TO
GET THE SAME RUBRIC AS AN R01.
SO IF YOU'RE GOING TO PUT IN ALL
THE WORK, JUST GO FOR THE
R01 AND TRY TO HIT THAT BECAUSE
THE CRITERIA FOR WHICH THE
REVIEW HAPPENS DOESN'T GIVE YOU
MUCH ALLOWANCE FOR AN R21.
BUT IT'S REALLY A STIMULUS
GRANT, AND WHEN WE THEN LOOK AT
WOMEN IN NON-R01 CENTERS, IT
WOULD BE GREAT TO HAVE A
STIMULUS GRANT, CALL IT AN R22,
CALL IT SOMETHING ELSE IF YOU
WANT, BUT A TWO-YEAR, 275, THAT
STIMULATES THE TOPIC, BECAUSE I
THINK THERE'S A LOT OF
INVESTIGATORS THAT HAVE
POTENTIAL TO COME IN TO WOMEN'S
RESEARCH FOR PREMENOPAUSE,
MENOPAUSE OR THAT NEED ENOUGH
RESOURCES TO STIMULATE THE
RESEARCH TO START, BUT RIGHT NOW
THE TOOLS ARE AN R03 BUT VERY
FEW HAVE THAT.
AN R01 WH -- OR PILOT PROJECTS E
USUALLY 60 OR 4 40,000 AND THEYE
NOT ENOUGH TO BREAK INTO A NEW
TOPIC.
SO I WOULD ENCOURAGE YOU TO
RENAME THE R21 INTO -- OR -- IN
STIMULUS GRANT AND MAYBE TRY TO
INCENTIVIZE THE RESEARCH AS
OPPOSED TO PUT THE RUBRIC OF
INNOVATION AND THE EXPECTATION
FROM THE REVIEWERS THAT THIS IS
A MINI R01.
AND LASTLY, I WOULD SAY WE HAVE
A GREAT RESOURCE IN THE FEDERAL
QUALIFIED HEALTH SYSTEM.
THIS IS A NETWORK NATIONALLY
THAT SERVES A LOT OF THE
POPULATIONS WE WANT TO REACH,
LIKE PREP IS A GOOD EXAMPLE.
YOU KNOW, THEY GIVE GOLD AWARDS
AND SILVER AWARDS WHENEVER THEY
CAN ACTUALLY GET ENOUGH
INDIVIDUALS TO GET WHATEVER
INTERVENTION THE FEDERAL
QUALIFIED HEALTH SYSTEMS WANTS
TO PROMOTE, AND ALL THE OF THEM
NEED TO MEET THESE BENCHMARKS.
AND IT'S REALLY A MISSED
OPPORTUNITY THAT NIH HASN'T
PARTNERED WITH THIS NETWORK TO
TRY TO INCENTIVIZE THE ACCESS TO
PREP, AND TO ENCOURAGE
INVESTIGATORS TO COME UP WITH
SOME DEGREE OF COLLABORATIVE
RESEARCH EFFORTS WITH THIS
NETWORK.
SO I WOULD ENCOURAGE THAT THAT
PERHAPS COULD BE EXPLORED.
>> THANK YOU SO MUCH,
DR. MONTANER.
ANY FURTHER COMMENTS?
DR. SLEASMAN.
>> I'D LIKE TO FOLLOW UP ON WHAT
LUIS AND ALSO GO BACK TO WHAT
DR. GANDHI SAID.
I THINK IT'S TIME THAT THE
WOMEN'S INITIATIVE STOP BEING A
CAMEO OR PILOT PROJECT AND
REALLY START TO GET INTO THE
MAINSTREAM.
I THINK THE POINTS LUIS MADE IS
SOMETHING WE SEE IN THE
PEDIATRIC AREA IN TERMS OF
RECRUITMENT AND RETENTION, SOME
OF THE LIMITATIONS, PARTICULARLY
WOMEN WITH CHILDREN AND SINGLE
MOMS, WE NEED TO PROVIDE MUCH
MORE IN TERMS OF INCENTIVE.
I THINK THIS NEEDS TO BE A VERY
HIGH PRIORITY FOR FUNDING FOR
O.A.R. AS WE START TO RE-LOOK AT
THE P.J. BUDGET AND THE C.J.
BUDGETS AND START TO REALLY LOOK
AT THESE THINGS, HOW ARE WE
GOING TO CARVE OUT FUNDING FOR
THIS INITIATIVE, AND THERE MAY
BE THINGS THAT HAVE TO BE
EITHER, YOU KNOW, DECREASED AND
REPRIORITIZED, BECAUSE THIS IS
SOMETHING WE'VE BEEN TALKING
ABOUT SINCE I HAD HAIR, THAT,
YOU KNOW, WOMEN CAN'T -- WE
TALKED ABOUT THIS -- DURING THIS
PHASE OF 076, WE WERE TALKING
ABOUT ENROLLING WOMEN IN THE
1990s, AND HERE WE ARE, WE'RE
HAVING THE SAME CONVERSATION.
I THINK THIS IS A VERY PIVOTAL
STAGE AND A GOOD TIME TO START
TO REALLY PUT SOME TRUE
RECOMMENDATIONS INTO HOW THE
RULES ARE PUT OUT FOR
INVESTIGATORS AND FOR PROGRAM.
>> THANK YOU.
DR. TURNBULL, I THINK WE'RE GOOD
IN THE ROOM.
SO --
>> CAN I MAKE ONE ADDITIONAL
COMMENT?
I'M SO SORRY.
JUST REALLY QUICK, I ACTUALLY
THOUGHT THAT WAS AN INCREDIBLY
ASTUTE POINT ABOUT --
DR. MONTANER, ABOUT THE R03 AND
R21 MECHANISMS, BECAUSE REMEMBER
THE NEXT INVESTIGATOR INITIATIVE
THAT GOT DESIGNED WHEN THERE
WAS -- REMEMBER WHEN THERE WAS A
POINT SYSTEM THAT WAS GOING TO
BE ESTABLISHED, AND THEN
EXPERIENCED INVESTIGATORS SORT
OF PROTESTED AND THEN THE NEXT
INVESTIGATOR INITIATIVE WAS
LAUNCHED.
IN THAT, THERE WAS REALLY A PUSH
TOWARDS NEW INVESTIGATORS, EARLY
STAGE INVESTIGATORS PUTTING IN
R03s, R21s, BECAUSE THEY
WOULDN'T TAKE AWAY YOUR ESI
STATUS, AND THEY WERE SUPPOSEDLY
LOW HANGING FRUIT AND, INDEED,
THE NIAID PAYLINES FOR THOSE
GRANTS ARE AROUND 29.
SO MUCH BETTER THAN THE PAYLINE
FOR AN R01.
BUT I LOVE THE COMMENT ABOUT
THAT IN THE STUDY SECTION, WE
HAVE TO, YOU KNOW, ENSURE THAT
THEY'RE SCORED AND NOT EXPECTED
TO BE R01s BECAUSE EVEN IF YOU
GET A WORSE SCORE IN THE 29
YOU'RE GOING TO GET IT, YOU
SHOULDN'T BE JUDGED ON THE SAME
CRITERIA, ESPECIALLY WHEN IT'S A
$275,000 GRANT OVER TWO YEARS.
SO I LOVE THAT, I'VE ALWAYS
PUSHED OUR EARLY ASIs TO DO
R21s AND A03s AND I LOVE
THAT COMMENT ABOUT THE EARLY
REVIEW PROCESS.
THANK YOU.
>> ARE THERE ANY OTHER
ADDITIONAL COMMENTS IN THE ROOM,
MARY?
I DON'T SEE ANY ON THE ZOOM.
>> NO, MA'AM.
>> OKAY.
THANK YOU.
COLLEAGUES, THANK YOU FOR THIS
FRUITFUL CONVERSATION.
WE WILL NOW TAKE A 15-MINUTE
BREAK, AND WE'LL RESTART
PROMPTLY AT 1:50 P.M. EASTERN 1.
PLEASE DO NOT LOG OUT OF THE
ZOOM MEETING BUT FEEL FREE TO --
WE'LL SEE YOU BACK AT 2:05.
WELCOME BACK, EVERYONE, FROM THE
BREAK.
WE WILL RESUME THE MEETING
HEARING UPDATES ABOUT THE NIH
O.A.R. SIGNATURE PROGRAMS, HIV
AND AGING, AND EARLY CAREER
INVESTIGATORS.
FIRST UP IS HIV AND AGING.
DR. GEETANJALI BANSAL IS A
SENIOR SCIENCE ADVISOR AT THE
O.A.R., AND LEADS THE O.A.R. HIV
AND AGING SIGNATURE PROGRAM.
AFTER DR. BANSAL, WE WILL HAVE
MISS RAHEL ABEBE, WHO WILL GIVE
US UPDATES ON THE EARLY CAREER
INVESTIGATORS.
MS. ABEBE JOINED THE O.A.R. IN
2016, AND CURRENTLY WORKS AS A
PUBLIC HEALTH ANALYST.
DR. BANSAL, OVER TO YOU TO
START.
>> THANK YOU, DR. TURNBULL.
GOOD AFTERNOON, EVERYONE.
I'M GEETANJALI BANSAL.
I'M A SENIOR SCIENCE ADVISOR IN
HEALTH SCIENTIST ADMINISTRATOR
IN NIH OFFICE OF AIDS RESEARCH
AND MANAGE THE HIV AND AGING
SIGNATURE PROGRAM.
AS DR. KAPOGIANNIS MENTIONED IN
HIS PRESENTATION, O.A.R. HAS
FOUR SIGNATURE PROGRAMS.
AND I'M HERE TO PROVIDE YOU AN
UPDATE FOR THE SIGNATURE PROGRAM
ON HIV AND AGING.
SO I WILL START WITH A
BACKGROUND ABOUT HOW THE
SIGNATURE PROGRAM CAME ABOUT TO
BE, AND AN UPDATE ON THE CURRENT
AND FUTURE ACTIVITIES, AS WELL
AS A TIMELINE FOR ALL THE
EVENTS.
SO AS DR. I KASSAYE MENTIONED AD
AS WE ALL KNOW, THE SUCCESS OF
ANTIRETROVIRAL THERAPIES, PEOPLE
WITH HIV ARE LIVING LONGER, AND
NOW CAN HAVE A NEARLY NORMAL
LIFESPAN WITH APPROPRIATE
TREATMENT.
MORE THAN HALF OF THE PEOPLE
LIVING WITH HIV IN THE UNITED
STATES ARE 50 YEARS AND OLDER.
THE NUMBER PROJECTED TO GO UP TO
75% BY 2030.
GLOBALLY, ONE ESTIMATE FROM U.N.
AIDS IS THAT NUMBER OF PEOPLE
WITH HIV IN THIS AGE GROUP
INCREASED TO OVER 8 MILLION IN
2020, AND EXPECTED TO INCREASE
STEADILY.
OLDER ADULTS WITH HIV FACE
SIMILAR ISSUES AS THEIR PEERS
WITHOUT HIV.
THEY ALSO FACE SOME UNIQUE
CHALLENGES.
OLDER PEOPLE WITH HIV FACE
ACCELERATED AGING FOR CERTAIN
COMORBIDITIES SUCH AS
NEUROCOGNITIVE IMPAIRMENT,
FRAILTY, MULTI-MORBIDITY AND
SUBSTANCE USE AND POLYPHARMACY,
AS YOU SEE HERE.
MULTIPLE INTERSECTIONAL STIGMAS
AND OTHER MENTAL COMORBIDITIES.
SO AGING WITH HIV IS MORE
COMPLEX WITH MORE COMPLEX CARE
AND SUPPORT NEEDS.
RECOGNIZING THE UNIQUE
CHALLENGES OLDER PEOPLE WITH HIV
FACE, HIV AND AGING IS A HIGH
PRIORITY TOPIC FOR
ADMINISTRATION, HHS AND NIH.
BASED ON INPUT FROM VARIOUS
PERSPECTIVES AND COMMUNITY
VOICES, NIH O.A.R. LAUNCHED THE
SIGNATURE PROGRAM ON HIV AND
AGING LAST YEAR, BUILDING ON THE
CURRENT NIH EFFORTS.
THIS PROGRAM AIMS TO CATALYZE
COLLABORATIONS TO ADDRESS
RESEARCH GAPS AND OPPORTUNITIES
AT THE INTERSECTION OF HIV AND
AGING WITH FOCUS ON BIOMEDICAL
AS WELL AS BEHAVIORAL AND SOCIAL
NEEDS AND ASPECTS OF THE
RESEARCH.
SO THIS SLIDE JUST GIVES AN
OVERVIEW OF ALL THE CURRENT AND
FUTURE ACTIVITIES, STARTING WITH
THE MULTI-ICO WORKING GROUP.
EARLIER THIS YEAR, NIH O.A.R.
LAUNCHED A MULTI-IC HIV AND
AGING WORKING GROUP THAT IS
CO-LED BY NIA AND NIH O.A.R.
THIS IS AN INTERNAL GROUP
COMPRISING MAINLY OF NIH PROGRAM
STAFF.
SINCE ITS LAUNCH, THE NUMBER OF
ICOs IN THIS GROUP HAS ALMOST
DOUBLED WITH CURRENTLY 12, PLUS
O.A.R., SO REPRESENTING THE
MULTI-I.C., MULTIFACETED HIV AND
AGING PORTFOLIO.
THE GOAL OF THE WORKING GROUP IS
TO FACILITATE INTEGRATIVE
COLLABORATIONS FOR
INTERDISCIPLINARY RESEARCH AND
TRAINING AT THE INTERSECTION OF
HIV AND AGING, AND TO IDENTIFY
RESEARCH GAPS AND OPPORTUNITIES
TO ADDRESS THE NEEDS OF PEOPLE
AGING WITH HIV.
AS A FIRST STEP, THE WORK GROUP
IS COLLATING INFORMATION ON HIV
AND AGING RELATED RESEARCH
RESOURCES AND ACTIVITIES.
FOR EXAMPLE, COHORTS, NETWORKS,
REPOSITORIES, RESEARCH PROGRAMS,
ET CETERA, TO LEVERAGE EXISTING
RESOURCES AND TO IDENTIFY
OPPORTUNITIES FOR NEW
COLLABORATIONS AND DEVELOP
INFORMATIONAL DOCUMENTS FOR THE
COMMUNITY AND COLLABORATIONS.
THE WORKING GROUP ALSO HAS
DISCUSSED IMPORTANT RESEARCH
QUESTIONS SUCH AS HOW DOES
AGING -- IS DIFFERENT FROM AGING
WITHOUT -- IN PEOPLE WITH HIV
VERSUS WITHOUT HIV, AND IN THE
SAME IN THE COU CONTEXT OF DIFFT
COMOCOMORBIDITIES, MACS WIHS TOE
A FEW TO POTENTIALLY ANSWER SUCH
QUESTIONS.
RECENTLY THE WORKING GROUP AND
NIH O.A.R. CO-HOSTED DR. AMY
JUSTIJUST WHO SHARED 25 YEARS HY
OF THE COHORT WHICH IS A LARGE
COHORT OF OVER 60,000 PEOPLE
WITH NIH.
THIS WAS AN INTERNAL NIH
ACTIVITY AND EXPLORED ANSWERS TO
SEVERAL QUESTIONS THAT THE
WORKING GROUP HAS BEEN
DISCUSSING AND OPPORTUNITIES AND
AREAS THAT WE CAN FURTHER
DISCUSS.
THE WORKING GROUP WILL ALSO BE
HOLDING A WORKSHOP AND A LINKAGE
SESSION THAT WILL TAKE PLACE IN
CONNECTION WITH THE U.S.
CONFERENCE ON HIV AND AIDS OR
US CHA IN SEPTEMBER.
THIS YEAR THE PLANNING GROUP FOR
THESE ACTIVITIES INCLUDES AND IS
BEING INFORMED BY COMMUNITY, AS
WELL AS NIH SIBLING AGENCIES,
CDC AND HRSA.
IT HAS TWO COMPONENTS.
THE FIRST IS A RESEARCH WORKSHOP
WHICH WILL BE ALL VIRTUAL, AND
THE SECOND PART IS THE LINKAGE
SESSION, WHICH IS ENVISIONED AS
A PANEL DISCUSSION ON CURRENT
LANDSCAPE AND OPPORTUNITIES FOR
HIV AND AGING EFFORTS.
AND THIS DISCUSSION IS AGAIN
PLANNED TO INVOLVE U.S. AGENCIES
AND RESEARCH COMMUNITIES, THIS
SESSION BEING HYBRID.
SO THIS WORKSHOP AND THE SESSION
ARE BEING DEVELOPED AROUND THE
FOUR PILLARS THAT YOU SEE ON THE
SCREEN, THE FOUR Is, AS WE
CALL THAT.
CONSIDERING THE
INTERSECTIONALITY OF STIGMAS OF
HIV INFECTION, AGING AND RELATED
COMORBIDITIES IN BIOLOGICAL AND
SOCIAL AND BEHAVIORAL CONTEXT.
INTERDISCIPLINE AREA RESEARCH IS
NEEDED.
THERE IS URGENT NEED FOR
INTEGRATED MODELS OF CARE AND
IMPLEMENTATION RESEARCH, AND
DIFFERENT U.S. AGENCIES HAVING
DIFFERENT ROLES, INTERAGENCY
EFFORTS PLAY A CRUCIAL ROLE IN
ADDRESSING THE NEEDS OF OLDER
ADULTS WITH HIV.
HENCE THE FOUR Is,
INTERDISCIPLINARY RESEARCH,
INTEGRATED MODELS OF CARE,
IMPLEMENTATION RESEARCH AND
INTERAGENCY EFFORTS LEADING
THESE TWO EVENTS.
SO THIS SLIDE JUST SHOWS THE
TIMELINE OF EVENTS.
WE STARTED WITH AN ANALYSIS OF
THE NIH-WIDE HIV AND AGING
PORTFOLIO, WHICH IS DONE BY NIH
O.A.R. ANALYTICS AND SCIENCE
TEAMS, AND WE SHARED WITH YOU AT
THE LAST OARAC IN MARCH DURING
THE HIV AND AGING SESSION LED BY
NIA DIRECTOR DR. HODES.
THAT PLUS THE HIV AND AGING
WORKING GROUP CO-LED BY NIH AND
O.A.R. AND PLANNING GROUP IN
PARTNERSHIP WITH OTHER ICs AND
COLLABORATORS ARE ACTIVELY
INFORMING THESE ACTIVITIES UNDER
THE LEADERSHIP OF DR. HOLTZ,
DEPUTY DIRECTOR, PREVIOUSLY
DR. GOODENOW, AND NOW ACTING
DIRECTOR DR. KAPOGIANNIS.
ANOTHER ACTIVITY IS THE MULTIPLE
I.C.NOSI PUBLISHED IN APRIL, LED
BY NIA IN PARTNERSHIP WITH
O.A.R. AND OTHER ICs.
DRTHE SEMINAR WE HAD EARLIER THS
MONTH, SO WE ARE HERE IN THE
LAST QUARTER OF THIS FISCAL
YEAR.
THE WEBPAGE FOR SIGNATURE
PROGRAM IS CURRENTLY UNDER
DEVELOPMENT, AND THE UPCOMING
ACTIVITIES AS I MENTIONED
INCLUDE THE WORKSHOP AND THE
LINKAGE SESSION.
OUTPUTS FOR WHICH ARE GOING TO
BE BEYOND THE TIMELINE SHOWN ON
SCREEN.
SO THIS SLIDE HIGHLIGHTS THE
GROWING COLLABORATIONS ACROSS
NIH AND OUTSIDE.
IT'S NOT AN ACKNOWLEDGMENT
SLIDE, IT WILL BE HARD TO FIT
THE NAMES ON ONE SLIDE.
THIS IS JUST A CURRENT LIST OF
MEMBERS ON THE NIH HIV AND AGINR
MEETING PLANNING GROUP.
THE NIH HIV AND AGING WORKING
GROUP BEING AN NIH INTERNAL
GROUP, SOME MEMBERS OVERLAP
BETWEEN THE TWO GROUPS.
AND YOU ALSO SEE THE
COLLABORATION WITH COMMUNITY AND
OTHER FEDERAL AGENCIES HERE IN
BLUE ON YOUR SCREEN.
AND AGAIN, THESE ARE CO-LED BY
NIA AND NIH O.A.R., AND JUST
WANT TO MAKE A POINT THAT THIS
IS A DYNAMIC TEAM, GROWING AS WE
MOVE FORWARD.
SO THIS IS NOT A STOP HERE.
THANK YOU.
>> THANK YOU, DR. BON SAL.
BANSAL.
DR. ABEBE, PLEASE PROCEED.
>> THANK YOU, DR. TURNBULL.
GOOD AFTERNOON, EVERYONE.
MY NAME IS RAHEL ABEBE, I'M A
PUBLIC HEALTH ANALYST AT NIH
O.A.R.
ON BEHALF OF DR. LIZ KA KELLER,I
WILL PRESENT AN UPDATE ON EARLY
CAREER INVESTIGATORS ON THE NIH
WORKSHOP THAT TOOK PLACE ON
APRIL 24TH.
DR. KELLER IS THE LEAD ORGANIZER
OF THE WORKSHOP ALONG WITH OOR
STAFF AND OTHER NIH WORKING
GROUP WHO HAVE BEEN VERY
INSTRUMENTAL TO MAKE THE
WORKSHOP POSSIBLE.
AS YOU HEARD EARLIER, O.A.R. HAS
FOUR SIGNATURE PROGRAMS: EARLY
CAREER INVESTIGATOR OR ECI IS
ONE OF THEM.
I WILL BE FOCUSING ON ECI FOR
THE NEXT FEW MINUTES.
PLEASE NOTE THAT THE TERM EARLY
STAGE INVESTIGATORS OR ESI ARE
THOSE WITHIN 10 YEARS OF THEIR
TERMINAL DEGREE THAT DO NOT HAVE
R01 EQUIVALENT AWARD YET.
HERE IS THE ORDER ROVER VIEW OFY
PRESENTATION.
I WILL TALK ABOUT THE BACKGROUND
ON THE ECI SIGNATURE PROGRAM AND
OBJECTIVES, AND OUR MOST RECENT
ACTIVITIES AND FUTURE PLANS.
THE ECI SIGNATURE PROGRAM WAS
CREATED TO PROVIDE RESOURCES AND
NETWORKING OPPORTUNITIES FOR HIV
JUNIOR INVESTIGATORS.
ALIGNED WITH THE NEXT RESEARCH
OBJECTIVE TO PROVIDE
OPPORTUNITIES FOR EARLY RESEARCH
INDEPENDENCE WHILE ENHANCING
WORKFORCE DIVERSITY.
O.A.R. HAS FORMED PARTNERSHIP
WITH MULTIPLE INSTITUTES,
CENTERS AND OFFICES ACROSS NIH
TO FACILITATE A NETWORKING
ENVIRONMENT FOR ESIs AND
ECIs AND PROVIDE OPPORTUNITIES
FOR WORKFORCE DEVELOPMENT AND
DIVERSIFICATION.
I DON'T THINK YOU ARE ADVANCING
THE RIGHT SLIDE.
BACK.
I THINK I'M AT THE OVERVIEW.
OVERVIEW.
THANK YOU.
HERE IS THE OVERVIEW OF MY
PRESENTATION.
NEXT SLIDE, PLEASE.
THE ECI SIGNATURE PROGRAM WAS
CREATED TO PROVIDE RESOURCES AND
OPPORTUNITIES FOR HIV JUNIOR
INVESTIGATORS.
THE GOAL OF THE PROGRAM WAS
ALIGNED WITH THE NEXT GENERATION
RESEARCH INITIATIVE AND AIMED TO
PROVIDE OPPORTUNITIES FOR EARLY
RESEARCH INDEPENDENCE WHILE
ENHANCING WORKFORCE DIVERSITY.
O.A.R. HAS FORMED PARTNERSHIPS
WITH MULTIPLE INSTITUTES,
CENTERS AND OFFICES ACROSS THE
NIH.
SLIDE 6, PLEASE.
>> RAHEL, YOU CAN PROCEED WITH
THE STRATEGIC PLAN.
>> OKAY.
THE HIV WORKFORCE IS A HIGH
PRIORITY AREA THAT IS
HIGHLIGHTED IN OUR STRATEGIC
PLAN.
THE NATIONAL HIV/AIDS STRATEGY
OR KNOWN AS NHANS -- THE
IMPLEMENTATION PLAN.
THE NIH STRATEGIC PLAN FOR HIV
AND HIV RELATED RESEARCH HAS
FOUR MAIN STRATEGY GOALS.
THE STRATEGY GOAL IS TO BUILD
HUMAN RESOURCES AND -- TO
ENHANCE SUSTAINABILITY OF
DISCOVERY AND IMPLEMENTATION OF
FINDINGS BY DIVERSE AND
MULTIDISCIPLINARY WORKFORCE.
IN THE NATIONAL NIH AIDS
STRATEGY -- CALLS FOR TRAINING
AND EXPANSION OF A DIVERSE HIV
WORKFORCE BY FURTHER DEVELOPING
AND PROMOTING OPPORTUNITIES TO
SUPPORT THE NEXT GENERATION OF
HIV PROVIDERS, INCLUDING
RESEARCHERS.
THE OBJECTIVE OF THE ECI
SIGNATURE PROGRAM ARE TO EXPAND
AND SUPPORT NEW HIV
INVESTIGATORS, COLLABORATE WITH
INSTITUTES, CENTERS AND OFFICES
ACROSS NIH, PROMOTE NETWORKING
AND MENTORSHIP ENVIRONMENTS, AND
DEVELOP AND DIVERSIFY THE HIV
RESEARCH WORKFORCE.
NOW I'LL TALK ABOUT THE OAR, THE
CURRENT ACTIVITIES.
IN 2022, WE HELD AN ECI WORKSHOP
IN 2023.
THE PURPOSE OF THE WORKSHOP WAS
TO STIMULATE SCIENTIFIC
EXCHANGE, NETWORKING AND
COLLABORATION AMONG THE NEXT
GENERATION OF HIV INVESTIGATORS.
FACILITATE INTERACTIONS BETWEEN
FELLOW INVESTIGATORS, MENTORS
AND NIH PROGRAM STAFF.
INCREASE FAMILIARITY ABOUT THE
NIH REVIEW AND FUNDING PROCESS,
AND HIV RELATED RESEARCH
PROGRAMS AVAILABLE ACROSS THE
NIH AS WELL AS PROVIDE A
PLATFORM TO DISSEMINATE
INFORMATION ABOUT HIV-RELATED
ACTIVITIES AND OPPORTUNITIES.
SLIDE 13, PLEASE.
THANK YOU.
ON THIS SLIDE, WHAT YOU SEE IS
THE OUTCOME OF THE 2023
WORKSHOP.
WE HAD A TOTAL OF 548
REGISTRANTS.
43% REPORTED THAT THEY APPLIED
FOR FUNDING, AND 26% REPORTED
THEY HAD OBTAINED FUNDING.
AS YOU CAN SEE ON THE PIE CHART,
PARTICIPANTS REPRESENTED
NUMEROUS DISCIPLINES OF HIV
RESEARCH.
THIS YEAR, WE HAVE INCORPORATED
LOTS OF FEEDBACK FROM LAST
YEAR'S WORKSHOP.
WHICH RESULTED IN SOME UPDATES
IN THE STRUCTURE OF THE FY 2023
EVENT.
BOTH THE 2022 AND 2023 WORKSHOP
WERE VIRTUAL.
HOWEVER, IN THE 2022 WORKSHOP,
WE INCLUDED INTERNATIONAL
ATTENDEES, INCREASE OUR
PROMOTION PLAN, HELD A WORKSHOP
IN WEBINAR FORMAT, MAINLY DUE TO
THE LARGE NUMBER OF ATTENDEES,
THEREFORE, WE COULDN'T ASK FOR
BREAKOUT SESSION BUT WE ARE IN
THE PROCESS OF EVALUATING
FEEDBACK FROM THIS YEAR.
ANOTHER DIFFERENCE WITH THAT,
THIS TIME WE FOCUSED ON
MENTORSHIP, AND DRS. JOHNSON AND
RODRIGUEZ FROM UCSF AND G.W.
GAVE THEIR PRESENTATION ON
MENTORSHIP AND SHARED THEIR
EXPERIENCE AS MENTORS AND
MENTEES.
WE ALSO EXPANDED OUR RESOURCES
MORE IN YEAR THAN LAST YEAR.
AS NOTED EARLIER, WE HAD OVER
500 REJ STRENTS AND ABOUT
260 ATTENDEES.
O.A.R. CONTINUES TO PRIORITIZE
WORKFORCE SUPPORT, TO INCREASE
HIV EARLY CAREER INVESTIGATORS,
O.A.R. HAS CREATED A PILOT
PROGRAM, THE OBJECTIVE OF THE
PROGRAM IS TO ACHIEVE 5% OF THE
HIV PORTFOLIO, WHICH IS SIMILAR
TO OVERALL NIH.
THROUGH A RECENT INTERNAL DATA
POLL, WE SUPPORTED SIX EARLY
CAREER INVESTIGATORS APPLICATION
FROM FIVE ICs.
THEY INCLUDE THREE INTRAMURAL
AWARDS, ONE K23 AWARD, ONE
R21 AND 1 R01, INCLUDING
POSTDOCS, NEW INTRAMURAL
INVESTIGATORS AND ONE OFFICIAL
ECI.
ONE OF THE MOST IMPORTANT ITEMS
THAT WE HEARD ABOUT THROUGH THE
VARIOUS LISTENING SESSION WE
HELD WITH THAT, THERE IS A NEED
OF HAVING A CONSOLIDATED PLACE
WHERE ONE CAN FIND AVAILABLE
RESOURCES ABOUT HIV PROGRAMS.
BASED ON THE FEEDBACK, O.A.R.
CREATED EARLY CAREER
INVESTIGATOR RESOURCES WEBPAGE
WHERE WE PUT AS MUCH INFORMATION
AS POSSIBLE ABOUT HIV TOOLS SUCH
AS GRANT INFORMATION, TRAINING
OPPORTUNITIES, CAREER
DEVELOPMENT, CONFERENCES, PEER
REVIEW AND SUBMISSION DATES AND
MORE.
FOR MORE INFORMATION ON T, PLEAE
CONNECT TO THE URL THAT YOU SEE
ON THIS WEBPAGE.
IN CONCLUSION, WE WILL CONTINUE
ENGAGEMENT WITH ESIs AND ECI.
WE PLAN TO INCLUDE SUMMER COFFEE
HOURS WITH THE NIH STAFF AND
INVITE HIV ESI TO TALK ABOUT
THEIR SCIENCE.
WE WILL START PLANNING THE 2024
WORKSHOP AND CONTINUE MENTORING
CONTINUE MONITORINGPROGRAM OF E.
FINALLY I WOULD LIKE TO
GRATEFULLY ACKNOWLEDGE ALL THE
WORKING GROUPS AND THE WORKSHOP
PLANNING GROUP THAT CONTRIBUTE
TO THE O.A.R. HIV ECI PROGRAM.
WITH THAT, I WILL END MY
PRESENTATION AND THANK YOU AND
OVER TO YOU, DR. TURNBULL.
THANK YOU.
>> THANK YOU, MS. ABEBE AND
DR. BANSAL, FOR YOUR
PRESENTATIONS.
WE WILL NOW HAVE OPEN
DISCUSSION.
ONCE AGAIN AT THIS TIME, THIS IS
THE TIME TO ASK QUESTIONS ABOUT
HIV AND AGING AND EARLY CAREER
INVESTIGATOR PRESENTATION.
ONCE AGAIN, DR. GLENSHAW AND I
WILL MODERATE THE DISCUSSION.
LET'S START WITH COMMENTS IN THE
ROOM FIRST THIS TIME.
MARY, OVER TO YOU.
>> THANK YOU.
DR. MONTANER.
>> THANK YOU FOR THAT
PRESENTATION.
AND CONGRATULATIONS ON THE
WEBSITE.
I THINK IT'S REALLY NICE.
ONE SUGGESTION FOR THE WEBSITE
IS, YOU KNOW, THERE IS A LOT OF
CORES THAT ARE BEING SUPPORTED
THROUGH CENTER FOR AIDS
RESEARCH, AND A LOT OF THE INPUT
THAT I OFTEN HAVE TO REMIND
YOUNG INVESTIGATORS IS THAT
THESE COURSES ARE OPEN TRANS
INSTITUTIONALLY, MEANING THAT
JUST BECAUSE YOU'RE NOT PART OF
THE CFAR DOES NOT MEAN YOU CAN'T
EXCESS THE CORE.
ACCESS THE CORE.
THERE ARE MULTIPLE CORES THAT
HAVE BEEN CREATED THROUGH THIS
NETWORK NATIONALLY, AND IT WOULD
BE GOOD TO LIST THEM SOMEWHERE
AS A RESOURCE FOR YOUNG
INVESTIGATORS TO KNOW WHO TO
CONTACT AND WHAT TYPE OF
EXPERTISE IS OUT THERE FOR THEM
TO ACCESS.
AND AGAIN, I HAVE TO REMIND THEM
THAT JUST BECAUSE YOU'RE NOT IN
THE IN CROWD DOESN'T MEAN THAT
YOU CAN'T ASK FOR SUPPORT.
A LOT OF THEM ASSUME IF YOU'RE
NOT A MEMBER OF THE GROUP, THOSE
RESOURCES ARE NOT AS READILY
AVAILABLE.
SO MAYBE THIS WEBSITE CAN BE A
PLATFORM TO ENCOURAGE THAT.
>> THANK YOU, DR. MONTANER.
THAT'S A GOOD SUGGESTION.
ANY OTHER COMMENTS FROM THE
ROOM?
DR. AKE?
>> THANKS SO MUCH.
I HAVE MAYBE A COMMENT AND A
QUESTION FOR GEETA, TO COMMENT
ON THE INCREASING IMPORTANCE OF
HIV AND AGING IN THE LMIC
SETTING AND TO LARGE BILATERAL
PROGRAMS LIKE PEPFAR.
I WAS JUST INTERESTED IN, YOU
KNOW, HOW THAT HIV AND AGING
AGENDA IS INCORPORATING, YOU
KNOW, GLOBAL HIV CONSIDERATIONS.
>> SO THANK YOU FOR THAT.
THAT'S A GREAT POINT.
SO WE HAVE BEEN DISCUSSING IN
OUR WORKING GROUP AND THE
PLANNING GROUP FOR THE SEPTEMBER
MEETING HOW WE CAN ADDRESS THAT
AND AT LEAST FOR THE SEPTEMBER
MEETING, WE ARE PLANNING TO HAVE
PROBABLY AT LEAST ONE
INTERNATIONAL SPEAKER
HIGHLIGHTING THAT AS WELL.
SO -- AND THEN MOVING FORWARD,
WE'LL BE DISCUSSING MORE OF THAT
IN OUR WORKING GROUP AS WELL.
>> I JUST WANT TO COMMENT FROM
THE PEDIATRIC STANDPOINT, YOU
KNOW, IT'S HARD TO ADVISE JUNIOR
TRAINEES AND JUNIOR
INVESTIGATORS TO GO INTO
PEDIATRIC HIV.
WE'RE FURTHER ALONG THE
ELIMINATION TIMELINE.
AND YET THE RESOURCES ARE THERE,
AND SO WHAT WE HAVE AT NICHD
REALLY TRIED TO DO IS LOOK FOR
WAYS TO LEVERAGE BEING ABLE TO
UTILIZE AIDS FUNDING TO BUILD A
CAREER, AND I LOOK AT INFANT
IMMUNITY AS ONE REALLY, REALLY
IMPORTANT FACTOR, AND WE HEARD
IN THE LAST SESSION JUST, YOU
KNOW, SORT OF VERY QUICKLY THAT
INFANTS WHO ARE EXPOSED TO HIV
BUT ARE UNINFECTED HAVE A HIGHER
MORTALITY RATE THAN THOSE THAT
ARE UNEXPOSED.
AND REALLY, YOU KNOW, TRYING TO
CONCENTRATE ON THAT POPULATION
AS A WAY TO ACCESS THE FUNDING
BUT ALSO REALLY TO BE LOOKING AT
AREAS BROADER THAN JUST HIV, AND
SO I THINK THAT'S ONE THING THAT
I REALLY WANT TO COMMEND O.A.R.
FOR SUPPORTING THE AGENDA AROUND
THOSE WITH HIV WHO ARE EXPOSED
AND UNINFECTED.
AND THEN I JUST WANT TO QUICKLY
HIGHLIGHT, WE'VE HEARD NOW TWICE
ABOUT THE LIFE EXPECTANCY FOR
ADULTS WITH HIV, AND LET ME JUST
HIGHLIGHT THAT ANNE NEILAN ALONG
WITH -- PATEL AT HARVARD SCHOOL
OF PUBLIC HEALTH ARE NOW
STARTING TO LOOK AT THAT FOR
PERINATALLY ACQUIRED INFECTION.
HAVING TAKEN CARE OF THOSE
PATIENTS, HOW POWERFUL IT WILL
BE, ONCE ANNE'S DATA ARE FULLY
VETTED, I DON'T KNOW IF --
THEY'RE STILL UNDER REVIEW, I
THINK, BUT TO BE ABLE TO LOOK AT
AN ADOLESCENT WITH PERINATALLY
ACQUIRED HIVE IN THE EYE AND SAY
WE EXPECT TO YOU LIVE A NORMAL
LIFESPAN IS REALLY, REALLY
POWERFUL, SO JUST THANK THEM FOR
PUTTING THAT DATA TOGETHER,
DOING THAT ANALYSIS.
I KNOW IT'S TAKEN A WHILE.
>> SO THANK YOU, ROHAN.
GREAT POINTS.
I'D LIKE TO ALSO ADDRESS YOUR
POINT, JULIE, ABOUT -- OR YOUR
QUESTION ABOUT SORT OF THE
MULTILATERAL RELATIONSHIPS THAT
WE MIGHT HAVE WITH OTHER
AGENCIES, FOR EXAMPLE, SCAC, WE
HAVE HAD A LONG-STANDING
RELATIONSHIP WITH FOLKS THERE IN
THE PEPFAR PROGRAM AND NIH HAVE
BEEN WORKING TOGETHER, AND I
THINK WE'LL CONTINUE TO HAVE
ACTIVITY THAT WE ARE LOOKING AT
GOING FORWARD, LOOKING, IN
ADDITION TO THOSE THAT WE'VE
BEEN PART OF, AND I THINK IT'S
VERY VALUABLE.
I MEAN, AGING AND, YOU KNOW,
NON-COMMUNICABLE DISEASES, OTHER
AREAS ARE VERY RIPE FOR THE
PICKING, I THINK, AND WE DO NEED
TO ENGAGE MORE.
>> D
>> MORE REFLECTION THAT THE
CRITICAL EVENT SUMMIT MENTAL
FUNDING FOR CAREER DEVELOPMENT
IS REALLY POWERFUL MECHANISM,
WHERE THERE ARE OPPORTUNITIES TO
FLAG THAT, I THINK THAT COULD BE
REALLY VALUABLE.
THANK YOU.
>> THANK YOU.
THESE ARE GREAT SUGGESTIONS.
ROHAN.
>> I THINK THE OTHER ONE WE WANT
TO REALLY WANT TO TRY TO
HIGHLIGHT IS THE LOAN REPAYMENT
PROGRAM AND REALLY WANT TO MAKE
SURE THAT THE INFORMATION IS
THERE.
>> I SEE AN UPGRADE TO OUR
WEBSITE IN OUR FUTURE.
THANK YOU.
DR. TURNBULL, OVER TO YOU.
>> YES.
ARE THERE ANY PARTICIPANTS, ANY
MEMBERS WHO WANT TO MAKE A
COMMENT, PLEASE DON'T FORGET
RAISE YOUR HAND OR USE THE HAND
FUNCTION IN THE ZOOM.
SO YOU CAN BE RECOGNIZED.
DR. OTT.
>> I HAVE A QUESTION FOR DR
DR. ABEBE.
I HAVE A QUESTION ABOUT THE
METRICS OF SUCCESS FOR THE EARLY
INVESTIGATOR, THE SIGNATURE
PROGRAM AND SEE HOW SUCCESSFUL
WE ARE TO REALLY RECRUIT YOUNG
INVESTIGATORS INTO THE PROGRAM
AND SORT OF HOW THE DYNAMICS ARE
OVER THE YEARS, AND WHETHER WE
SEE A DECREASE IN INTEREST AND
ALSO HOW SUCCESSFUL WE ARE IN
GIVING THEM ACTUALLY THE SUPPORT
THAT THEY NEED AND IN TERMS OF
SUCCESS IN R01 RECRUITMENT OR
R01 ACHIEVEMENTS HERE.
SO I WOULD BE INTERESTED TO HEAR
MORE ABOUT THESE METRICS.
>> UNFORTUNATELY I DON'T HAVE
THE METRICS AVAILABLE WITH ME,
BUT IN TERMS OF PROVIDING
SUPPORT LIKE I SAID EARLIER, WE
HAVE SPECIAL PROGRAM THROUGH OUR
INNOVATION PROGRAM, WE CONTINUE
TO PROVIDE SUPPORT FOR BOTH ASI
AND ECI, LIKE I SAID WE TRY TO
ACHIEVE 5% OF THE HIV PORTFOLIO,
WHICH IS SIMILAR TO THE NIH
OVERALL GOAL, AND ALSO THROUGH
OUR DATA MOST RECENTLY, WE ARE
PLANNING OR IN FACT WE HAVE
PROVIDER SUPPORT FOR EARLY
INVESTIGATORS APPLICATION.
APPLICANTS.
LIKE I SAID, I DON'T HAVE THE
METRIC WITH ME, BUT IT'S
SOMETHING THAT I CAN FIND AND
CAN GET BACK TO YOU.
>> THANK YOU.
>> ANYONE ELSE ON THE ZOOM?
I DON'T SEE ANY OTHER HANDS
RAISED ON THE ZOOM.
ANYBODY ELSE IN THE ROOM, MARY?
>> NO THE, NOT AT THIS TIME, DR.
TURNBULL, I THINK WE CANMOVE OT
PRESENTATION.
GLL OKAY, GREAT.
WE WILL NOW SHIFT GEARS TO A
DATA PRESENTATION AND DEMO BY
ROBERT CREGG.
MR. ROBERT CREGG IS THE LEAD OF
THE O.A.R. ANALYTICS AND
EVALUATIONS TEAM AND SENIOR
ANALYTICS ADVISOR.
HE JOINED O.A.R. IN 2016 AND
BRINGS OVER 20 YEARS OF NIH
EXPERIENCE SPECIALIZING IN
INFORMATION SYSTEMS, DESIGN AND
IMPLEMENTATION, FOCUSING ON TEXT
ANALYTICS, DATA SCIENCE AND
PORTFOLIO EVALUATION.
OVER TO YOU.
>> AGAIN, MY NAME IS ROB CREGG,
SENIOR ANALYTICS ADVISOR AND
LEAD OF THE ANALYTICS AND
EVALUATION TEAM HERE AT THE
O.A.R.
THE O.A.R. AN LE TICS AND
EVALUATION TEAM IS RESPONSIBLE
FOR ANALYZING THE HIV RESEARCH
PORTFOLIO TO GAIN A BETTER
UNDERSTANDING OF THE TRAJECTORY
OF FUNDING FOR VARIOUS FACETS OF
HIV RESEARCH.
THE HIV PORTFOLIO IS MADE UP OF
ABOUT 3800 GRANTS, INTRAMURAL
PROJECTS AND CONTRACTS WITH AN
ANNUAL BUDGET OF ROUGHLY 3 MO 3-
THROUGH A SERIES OF INTERACTIVE
DASHBOARDS, WE CALL THE NIH
O.A.R. DATA HUB.
SO THE OFFICE OF AIDS RESEARCH
IS LEGISLATIVELY MANDATED TO DI
DISSEMINATE INFORMATION ABOUT
THE NIH HIV/AIDS RESEARCH
PORTFOLIO.
THE GOAL IS TO MAKE DATA ABOUT
THE RESEARCH PORTFOLIO AVAILABLE
TO THE PUBLIC IN A WAY THAT IS
CLEAR, COMPREHENSIVE AND
COMPREHENSIBLE.
THE PURPOSE OF THIS PROJECT IS
TO PROVIDE A WAY TO EXPLORE THE
NIH HIV FUNDED RESEARCH DATA TO
INVESTIGATORS, ADVOCACY
COMMUNITY, AND THE GENERAL
PUBLIC IN A WAY THAT IS EASY TO
USE AND INFORMATIVE.
SINCE THE O.A.R. WAS ESTABLISHED
IN 1988, THE MISSION CONTINUES
TO BE TO CATALYZE, COORDINATE,
COMMUNICATE AND COLLABORATE.
THIS PROJECT'S FOCUS IS ON
COMMUNICATION.
WE AIM TO DISSEMINATE
INFORMATION TO A PUBLIC AUDIENCE
THAT IS ACCESSIBLE AND
SEARCHABLE.
BY LEVERAGING AND DISPLAYING
PUBLICLY AVAILABLE DATA IN A
COMBINATION WITH THE HIV
RESEARCH OVERARCHING PRIORITIES
AND OBJECTIVES.
SO THIS PROJECT SUPPORTS THE
BROADER NIH EFFORT TO CAN
DISSEMINATE INFORMATION.
NIH'S EFFORT TO PROMOTE
SCIENTIFIC TRANSPARENCY AND
PUBLIC ACCOUNTABILITY, AND ALSO
NIH'S COMMITMENT TO SUPPORT AND
EXPAND THE HIV/AIDS RESEARCH
WORKFORCE, INCLUDING EARLY
CAREER INVESTIGATORS THAT YOU'VE
HEARD ABOUT EARLIER, OF DIVERSE
BACKGROUNDS.
SO HOW IS THIS PROJECT UNIQUE?
IT FOCUSES ON THE HIV RESEARCH
PORTFOLIO SPECIFICALLY.
INCLUDES DATA THAT IS ON THE NIH
HIV RESEARCH PRIORITIES AND
OBJECTIVES, ADDING MORE DETAIL
AND LINKS TO PUBLICLY AVAILABLE
PROJECT DATA.
IT INCLUDES THE ABILITY TO
VISUALIZE THE HIV PORTFOLIO IN
THE CONTEXT OF OTHER TOPICAL
AREAS OF SCIENCE, INCLUDING
EXAMPLES AGING, COMORBIDITIES,
COINFECTIONS.
THE DASHBOARD VISUALIZATIONS ARE
INTERACTIVE AND ALLOWS THE USE
INVENTORY DRILL DOWN TO
INFORMATION OF INTEREST.
SO IF WE COULD JUMP TO THE LIVE
DEMO, THAT WOULD BE GREAT.
SO BEFORE WE JUMP INTO THE
ACTUAL DEMO, I WOULD LIKE TO
START OFF BY GIVING A FEW
STATISTICS YOU MIGHT NOT BE
AWARE.
THE NIH INVESTS ABOUT
$49 BILLION ANNUALLY IN
BIOMEDICAL HEALTH RESEARCH, MORE
THAN 80% OF NIH'S FUNDING IS
AWARDED FOR EXTRAMURAL RESEARCH,
LARGELY THROUGH ABOUT 50,000
COMPETITIVE GRANTS TO MORE THAN
300,000 RESEARCHERS AT 2500
UNIVERSITIES, MEDICAL SCHOOLS
AND OTHER RESEARCH INSTITUTIONS
IN EVERY STATE.
ABOUT 10% OF THE NIH'S BUDGET
SUPPORTS INTRAMURAL RESEARCH
PROJECTS CONDUCTED BY NEARLY
6,000 SCIENTISTS IN ITS OWN
LABORATORIES, MOST OF WHICH ARE
ON THE NIH CAMPUS.
AS PART OF THE NIH INVESTMENT,
THE HIV/AIDS BUDGET IS AROUND
$3.2 BILLION AND SUPPORT CLOSE
TO 3800 ACTIVE PROJECTS
ANNUALLY, WHICH INCLUDE
EXTRAMURAL GRANTS, EXTRAMURAL
PROJECTS AS WELL AS CONTRACTS.
NOW I'D LIKE TO TALK A LITTLE
BIT ABOUT THE TYPES OF DATA
THAT'S AVAILABLE FOR HIV
RESEARESEARCH PROJECTS.
FIRST EVERY HIV PROJECT IS
MANUALLY CODED BY THE INSTITUTES
TO ONE OF MORE THAN 44 OBJECTIVE
CODES.
THESE OBJECTIVE CODES PROVIDE A
FAIRLY GRANULAR BREAKDOWN OF THE
TYPE OF RESEARCH BEING
CONDUCTED.
FOR EXAMPLE, ONE OF THE
OBJECTIVE CODES IS BASIC
MECHANISMS OF MUCOSAL
TRANSMISSION.
A PROJECT WILL BE CODED TO ONE
OR MORE OF THESE OBJECTIVE
CODES.
FINALLY, THROUGH THE OBJECTIVE
CODES, EACH GRANT IS MAPPED TO
ONE OF THE FIVE RESEARCH
PRIORITIES, INCLUDING COST
CUTTING RESEARCH, WHICH INCLUDES
TRAINING, INFRASTRUCTURE AND
CAPACITY BUILDING, BEHAVIORAL
SOCIAL SCIENCE RESEARCH, AND
CROSS-CUTTING BASIC RESEARCH.
IT ALSO INCLUDES HIV-ASSOCIATED
COMORBIDITIES, COINFECTIONS AND
COMPLICATIONS.
REDUCING THE INCIDENCE OF HIV,
WHICH INCLUDES VACCINE STUDIES
AND PREVENTION.
NEXT GENERATION THERAPIES, WHICH
INCLUDES ANTIRETROVIRAL THERAPY,
AND RESEARCH TOWARDS A CURE.
THIS HIERARCHICAL CODING SCHEME
ALLOWS US TO LOOK AT THE NIH
PORTFOLIO IN A VARIETY OF WAYS
DEPENDING ON THE NEED.
SWITCH GEARS.
SO ON OUR O.A.R. WEBSITE, ACTIVE
AS OF LAST NIGHT, YOU WILL SEE
THIS NEW -- IT ACTUALLY UNDER
THIS TAB RIGHT HERE AT THE VERY
BOTTOM.
THE O.A.R. DATA HUB SHOWCASING
THE NIH HIV/AIDS RESEARCH
PORTFOLIO.
SO ON THE LANDING PAGE, YOU WILL
HAVE ACCESS TO ALL OF THE
CURRENT DASHBOARDS THAT WE HAVE,
AND THERE'S ALSO A HELP PAGE TO
GET YOU STARTED, SO IF I CLICK
HERE, IT WILL TAKE YOU TO A
NUMBER OF VIDEO TUTORIALS THAT
WILL GUIDE YOU THROUGH EACH OF
THE DASHBOARDS.
AS WELL AS DATA NOTES AND
INFORMATION INTERPRETATION, SO
THIS WILL GIVE YOU ALL OF THE
GLOSSARY OF HOW TO INTERPRET THE
DATA THAT IS FOUND ON THE
DASHBOARD.
ALL OF THESE LINKS IN THE
GLOSSARY TAKE YOU BACK TO THE
NIH GLOSSARY ON THE NIH WEBSITE.
IF YOU WANT TO GET TO THE DATA
HUB, JUST CLICK DATA HUB.
NOW WE'LL JUMP TO THE ACTUAL
FIVE ACTIVE DASHBOARDS THAT WE
HAVE.
SO WE HAVE NIH AWARDS BY
RESEARCH TOPIC, HIV AWARDS BY
NOFO AND NOSI, WHICH ARE NOTICE
OF FUNDING OPPORTUNITY OR NOTICE
OF SPECIAL INTEREST.
YOU CAN LOOK AT THE HIV AWARDS
BY ORGANIZATION OR INVESTIGATOR.
YOU CAN LOOK AT THE HIV AWARDS
BY THE ADMIN INSTITUTE CENTER OR
OFFICE, ICO, THE FUNDING ICO,
THE ACTIVITY CODE OR MECHANISM,
AND THEN FINAL DASHBOARD IS ALL
OF THE DATA ELEMENTS TOGETHER.
SO THIS IS PHASE ONE OF THIS
PROJECT.
WE ANTICIPATE THAT THERE WILL BE
MANY ADDITIONAL DASHBOARDS IN
THE NEAR FUTURE.
SO ONE OF THE POWERFUL THINGS
ABOUT THIS PLATFORM IS THAT WE
CAN GENERATE THESE DASHBOARDS
WITHIN A NUMBER OF DAYS BASED ON
PUBLICLY AVAILABLE DATA AND
PUBLISH THEM TO OUR WEBSITE.
SO I'LL START HERE WITH THE
FIRST ONE.
SO WHEN YOU FIRST COME INTO IT,
YOU SEE THE OVERALL LANDSCAPE OF
WHAT THE HIV PORTFOLIO LOOKS
LIKE.
SO WE HAVE DATA GOING BACK TO
2018.
THIS ONE IS FOCUSED JUST ON
2022, SO YOU CAN SEE ALL OF THAT
HERE ON THE FIRST ROW.
THERE'S 3799 AWARDS FOR A TOTAL
OF $3.193 BILLION.
IT IS BROKEN DOWN BY THE HIV
RESEARCH PRIORITIES THAT I
MENTIONED BEFORE.
AS YOU CAN SEE THE NUMBER OF
AWARDS FOR CROSS-CUTTING
RESEARCH IS ROUGHLY 2500,
CO-OCCURRING CONDITIONS AND SO
ON DOWN THE LIST.
LIKE I SAID, EVERY PROJECT CAN
HAVE MORE THAN ONE OBJECTIVE
CODE, WHICH MEANS THAT IT CAN BE
MAPPED TO MORE THAN ONE RESEARCH
PRIORITY.
SO THAT'S WHY THE NUMBERS ADD UP
TO MORE THAN THAT, IF YOU WERE
LOOKING ACROSS ALL OF THESE.
I ALSO MENTIONED RESEARCH
OBJECTIVE, OF WHICH THERE ARE
44, THIS SHOWS THE NUMBER OF
PROJECTS BY EACH OF THOSE
44 DIFFERENT OBJECTIVE CODES.
IF WE WERE TO PICK ONE, SO SAY
DISEASE PROGRESSION, THE
DASHBOARD WILL UPDATE, THE
NUMBERS WILL UPDATE AND YOU WILL
BE ABLE TO SEE HOW MUCH FUNDING
GOES TOWARDS THAT PARTICULAR
RESEARCH OBJECTIVE, OF WHICH
THAT MAPS TO, AS YOU CAN TELL BY
THE COLOR CODING, TO THE
CO-OCCURRING CONDITIONS.
SO 136 MILLION OR 343 AWARDS
WERE IN THIS PARTICULAR RESEARCH
OBJECTIVE.
TO BACK OUT OF THIS TO GET BACK
TO THE MAIN LIST, YOU JUST CLICK
IT AGAIN.
IF YOU HOVER OVER ANY OF THESE,
IT WILL GIVE YOU A TOOL TIP,
WHICH TALKS ABOUT WHAT'S THE
FULL NAME AND WHAT'S THE TOTAL
FUNDING AND NUMBER OF AWARDS FOR
EACH OF THESE OBJECTIVES.
SO THIS PARTICULAR DASHBOARD IS
DEALING WITH THE NIH SPENDING
CATEGORIES.
OF WHICH THERE ARE ROUGHLY 300
CATEGORIES THAT ARE ON THE NIH
REPORTER WEBSITE.
SO IF WE WANT TO LOOK AT THE
INTERSECTION BETWEEN ANY OF
THESE SPENDING CATEGORIES AND
HIV, WE HAVE THAT HERE ON THIS
DASHBOARD.
SO IF WE'RE INTERESTED IN
LOOKING AT BEHAVIORAL AND SOCIAL
SCIENCE, WE CAN SEE THAT OF THE
37 OR 3800 PROJECTS, 1300 OF
THEM ARE IN BSSR.
IF WE CLICK ON THAT, IT WILL
FOCUS IN ON BSSR AND GIVE YOU AN
UPDATED LIST OF THE ICs THAT
ARE DOING RESEARCH IN THAT AREA.
AND THEN IF YOU SCROLL DOWN, IT
WILL ACTUALLY GIVE YOU A LIST OF
ALL OF THE PROJECTS WITH THE
FUNDING AMOUNT.
ONE OTHER THING YOU CAN DO IS
CLICK ON AN INDIVIDUAL PROJECT.
THEN YOU CAN ALSO CLICK ON THIS
LINK WHICH WILL TAKE YOU TO THE
REPORTER WEBSITE WHICH WILL GIVE
YOU THE ABSTRACT AND THE PUBLIC
HEALTH RELEVANCE, WHAT OTHER
SPENDING CATEGORIES IT'S IN,
SOME OF THE PROJECT TERMS, AS
WELL AS OTHER RELEVANT
INFORMATION, INCLUDING
ORGANIZATION, P.I., THE FOAs,
THINGS LIKE THAT.
IF YOU WANT TO COMPLETELY GO
BACK TO THE BEGINNING STATE, YOU
CAN CLICK THE BUTTON TO RESET.
AND IT WILL TAKE YOU BACK TO THE
OVERALL DASHBOARD.
LET'S JUMP TO THE NEXT ONE.
SO THIS ONE IS BY NOFO OR NOSI.
SO IF YOU'RE INTERESTED IN A
SPECIFIC NOFO, FOR EXAMPLE, IF
WE CLICK HERE, AND WE TYPE IN
AGING, IT WILL DO A SEARCH OF
ALL THE NOFO TITLES, IT WILL
BRING BACK A LIST OF THE FUNDING
OPPORTUNITIES AND THE NOTICE --
AND THE NOSIs THAT HAVE AGING
IN THE TITLE.
YOU CAN HOVER OVER, IT WILL GIVE
YOU THE FULL TITLE NAME AND ALL
OF THE PROJECTS THAT WERE FUNDED
UNDER A SPECIFIC NOFO.
AND AGAIN, IF YOU CLICK ON THE
PROJECT TITLE, IT WILL GIVE YOU
A LINK BACK TO THE REPORTER TO
DO MORE INVESTIGATING.
THE NEXT ONE IS BY ORGANIZATION
OR INVESTIGATOR.
SO AS THE NAME IMPLIES, YOU HAVE
THE SAME OVERALL -- THIS PART UP
HERE DOESN'T CHANGE, THE
FUNDING, THE CROSS-CUTTING, BUT
WHAT DOES CHANGE IS THE
ORGANIZATION AND THE INDIVIDUAL
INVESTIGATOR.
SO IF WE'RE INTERESTED IN
LOOKING AT UNC, CHAPEL HILL, YOU
CAN CLICK ON THAT, GET A LIST OF
INVESTIGATORS.
WITH THE NUMBER OF AWARDS.
AND THEN ALSO A LIST OF AWARDS
FOR THAT PARTICULAR INSTITUTE OR
IF YOU DRILL DOWN TO THE
INDIVIDUAL P.I., YOU CAN GET
THAT AS WELL.
SO THESE FILTERS HERE ARE
CLICKABLE BUT YOU ALSO HAVE
ANOTHER SET OF FILTERS HERE
WHICH CORRESPOND TO THE LIST SO
IF YOU WANT TO DO A
MULTI-SELECT, YOU CAN SELECT A
NUMBER OF DIFFERENT INSTITUTIONS
OR A NUMBER OF DIFFERENT PIs,
AND IT WILL DO BASICALLY THE
SAME THING.
SO FINALLY, WE HAVE BY I.C.
AND BY ACTIVITY CODE.
SO IT WAS MENTIONED EARLIER
ABOUT R21s, SO IF YOU'RE
REALLY INTERESTED IN THE NUMBER
OF R21s THAT WERE AWARDED IN
2022, YOU COULD CLICK HERE.
IT WILL UPDATE, IT WILL TELL YOU
WHICH INSTITUTES ARE
ADMINISTERING AND FUNDING THEM.
IT WILL TELL YOU THE BUDGET
MECHANISM, WHICH IS EITHER A
GRANTS OR INTRAMURAL OR
CONTRACT.
IT WILL ALSO GIVE YOU A LINK OR
A LIST OF ALL OF THOSE AWARDS,
AND AGAIN, A LINK BACK TO
REPORTER IF YOU'RE INTERESTED IN
FINDING OUT MORE INFORMATION.
AND FINALLY, I WON'T GO THROUGH
THE LAST ONE.
THE LAST ONE HAS GOT ALL OF THE
METRICS THAT WE WERE JUST
LOOKING AT ALL IN ONE SINGLE
DASHBOARD.
SO IT ALLOWS TO YOU LOOK ACROSS
EVERYTHING THAT WE'VE LOOKED AT
PRIOR TO THAT ALL IN ONE
DASHBOARD.
IT'S A LITTLE COMPLICATED, AND
BUSY, SO IF YOU WANT TO JUST
FOCUS IN, IT'S PROBABLY BETTER
TO USE ONE OF THESE OTHER ONES
FIRST.
WITH THAT, IF WE COULD JUMP BACK
TO THE SLIDES, PLEASE.
SO I WOULD LIKE TO THANK THE
ENTIRE TEAM AT O.A.R. THAT ARE
LISTED HERE THAT PLAYED A
SIGNIFICANT ROLE IN BUILDING
THIS EXCITING NEW TOOL.
I'D ALSO LIKE TO THANK TWO
MEMBERS OF OUR EXECUTIVE
COMMITTEE, ROB PALMER AND
KENDALL BRYANT WHO OFFERED
SUGGESTIONS AND FEEDBACK ON THE
DATA HUB.
I'D ESPECIALLY LIKE TO THANK
DANNY MURPHY FOR LEADING THE
DEVELOPMENT OF THIS ENDEAVOR.
HE'S REALLY BEEN A FORCE FOR
CHANGE IN THIS.
SO I APPRECIATE ALL OF HIS HARD
WORK.
THIS QR CODE WILL TAKE YOU
DIRECTLY TO THE DATA HUB, AND
WITH THAT, I WILL PASS IT BACK
TO YOU, DR. TURNBULL, AND TAKE
ANY QUESTIONS THAT YOU MIGHT
HAVE.
>> THANK YOU, MR. CREGG, FOR A
VERY INFORMATIVE PRESENTATION ON
THIS NEW TOOL THAT HIGHLIGHTS
THE NIH HIV/AIDS RESEARCH
PORTFOLIO.
WE WILL NOW HAVE OPEN DISCUSSION
ABOUT THIS NEW O.A.R. DATA HUB.
AGAIN, DR. GLENSHAW AND I WILL
CO-FACILITATE THE DISCUSSION.
THIS TIME, LET'S START WITH ANY
COMMENTS FROM THE MEMBERS ON THE
ZOOM.
DR. NAGHAVI.
>> THANK YOU VERY MUCH.
THAT WAS A GREAT PRESENTATION.
I'M JUST WONDERING, WOULD IT BE
HELPFUL TO ADD A DA DASHBOARD TO
EARLY CAREER INVESTIGATORS SO
THAT JUNIORS CAN QUICKLY FIGURE
OUT HOW A SUCCESSFUL APPLICATION
LOOKS LIKE AMONGST THEIR PEERS?
>> ABSOLUTELY.
THAT WAS AT THE VERY TOP OF OUR
LIST FOR THE NEXT ROUND OF
DASHBOARDS TO BE CREATED.
>> I'M SORRY, I MISSED THAT.
>> THAT'S ON THE TOP OF OUR LIST
FOR -- I DIDN'T MENTION THAT.
THIS IS THE FIRST TIME I
MENTIONED IT, BUT IT WILL BE ON
THE TOP OF OUR LIST.
>> GOOD.
>> DR. GALARRAGA.
>> GREAT TOOL.
THANKS FOR THE PRESENTATION.
I WAS JUST WONDERING, HOW DOES
THE DASHBOARD AT O.A.R. INTERACT
WITH THE NIH REPORTER?
>> SO REPORTER IS ALL THE
PUBLICLY AVAILABLE DATA ACROSS
THE ENTIRE NIH.
THIS IS SPECIFICALLY FOCUSED ON
HIV.
THE ONE THING THAT REPORTER DOES
NOT HAVE THAT THE DATA HUB DOES
HAVE ARE THE INDIVIDUAL
OBJECTIVE CODES AND THE LINKS TO
THE OVERARCHING PRIORITIES.
SO AS I SHOWED, THERE ARE LINKS
THAT GO BACK AND FORTH
BETWEEN -- OR ACTUALLY JUST ONE
WAY TO REPORTER FROM THE DATA
HUB, WHICH WILL ALLOW YOU TO
LOOK AT SPECIFIC PROJECT DATA.
DOES THAT ANSWER YOUR QUESTION?
>> I WAS JUST CURIOUS IF WE RUN,
SAY, A REPORT ON THE NUMBERS FOR
HIV PROJECT IN NIH REPORTER,
WILL WE GET THE SAME AS THE
NUMBERS FOR THE DASHBOARD IN
O.A.R., MEANING DO THEY COME
FROM THE SAME DATASET AND
THEY'RE PULLING THE SAME DATA,
OR ARE THERE GOING TO BE
DISCREPANCIES? THAT IS JUST
WHAT I WAS WONDERING.
>> THAT'S WHERE IT GETS A LITTLE
COMPLICATED.
THERE WILL BE DIFFERENCES
BECAUSE REPORTER IS BASED ON
WHAT'S CALLED CURRENT DATA, SO
ANYTHING THAT HAPPENS AFTER THE
END OF A FISCAL YEAR WOULD BE
REFLECTED IN REPORTER, BUT IT'S
NOT GOING TO BE REFLECTED IN OUR
DATA HUB BECAUSE THAT IS A
FROZEN DATASET FOR THAT
PARTICULAR FISCAL YEAR.
SO THAT'S WHAT'S REPORTED ON A
DIFFERENT WEBSITE WHICH ADDS UP
TO THE EXACT AMOUNT OF MONEY
THAT WAS ALLOCATED FOR HIV.
SO THAT'S A GOOD QUESTION,
THOUGH.
THEY'RE NOT GOING TO BE 100% THE
SAME.
THEY'LL BE 99% THE SAME, THOUGH.
>> MAYBE A FOOTNOTE, SMALL PRINT
SOMEWHERE FOR THE RESEARCHERS.
I KNOW THAT THERE ARE COLLEAGUES
THAT, YOU KNOW, DO RESEARCH
BASED ON WHAT COMES OUT OF THE
REPORTER AND IF THE SAME IS NOT
FROM THE DASHBOARD, THEY'RE
GOING TO BE SURPRISED, SO MAYBE
A SMALL FOOTNOTE SOMEWHERE TO
THIS POINT MAY BE USEFUL FOR
SOME PEOPLE.
>> YES, THERE IS ONE ACTUALLY,
BUT THANK YOU.
>> GREAT.
EXCELLENT.
>> MARY, ANY COMMENTS IN THE
ROOM?
>> YES, DR. MONTANER.
>> SO CONGRATULATIONS, THAT'S A
GREAT TOOL.
SO JUST TO CLARIFY, SO YOU'RE A
YEAR BEHIND?
ARE YOU SAYING THE FISCAL YEAR
STARTS TO PUT REPORTER ON
REALTIME, SO SAY AUGUST, YOU
DON'T UPLOAD UNTIL THE END OF
THE FISCAL YEAR?
>> SO REPORTER IS ALSO --
DOESN'T REPORT THE CURRENT
FISCAL YEAR.
IT'S NOT UNTIL THE FISCAL YEAR
CLOSES.
SO THERE WON'T BE '23 DATA UNTIL
'23 FISCAL YEAR CLOSES IN
OCTOBER.
THERE WILL BE CURRENT DATA BUT
IT WON'T BE, YOU KNOW, ASSIGNED
TO A SPECIFIC SPENDING CATEGORY.
SO YOU'LL SEE A GRANT IN
REPORTER BUT IT WON'T HAVE ANY
OF THOSE 300 SPENDING CATEGORIES
OR INCLUDING HIV.
>> SO MY ONLY SUGGESTION MIGHT
BE, AS I SAY, YOU PROBABLY HAVE
A HUGE LIST OF WANTS.
BUT CRITERIA SUCH AS P.I.
SPECIFIC LIKE SEX, MINORITY,
YOUNG INVESTIGATOR OR PRIOR R01,
EARLY INVESTIGATOR VERSUS NOT,
AND ALSO INSTITUTIONAL
INFORMATION BECAUSE THE NUMBER,
YOU KNOW, WE KIND OF
CHARACTERIZE INSTITUTION AS
MINORITY RELATED OR PRIMARILY
UNDERGRADUATE WHEN IT COMES TO
SOME INSTRUMENTS LIKE R15 AND SO
FORTH, AND ALSO CLUSTERS OF
SPECIFIC AMOUNTS OF R01s
BECAUSE WE TEND TO TARGET SORT
OF INSTITUTIONS THAT HAVE LESS,
AND HAVING SOME CLARITY AS TO
WHAT IS THE LANDSCAPE WITH
RESPECT TO FUNDING WITH THESE
POCKETS WOULD BE USEFUL BECAUSE
THEN WE CAN ADVOCATE FOR OKAY,
LOOK AT THIS SUBSET THAT IS
UNDERREPRESENTED IN THE
PORTFOLIO OR SOME OTHER, YOU
KNOW, ACCOUNTABILITY MEASURE.
>> THAT'S A GREAT SUGGESTION.
THANK YOU.
>> DR. SLEASMAN.
>> FANTASTIC TOOL.
I'M ASSUMING THAT YOU'LL BE ABLE
TO LOOK AT THIS AS A TOOL TO
LOOK AT THE PRIORITIES AND
ULTIMATELY EQUATE IT BACK TO THE
BUDGETARY P.J. AND C.J. BUDGETS
GOING FORWARD, SO PROVIDE, YOU
KNOW, BASICALLY DOCUMENTATION
THAT THE PRIORITY ARE BEING
FOLLOWED.
>> CORRECT, YES.
>> JOHN, THAT'S RIGHT ON TARGET.
I MEAN, ONE OF THE INTENTS HERE
IS TO BE ABLE TO NOT HAVE SUCH
BLUNT INSTRUMENTS TO HAVE
SOMETHING THAT THEN CAN INFORM
MORE OBJECTIVELY WHAT WE'RE
DOING AND HOW WE'RE GOING
FORWARD.
>> I'D ALSO JUST LIKE TO MAKE
THE POINT THAT I'M NOT CERTAIN
HOW CLEAR IT IS TO THE FOLKS
OUTSIDE OF OUR OFFICE THAT, YOU
KNOW, WE DO HAVE THESE FIVE
OVERARCHING RESEARCH PRIORITIES,
BUT WE HAVE THE 44 OBJECTIVES
THAT ARE MUCH MORE GRANULAR IN
NATURE, AND SO SORT OF A
DIFFERENT WAY OF CATEGORIZING
THE DATA THAT IS NOW AVAILABLE
TO ANYONE.
IT'S A VERY, VERY USEFUL LEVEL
OF ANALYSIS INSTEAD OF JUST THE
FIVE BI BIG BUCKETS.
ANY MORE COMMENTS FROM THE ROOM?
>> -- 44 WERE DEFINED?
HOW DID YOU DEFINE WHO THOSE
44 ARE?
>> THAT GOES WAY BACK.
IT'S BEEN CODED THAT WAY FOR AT
2008.
SO I DON'T KNOW WHO ACTUALLY
CAME UP WITH THEM, BUT THEY HAVE
BEEN AROUND FOR QUITE A WHILE.
AND THEY DO MAP WHAT USED TO BE
CALLED THE AREAS OF EMPHASIS,
THERE WERE NINE OF THOSE.
WE'VE GOTTEN RID OF THE AREAS OF
EMPHASIS AND WE'VE GONE DIRECTLY
FROM THE OBJECTIVE CODE STRAIGHT
TO THE PRIORITY.
BUT I CAN'T GIVE YOU A MORE
DEFINITIVE HISTORY ON THE
OBJECTIVE CODES.
>> THE ONLY THING I CAN ADD TO
THAT IS SORT OF HISTORICAL PR
PERIPHERAL KNOWLEDGE, THERE WERE
WORKING GROUPS THAT MET EVERY
YEAR THAT INCLUDED ACADEMIC,
INCLUDED EXTRAMURAL CLINICIANS
AND NIH FOLKS AND THEN THEY CAME
UP WITH A LOT OF THESE
CATEGORIES THAT WE REFINED
ANNUALLY, SO I THINK MORE THAN
THAT, WE'LL HAVE TO GO INTO THE
BOOKS.
>> THEY'RE POSTED ON THE
WEBSITE, THE 44?
>> YES.
>> GREAT.
THANK YOU.
>> I THINK THAT'S IT FROM THE
ROOM, DR. TURNBULL.
>> THANK YOU.
AND I DON'T SEE ANY MORE
MEMBERS' HANDS RAISED IN THE
ZOOM.
SO THANK YOU ALL ONCE AGAIN,
COLLEAGUES, FOR SUCH A RICH
DISCUSSION.
WE WILL NOW HAVE OUR LAST
15-MINUTE BREAK.
PLEASE RETURN PROMPTLY AT
3:35 P.M. EASTERN TIME.
AS A REMINDER, DO NOT TURN OFF
YOUR ZOOM, BUT FEEL FREE TO TURN
OFF YOUR CAMERA AND YOU CAN MUTE
YOUR SOUND.
>> ACTUALLY, SORRY,
DR. TURNBULL, WE'RE A LITTLE BIT
AHEAD OF SCHEDULE, SO IF
COLLEAGUES AGREE, WE COULD
RETURN AT ABOUT 3:20?
AND WE CAN MAKE UP A LITTLE BIT
OF TIME.
>> OKAY.
>> THAT WILL GIVE US ABOUT A
15-MINUTE BREAK.
>> OKAY.
SO 3:20, YOU SAID?
>> THANKS, EVERYONE.
SEE YOU IN 15 MINUTES.
>> OKAY.
THANK YOU.
>>WELCOME BACK, EVERYONE.
WE WILL NOW HEAR BRIEF UPDATES
FROM OTHER NIH ADVISORY COUNCIL,
AND THE NATIONAL AIDS EXECUTIVE
COMMITTEE.
I WOULD LIKE TO INVITE DR. CARL
DIEFFENBACH, MS. CORETTA BYRD,
AND DR. DIANNE RAUSCH TO PROVIDE
SHORT SUMMARIES OF RECENT
MEETINGS.
DR. DIEFFENBACH SERVES AS
DIRECTOR OF THE DIVISION OF AIDS
AT NIAID.
DR. DIEFFENBACH OVERSEES THE
GLOBAL HIV/AIDS RESEARCH
PORTFOLIO OF MORE THAN
$1 BILLION, AND A STAFF OF MORE
THAN 150 FEDERAL EMPLOYEES.
DR. DIEFFENBACH PLAYED A KEY
ROLE IN RESTRUCTURING THE
DIVISION OF AIDS SUPPORTED
CLINICAL TRIALS RESEARCH
NETWORKS, AND HAS ACTIVELY
FOSTERED COLLABORATION AND
PARTNERSHIP WITH OTHER FEDERAL
AGENCIES, INTERNATIONAL RESEARCH
ORGANIZATIONS, PROFESSIONAL
SOCIETIES, FOUNDATIONS,
COMMUNITY ADVOCACY GROUPS, AND
INDUSTRY.
MS. CORETTA BYRD JOINED THE NIH
O.A.R. IN MARCH 2021 AS A HEALTH
SCIENCE POLICY ANALYST,
COORDINATING O.A.R. HIV INFO AND
CLINICAL GUIDELINE ACTIVITIES.
AND DR. DIANNE RAUSCH IS THE
DIRECTOR OF THE OFFICE OF AIDS
AT THE NATIONAL INSTITUTE OF
MENTAL HEALTH.
DR. DIEFFENBACH, WE WILL BEGIN
WITH YOU.
>> THANK YOU FOR THAT LOVELY
INTRODUCTION.
GO AHEAD AND START A TIMER SO I
STAY ON TIME.
SO I'M HERE TO REPORT ON THE
MOST RECENT ARAC MEETING THAT
WAS HELD JUST A COUPLE WEEKS
AGO.
SO THE STRUCTURE OF THE ARAC
MEETING THAT I'M GOING TO TALK
ABOUT IS -- I'LL GIVE YOU A
SUMMARY OF MY DIRECTOR'S REPORT
THAT WAS PART OF THE MEETING AND
THEN I'LL GIVE YOU A PREVIEW OR
A QUICK SNAPSHOT OF THE NEW AND
RENEWING FISCAL YEAR
'25 INITIATIVES.
THESE ARE RESEARCH PROGRAMS THAT
WE ARE EITHER SEEKING TO
CONTINUE OR START ANEW WITH
FISCAL YEAR 25 DOLLARS.
WITHIN NIAID, WE'RE USUALLY
PLANNING WITHIN THREE FISCAL
YEARS, CLOSING UP ONE AND IN A
STAGE OF EXECUTION, SO IN
GENERAL, WE'RE WORKING IN FOUR
FISCAL YEARS.
PARENTHETICALLY, WE'RE STARTING
OUR PLANNING FOR FISCAL YEAR
'26.
'25 IS PRETTY MUCH IN THE BOOKS.
SO TO START, WE'VE HAD A NUMBER
OF IMPORTANT CHANGES WITHIN
NIAID THAT WERE SPECIFICALLY
RELEVANT TO THE AIDS RESEARCH
ADVISORY COMMITTEE.
WE HAVE A NEW DIRECTOR AT THE
VRC, TED PIERSON JOINED AS VRC
DREKD TORE.
DIRECTOR.
IT'S GREAT TO HAVE HIM ON BOARD.
WE HAVE A NEW CHAIR FOR ARAC.
ELAINE ABRAMS HAS AGREED TO BE
THE CHAIR.
ELAINE IS A PROFESSOR OF
EPIDEMIOLOGY AND PEDIATRICS AT
COLUMBIA.
THIS WAS HER FIRST FULL MEETING,
AND IT WAS GREAT TO HAVE HER
SITTING THERE AND PARTICIPATING
AS THE CHAIR.
AND WE HAD A NEW O.A.R. ADVISORY
COMMITTEE LIAISON, ANNE NEILAN.
I GET TO SEE HER IN PERSON FOR
THIS MEETING.
SO NO PRESENTATION AT NIAID FROM
THE INSTITUTE IS COMPLETE
WITHOUT A BUDGET SLIDE.
SO THIS IS WHERE WE ARE FOR THE
FISCAL YEAR '23 ENACTED BUDGET.
YOU CAN SEE THAT NIAID IS
FLAT-FUNDED, ACCORDING TO THE
PRESIDENT'S BUDGET.
ALL OF THIS REMAINS TO BE WORKED
OUT IN LIGHT OF THE RECENT BILL
THAT WAS PASSED ON, CREATING THE
SPACE FOR KEEPING THE GOVERNMENT
OPEN.
WE HEAR LOTS OF NOISE COMING OUT
OF THE MAJORITY PARTY IN THE
HOUSE NOW ABOUT ADDITIONAL CUTS
THAT MAY BE COMING.
SO WE'LL SEE HOW THIS GETS
ENACTED INTO LAW WHEN THEY GET
AROUND TO PASSING THE FUNDING
FOR NEXT FISCAL YEAR.
SOMETHING THAT'S VERY IMPORTANT
TO THE INSTITUTE AND THE
DIVISION OF AIDS IN PARTICULAR
IS DIVERSITY, EQUITY AND
INCLUSION AND ABILITY.
I MADE IT A PRAY OR THE FOR
EVERY SINGLE MEETING TO HAVE A
SLIDE ON WHAT WE HAVE
ACCOMPLISHED IN THAT SHORT
PERIOD OF A COUPLE OF MONTHS
RELATIVE TO DIVERSITY, EQUITY
AND INCLUSION AND ACCESSIBILITY,
AND WHAT IS LISTED ON HERE ARE A
NUMBER OF FUNDING ANNOUNCEMENTS,
NOFOs, AND OTHER ACTIVITIES
THAT ARE RELEVANT TO DIVERSITY,
EQUITY AND INCLUSION AND
ACCESSIBILITY, ALSO HIGHLIGHTING
A VERY IMPORTANT CFAR PROGRAM
CALLED CDIPI, WHICH FOSTERS THE
ADVANCEMENT OF HIGH SCHOOL AND
COLLEGE STUDENTS ENGAGED IN --
GETTING THEM ENGAGED IN RESEARCH
AT ACADEMIC INSTITUTIONS SO THEY
LEARN ABOUT THE IMPORTANCE OF
HIV, LEARN HOW TO GET ENGAGED IN
HIV RESEARCH AND THEN CREATE A
PIPELINE OF DIVERSE
POPULATION GOING INTO GRADUATE
SCHOOL AND MEDICAL SCHOOL.
WE ALSO HAVE HAD NOTICE OF
SPECIAL INTEREST ADMINISTRATIVE
SUPPLEMENTS FOR AIDS RESEARCH
DONE IN COLLABORATION WITH NIMHD
THAT WAS PUBLISHED IN THE PAST
THREE MONTHS.
I ALWAYS HAVE A COUPLE OF
RESEARCH HIGHLIGHTS AS WELL, AND
I HAVE THREE THAT I'LL SHARE.
THIS IS A RESULT THAT CAME OUT
IN APRIL.
THIS WAS A CLINICAL TRIAL THAT
WE STARTED PLANNING FOR IN 2013.
IT STARTED ENROLLING IN 2015.
AND THE QUESTION IS, WHAT
HAPPENS -- IS THERE A CLINICAL
BENEFIT TO ADDING A STATIN TO A
PERSON'S HIV DRUG REGIMEN IF
THEY DON'T ACTUALLY QUALIFY FOR
A STATIN OTHER THAN THE FACT
THAT THEY ARE LIVING WITH HIV?
IT'S IMPORTANT TO THINK ABOUT
THIS, THAT WE ENROLLED A
RELATIVELY YOUNG POPULATION
STARTING AT AGE 40, AND YOU CAN
SEE WE ALSO DID A VERY GOOD JOB
ENROLLING WOMEN, 30% OF THE
ENROLLMENT WAS IN WOMEN.
WHAT WE SAW TOTALLY SURPRISED
US.
WE WERE EXPECTING AN EFFECT SIZE
OF BETWEEN 25 AN 30%.
WHAT WE SAW WAS A SIGNIFICANTLY
LARGER EFFECT SIZE OF 35%
REDUCTION IN CARDIOVASCULAR
DISEASE.
ALL WE HAVE RIGHT NOW IS THE TOP
LINE INFORMATION THAT THE DSMB
USED TO STOP THE STUDY.
THE PAPER IS MOVING THROUGH THE
PROCESS OF GETTING PUBLISHED IN
THE NEW ENGLAND JOURNAL OF MED
SAIND SHOULD MEDICINE AND SHOULN
MID JULY.
SO WE'RE VERY EXCITED ABOUT THE
QUALITY AND DEPTH OF THIS DATA.
YOU CAN SEE WE HAD A VERY LARGE
ENROLLMENT IN THE STUDY, AND A
LOT OF DATA WILL COME OUT ON
THIS STUDY OVER THE NEXT SEVERAL
YEARS.
IN TERMS OF CLINICAL TRIALS TO
WATCH, WE STILL ARE FINISHING UP
ONE OF THE RANDOMIZED CLINICAL
TRIALS OF A CORONAVIRUS VACCINE
IN SUB-SAHARAN AFRICA, LOOKING
SPECIFICALLY AT HOW THIS VACCINE
FUNCTIONS IN PEOPLE LIVING WITH
HIV.
THERE'S A LOT OF HYBRID IMMUNITY
IN SOUTH AFRICA, SO IT WILL BE
VERY INTERESTING TO PARSE OUT
PEOPLE WHO ARE LIVEING WITH HIV,
THE EFFECT OF THE VACCINE AND
THE EFFECT OF PRIOR INFECTION.
NOW THE DSMB FOR THIS IS COMING
UP FAIRLY SOON.
AND LAST BUT NOT LEAST, THERE'S
A STUDY THAT WE'RE HOPING MAYBE
IT WILL ENROLL BUT THAT MEANS
WE'RE HAVING ANOTHER MPOX
OUTBREAK.
SO THIS IS A STUDY WE LAUNCHED
AT THE VERY TAIL END OF THE
SUMMER LAST YEAR.
OUR ENROLLMENT HIT THE WALL
LITERALLY BECAUSE MPOX PRETTY
MUCH DRIED UP.
WE'RE STARTING TO SEE THREE
CASES IN DENVER, SEVEN CASES IN
CHICAGO.
WE'VE ALSO OPENED
INTERNATIONALLY AND WE ALSO HAVE
MOVED TO REMOTE ENROLLMENT.
SO THERE'S A PHONE NUMBER YOU
CAN CALL, IF YOU HAVE A PATIENT
AND YOU CAN GET REFERRED AND GET
DRUG DROP-SHIPPED IF THE PERSON
AGREES TO PARTICIPATE IN THE
STUDY.
WE'RE HOPING WE CAN GET TO FULL
ENROLLMENT WITHIN THE NEXT YEAR
OR SO.
SO WE DIDN'T CLOSE THE STUDY, WE
JUST KEPT IT GOING, AND EXPANDED
THE NUMBER OF SITES AND MOVED
INTERNATIONALLY.
THAT SAID, I'M NOW GOING TO MOVE
ON AND GROUP THE INITIATIVES
THAT WE PRESENTED TO THE COUNCIL
AND BUNDLE THEM SO THAT THERE IS
SOME DEGREE OF COHERENCE IN WHAT
WAS PRESENTED AND WHAT YOU'LL
HEAR ABOUT.
SO FIRST UP ARE THE HIV VACCINE
RESEARCH CONCEPTS THAT ARE
GRANTS THAT WERE PRESENTED AT
THE COUNCIL.
FIRST UP WAS A TOPIC OF -- THEY
WANT TO FUND RESEARCH AND
MECHANISMS FOR ESTABLISHING AND
MAIN TAKING IMMUNITY TO HIV IN
EARLY LIFE.
THE IMMUNITY AN INFANT OR
TODDLER DEVELOPS WHEN EXPOSED TO
A VACCINE, PARTICULARLY HIV, MAY
BE BETTER AND MORE DURABLE THAN
WHAT HAPPENS WITH ADULTS.
THERE'S DATA FROM NON-HUMAN
PRIMATES AND OTHERS, AND THERE
WERE ACTUALLY SOME VACCINE
STUDIES DONE YEARS AGO THAT
SUPPORT THIS.
WE ALSO HAVE RECENTLY STARTED
STUDIES WITH SOME OF THE NEW
MODERN IMMUNOGENS, RECENTLY
DEVELOPED IMMUNOGENS, TO SEE HOW
THIS ACTUALLY WORKS.
SO THIS IS AN AREA OF IMPORTANCE
TO US, TO SEE IF WE CAN TAKE
ADVANTAGE OF THE IMMUNITY IN
EARLY LIFE TO BOOST HIV IMMUN
IMMUNITY.
ONE OF OUR PROGRAMS WE'VE HAD
SEEMINGLY FOR A VERY LONG TIME
IS THE HIVRAD, A
MULTIDISCIPLINARY PROGRAM WHERE
PEOPLE APPLY FOR PROJECT TBRANTS
TO TRY TO EXPLAIN FUNDAMENTAL
MECHANISMS IN HIV VACCINE
RESEARCH, WERE IT'S IMMUNOGEN
DESIGN, T-CELL BEHAVIOR, BETTER
ADJUVANTS, YOU NAME IT.
SO ONE OF THE THINGS, AN EXAMPLE
OF A RESEARCH TOPIC WAS HOW DO
YOU BUILD A STABILIZED ENVELOPE
TRIMER.
JOHN MOORE BUILT THE FIRST SOCIP
THROUGH THIS PROGRAM.
LEO HAS BUILT SOME REALLY
EXCITING IMMUNOGENS THROUGH THIS
PROGRAM, AND THIS HAS LED TO A
NUMBER OF VACCINE CONCEPTS BEING
ADVANCED, INCLUDING DAN BARUK'S
WORD ON ED26.
ON THE CONTRACT SIDE, WE HAVE A
VERY LARGE PROGRAM CALLED THE
SIMIAN VACCINE EVALUATION UNITS
OR SVEUs, AND LINKED TO THOSE
EVALUATION UNITS ARE A SERIES OF
STANDARDIZED LABORATORIES.
SO THAT THE DATA THAT COMES OUT
OF THE LABS IS STANDARDIZED AND
YOU CAN THEN COMPARE APPLES TO
APPLES THAT ARE RESPONSIVE,
VACCINE A TO VACCINE B, BECAUSE
IT'S BEING DONE IN THE SAME
LABORATORIES.
SO WHAT WE HAD WERE
PRESENTATIONS ON FOUR OF THESE
ACTIVITIES, THE VIROLOGY LAB,
HUMORAL IMMUNOLOGY LAB,
FUNCTIONAL OMICS LAB, AND THEN A
RESOURCE SUPPORT PROGRAM THAT
MAKES REAGENTS AVAILABLE THAT
ARE TAILORED TO VACCINE RESEARCH
THAT ARE NOT READILY AVAILABLE
COMMERCIALLY.
THIS IS IN MANY WAYS --
DOVETAILS VERY NICELY WITH THE
HIV REAGENT PROGRAM THAT NIAID
HAS RUN FOR ABOUT 30 YEARS.
THESE TEND TO BE
VACCINE-SPECIFIC.
SO MOVING ON TO THERAPEUTICS, WE
HAVE REALLY THOUGHT ABOUT WHAT
WE COULD DO TO FACILITATE THE
ADVANCEMENT OF THERAPEUTICS
RESEARCH AND THERE'S THIS AREA,
THE VALLEY OF DEATH, THAT NEEDS
TO BE ADDRESSED.
SO CAN WE PROVIDE SUPPORT TO
INVESTIGATORS OR SMALL COMPANIES
THAT NEED TO ADVANCE A SPECIFIC
PRODUCT THROUGH THIS AREA.
SO THERE'S A PLANNING GRANT
PROCESS THAT WILL BE FUNDABLE
THROUGH AN R24 THAT WILL ALLOW
SOMEBODY WITH A GOOD IDEA TO
BUILD OUT THEIR PROCESS TO PUT
TOGETHER AN IND AND HELP GET
THROUGH THIS AREA OF TREMENDOUS
DIFFICULTY THAT PEOPLE HAVE A
HARD TIME-AND-A- TIME NAVIGATIN.
ADDITIONALLY, THERE'S SO MUCH
EXCITEMENT ABOUT CURE FOR HIV,
THERE'S ALSO A LARGE AMOUNT OF
EXCITEMENT FOR CURE IN HBV.
BECAUSE WE HAVE TO DEAL WITH HBV
AS A MAJOR COINFECTION AND IN
PEOPLE LIVING WITH HIV, WE THINK
IT'S IMPORTANT THAT WE START A
MULTIDISCIPLINARY RESEARCH
PROGRAM TO ACCELERATE THE
EVALUATION OF HBV CURE
ACTIVITIES IN PEOPLE LIVING WITH
HIV.
SO THIS IS AN AREA OF GROWTH FOR
US STARTING IN 2025.
IN THE AREA OF ADVANCING NOVEL
CURE CONCEPTS, WE HAVE THREE
THAT WE'RE PUSHING FORWARD.
ONE IS WHAT ARE THE BIOLOGICAL
PRODUCTS THAT COULD BE
DEVELOPED, WHETHER IT'S AN
ANTIBODY WITH A MODIFIED FC, IS
THERE A WAY OF USING CYTOKINES
TO TRIGGER APOPTOSIS THAT COULD
ELIMINATE THE HIV INFECTED
CELLS.
THAT'S A CONCEPT OF HOW YOU CAN
KILL.
WE TALK ABOUT AND HEAR A LOT
ABOUT KICK AND KILL.
WE'VE TENDED TO NEGLECT THE KILL
PART.
IT'S REALLY TIME TO SPEND SOME
TIME ON THAT.
WE ARE INTERESTED IN CONTINUING
TO GROW THE PIPELINE FOR CELL
AND GENE THERAPIES FOR HIV CURE,
AND A CONCEPT, IF YOU THINK
ABOUT IT, THAT WOULD BE REALLY
INTERESTING IS, COULD YOU TAKE
AN INDIVIDUAL THAT'S VERY WELL
CHARACTERIZED AND TAILOR A
CURATIVE STRATEGY BASED ON WHAT
YOU KNOW ABOUT THEIR VIRUS,
THEIR GENETIC MAKEUP, THEIR
IMMUNE RESPONSE, SO THERE'S THE
ABILITY HERE TO REALLY EXPLORE
THIS NOTION OF TAILORING A CURE.
I'M NOT SAYING THIS WILL EVER BE
AN EFFECTIVE STRATEGY THAT WOULD
GO FOR PUBLIC HEALTH, BUT THE
IDEA OF SEEING HOW YOU COULD
EXPLORE, SAY, ANTIGEN-BASED
ACTIVATION OF CD4 CELLS FOR THE
PURPOSE OF ELIMINATING A
RESERVOIR IS AN EXAMPLE OF THE
KINDS OF THINGS THAT COULD BE
DONE.
SO WITH THAT I'LL CLOAL CLOSE
AND LEAVE YOU WITH IF YOU WANT
TO SEE -- WE RECORD EVERY ONE OF
OUR ADVISORY COMMITTEE MEETINGS,
THEY'RE AVAILABLE ON THE WEBCAST
ARCHIVE.
I'M ALSO HAPPY TO ANSWER ANY
QUESTIONS.
THANK YOU.
>> THANK YOU, DR. DIEFFENBACH.
AND NOW WE'LL HEAR FROM MS. BYRD
AND DR. ROUSH.
>> CAN YOU HEAR ME?
HELLO?
GOOD AFTERNOON.
MY NAME IS CORETTA BYRD, AND I
AM A MEMBER OF THE O.A.R.
SCIENCE TEAM, AND I WILL BE
PRESENTING THE NEW AND REISSUED
CLEARED CONCEPTS BY INSTITUTES,
CENTERS AND OFFICES WITHIN NIH.
TO START OFF, THIS IS A SUMMARY
OF THE NEW AND REISSUED
CONCEPTS.
AS YOU CAN SEE HERE, THERE ARE
14 NEW AND 12 REISSUED CONCEPTS.
WHICH IS, OF COURSE, 26 IN
TOTAL.
SO TO START OFF, THE NATIONAL
CANCER INSTITUTE HAS ONE NEW
CONCEPT, TRANSLATIONAL RESEARCH
TOWARD DEVELOPMENT OF A KAPOSI
SARCOMA HERPES VIRUS VACCINE.
THE NATIONAL INSTITUTE OF
DIABETES AND DIGESTIVE AND
KIDNEY DISEASES HAS THREE NEW
CONCEPTS LISTED HERE.
THE FIRST IMPACT OF
COMORBIDITIES AND COINFECTIONS
ON HIV RESERVOIRS, SEEKS TO
BRING TOGETHER MULTIDISCIPLINARY
TEAMS TO ADDRESS HOW
COMORBIDITIES AND COINFECTIONS
PREVALENT IN PEOPLE WITH HIV
INTERACT WITH VIRAL RESERVOIRS
IN WAYS THAT CONFOUND CURE
STRATEGIES.
THE SECOND, EX VIVO STUDIES OF
HIV INFECTION AND PATHOGENESIS
WITHIN THE MISS -- PATHOGENESISD
THIRD, SYNDEMICS IMPACTING THE
HEALTH OF PEOPLE WITH HIV AND
NIDDK COMORBIDITIES ADDRESSES
THE IMPACT OF SYNDEMIC RACISM,
HOMOPHOBIA, TRANSPHOBIA,
DISCRIMINATION, AND STIGMA, AND
THEIR INTERRELATIONSHIPS WITH
SOCIAL RISK ON DEVELOPMENT.
EXACERBATION AND EFFECTIVE
MANAGEMENT OF HIV COMORBIDITIES
AND COINFECTIONS.
SO DR. DIEFFENBACH JUST
DISCUSSED THE SEVEN NEW CONCEPTS
LISTED HERE, SO I WILL NOT GO
INTO ANY DETAIL.
WITH THAT, I WILL TURN IT OVER
TO DR. DIANNE RAUSCH TO TALK
ABOUT THE NIMH CONCEPTS.
>> THANK YOU, AND I'M PLEASED TO
BE ABLE TO PRESENT THREE
CONCEPTS BASED ON SOME OF OUR
INITIATIVE PLANNING PROCESS THAT
I'M REPRESENTING DR. MARGUERITA
LIGHTFOOT, WHO IS OUR NIMH
REPRESENTATIVE TO THE OARAC BUT
COULDN'T BE HERE TODAY.
JUST AS A REMINDER WHAT NIMH
DOES, OUR RESEARCH SPANS A BROAD
RANGE OF ISSUES FROM -- AROUND
MENTAL HEALTH, LOOKING AT
BEHAVIORAL AND SOCIAL SCIENCE
ISSUES THAT IMPACT HEALTH
OUTCOMES AND ALSO NEUROSCIENCE
THAT LOOKS AT THE EFFECT OF HIV
ON THE CNS AND THE PATHOGENESIS
THAT RESULTS.
SO OUR THREE CONCEPTS, THE FIRST
ONE IS STREAMING MENTAL HEALTH
INTERVENTIONS FOR YOUTH LIVING
IN HIV AND LOW INCOME COUNTRIES.
THE OVERALL GOAL OF THIS IS TO
ADAPT SCALABLE MENTAL HEALTH
INTERVENTIONS FOR YOUTH LIVING
WITH HIV IN LOW AND MIDDLE
INCOME COUNTRIES THAT WILL LEAD
TO IMPROVEMENTS IN BOTH MENTAL
HEALTH AND HIV OUTCOMES.
AND THE COMPONENTS OF THIS
INCLUDE DEVELOPING INTERVENTIONS
THAT ARE TAILORED TO THE UNIQUE
NEEDS OF ADOLESCENTS LIVING WITH
HIV, AND ENSURE THAT THESE ARE
STREAMLINED SO THAT THEY CAN BE
IMPLEMENTED IN RESEARCH LIMITED
SETTINGS BROADLY.
THE SECOND ONE IS IN OUR
NEUROSCIENCE AREA, AND THAT IS
MECHANISMS OF RECIPROCAL
INTERACTIONS BETWEEN HIV
ASSOCIATED NEUROINFLAMMATION AND
CNS PERSISTENCE, AND TO LACK AT
IMPLICATIONS FOR THIS IN HIV
NEUROPATHOGENESIS AND CURE.
THIS IS TO ENCOURAGE RESEARCH
USING NOVEL CNS CELL SYSTEMS,
ORGANOID NO DELLS AND
TECHNOLOGIES, TO EXAMINE --
BETWEEN HIV ASSOCIATED NEURAL
INFLAMMATION AND HIV
PERSISTENCE, DESPITE EFFECTIVE
ART WITH THE ULTIMATE GOAL OF
ERADICATING CNS RESERVOIRS AND
UNDERSTANDING MECHANISMS OF
ASSOCIATED COMORBIDITIES.
THE THIRD ONE IS TARGETING
ADVANCINGSADVANCINGS TESTING, PN
AND CARE THROUGH PHARMACISTS AND
PHARMACIES, AND THE GOAL OF THIS
IS TO SUPPORT RESEARCH TO
FURTHER CAPACITY AND SCALE
ROUTINE DELIVERY OF HIV TESTING
PREVENTION AND CARE TO
PHARMACIST AND PHARMACY
SETTINGS, AND ANOTHER GOAL IS TO
ADVANCE TRAINING, CURRICULA AND
PROGRAMS TO ENABLE PHARMACY
STUDENTS, PHARMACISTS AND
PHARMACIES TO EFFECTIVELY
DELIVER HIV SERVICES WITHESE AND
EQUITY.
THE RATIONALE BEHIND THIS IS
THAT PHARMACISTS' KNOWLEDGE AND
ACCESSIBILITY IN NEARLY EVERY
URBAN AND RURAL COMMUNITY CAN BE
LEVERAGED AS PART OF A
COMPREHENSIVE HIV PREVENTION AND
CARE STRATEGY TO EXPAND ACCESS
TO CARE AND IMPROVE POPULATION
HELP.
WEALTH.
WE ARE CO-SPONSORING A MEETING
NEXT WEEK WITH O.A.R. ON WORK IN
PHARMACIES, AND THAT MEETING
WILL BE NEXT WEDNESDAY AND
THURSDAY AND WE CAN SEND AROUND
THE LINK TO EVERYONE IF THEY'RE
INTERESTING IN ATTENDING.
SO THANK YOU, AND ANSWER TO
ANSWER ANY QUESTIONS.
>> THANK YOU.
SO IN TERMS OF REISSUED
CONCEPTS, I WILL NOW DISCUSS
FOGARTY INTERNATIONAL CENTER HAS
TWO CONCEPTS.
INTERVENTIONS FOR STIGMA
REDUCTION TO IMPROVE HIV/AIDS
PREVENTION, TREATMENT AND CARE
IN LOW, MIDDLE INCOME COUNTRIES.
SEEKS TO SUPPORT RESEARCH TO
DEVELOP AND PILOT-TEST
INTERVENTIONS TO REDUCE THE
IMPACT OF HIV ASSOCIATED STIGMA
ON THE REVENGS AND TR THE PREVET
OF HIV AND ON THE QUALITY OF
LIFE OF PEOPLE WITH HIV.
THE SECOND CONCEPT, HIV
ASSOCIATED NON-COMMUNICABLE
DISEASES RESEARCH AT LMIC
INSTITUTIONS, SEEKS TO SUPPORT
LOCALLY RELEVANT RESEARCH IN
CRITICAL AREAS OF HIV-ASSOCIATED
NON-COMMUNICABLE DISEASES AT
LMIC INSTITUTIONS TO ENHANCE
RESEARCH CAPACITY.
THE NATIONAL CANCER INSTITUTE
HAS TWO REISSUE CONCEPTS.
THE RESEARCH ON HIV-ASSOCIATED
MALIGNANCIES, NOSI, WILL
CONTINUE ADVANCING THE
UNDERSTANDING OF THE RISKS,
DEVELOPMENT, PROGRESSION,
DIAGNOSES, AND TREATMENT OF
MALIGNANCIES OBSERVED IN
INDIVIDUALS WITH AN UNDERLYING
HIV INFECTION.
THE SECOND IMPLEMENTATION
SCIENCE FOR CANCER CONTROL IN
PEOPLE LIVING WITH HIV AND
LMICs, WILL CONTINUE TO
SUPPORT IMPLEMENTATION SCIENCE
RESEARCH TO ACCELERATE THE
INTEGRATION OF EVIDENCE-BASED
CANCER CONTROL INTERVENTIONS FOR
PEOPLE WITH HIV BY LEVERAGING
EXISTING HIV TREATMENT AND
PREVENTION INFRASTRUCTURE.
THE NATIONAL INSTITUTE ON
ALCOHOL ABUSE AND ALCOHOLISM HAS
REISSUED HIV PREVENTION AND
ALCOHOL FOR BOTH THE R34 AND R0.
THESE NOFOs SEEK TO EXPAND THE
HIV PREVENTION TOOLKIT AMONG
ALCOHOL IMPACTED POPULATIONS
WITH A RANGE OF PATTERNS OF
EPISODIC AND LONG-TERM USE AND
ASSOCIATED BEHAVIORAL AND
BIOLOGICAL CONTRIBUTORS FOR
VULNERABILITY TO HIV ACQUISI
ACQUISITION.
AS DR. DIEFFENBACH HAS DISCUSSED
THE REISSUED CONCEPTS FOR NIAID,
I WILL GO TO THE NEXT SLIDE,
PLEASE.
AND LASTLY, THE OFFICE OF
RESEARCH INFRASTRUCTURE PROGRAMS
HAS REISSUED ONE CONCEPT, ANIMAL
MODELS AND ANIMAL AND BIOLOGICAL
MATERIALS CENTER AND RESOURCE
PROGRAMS, WHICH SUPPORTS SPECIAL
COLONIES OF LABORATORY ANIMALS,
ANIMAL-RELATED MODELS, AND OTHER
RESOURCES THAT SERVE THE
BIOMEDICAL COMMUNITY IN A
VARIETY OF RESEARCH AREAS ON A
NATIONAL BASIS.
WITH THAT, I WANT TO THANK YOU
AND I WILL TURN IT BACK OVER TO
DR. TU TURNBULL.
>> THANK YOU, COLLEAGUES, FOR
YOUR UPDATES.
WE ARE NOW OPEN FOR DISCUSSION.
DR. GLENSHAW, ARE THERE ANY
COMMENTS OR QUESTIONS IN THE
ROOM?
>> YES, DR. TURNBULL.
DR. MONTANER.
>> YES, THANK YOU.
I JUST WANT TO COMMEND THE NIH
DATES PROGRAM FOR THE LEADERSHIP
ON THE CURE AGENDA, WHICH I'M
VERY PARTIAL TOO, BU TO, BUT I S
WHAT I WANTED TO PERHAPS RAISE
FOR CONSIDERATION AND MAYBE --
OR I'M NOT SURE WHETHER THAT
WOULD BE ANOTHER POTENTIAL IS
THAT THERE'S BEEN A LOT OF -- I
THINK A LOT OF DISCUSSION ABOUT
THE NEED TO EXTEND CURE RESEARCH
INTO AN INTERNATIONAL KIND OF
SETTING.
ONE OF THE BLESSINGS AND CURSE
OF OUR ADVANCEMENT IN THE LAST
FIVE YEARS IS THAT WE HAVE BEEN
ABLE NOW TO CHARACTERIZE VERY
ACUTELY THE HIV RESERVOIR
THROUGH MULTIPLE ASSAYS THAT
GIVE US A LOT OF RESOLUTION, AND
THE ENTIRE FIELD HAS EMBRACED
THIS NEW TECHNOLOGY WITH RESPECT
TO THE DIFFERENT WAYS THAT WE
CAN MEASURE THE PERSISTENCE OF
HIV ON SOMEONE THAT IS ON
ANTIRETROVIRAL THERAPY.
HOWEVER, THE LIMITATION COMES IN
THAT A LOT OF THESE ASSAYS THAT
ARE THE MOST PROMINENT ARE BASED
ON -- DETERMINATIONS.
SO TO ACTUALLY PROPOSE WHAT
WOULD BE A CREDIBLE PATH TO
EXTEND IN AN INTERNATIONAL
SETTING, YOU WOULD HAVE TO HAVE
THE SAME ASSAY ON OTHER PLATES,
AND THAT IS NOT READILY
ACCESSIBLE.
THE METHODS HAVE NOT BEEN YET
DEVELOPED AND THE COMMERCIAL
ENTITIES THAT ARE OTHERWISE
ENGAGED WITH THIS ARE VERY MUCH
INTERESTED TO DEVELOP THESE
ASSAYS BECAUSE WE'VE BEEN IN
TOUCH WITH THEM, PARTICULARLY
ACELOVIR, SO THEY'RE RECOGNIZED
AND THEY'RE WORKING WITH IT, BUT
WHEN YOU TRY TO MATCH
INDIVIDUALS WITH THE MAJORITY OF
THE SAMPLES WITH COMMERCIAL
ENTITIES, THERE'S SOME NATURAL
NEGOTIATION THAT NEEDS TO OCCUR
ABOUT ACCESS OF METHODS
AFTERWARDS AND THAT'S WHERE IT
KIND OF STOPS.
SO I WOULD MAYBE ENCOURAGE
MORE -- I'M NOT SURE WHETHER AN
RFA OR ANY OTHER INSTRUMENT THAT
TRIES TO INCENTIVIZE THE
DEVELOPMENT OF THESE ASSAYS FOR
MULTIPLE CLADES, BECAUSE THAT IS
A LIMITING FACTOR FOR ANY STUDY
PLAN TRIAL IN ORDER TO PROPOSE
IT IN AREAS WHERE CLADE B IS NOT
THE PREVALENT CLADE.
SO I'M SURE THIS IS NOT ANYTHING
NEW.
WE'VE ALL KNOWN THIS, BUT I
DON'T KNOW WHAT PROGRAMS ARE
UNDERWAY TO MAKE THESE
DEVELOPMENTAL INVESTMENTS
BECAUSE I UNDERSTAND THERE'S A
LOT OF SEQUENCING THAT NEEDS TO
BE AVAILABLE, A LOT OF ITERATIVE
PROCESS OF DETERMINING THE BEST
PRIMERS, ET CETERA, WHICH IS NOT
SOMETHING ANY ONE LAB CAN DO ON
THE SIDE.
SO IT WOULD BE GOOD TO CONSIDER
WHAT COULD WE DO IN THAT DOMAIN.
>> DR. AKE?
>> MHRP DOES A LOT OF TRIALS IN
LOW MIDDLE INCOME SETTINGS WITH
NON-CLADE B AND WE RAN INTO
THOSE SAME ISSUES.
AND I THINK -- I'M SURE OUR
COLLEAGUES CAN DESCRIBE SOME OF
THE EFFORTS THAT ARE BEING MADE
TO FURTHER SUPPORT EXCELIVIER
AND SOME OTHER -- YOU KNOW,
EFFORTS IN, YOU KNOW, IN OTHER
LABS TO SUPPORT.
I AGREE IT'S A GAP.
THE ONE OTHER THING I WOULD ADD
TO IT, THOUGH, IS THAT I THINK
THOSE ASSAYS ARE IN DEVELOPMENT
AND THE TRIALS TAKE SO LONG TO
DESIGN AND GET STARTED THAT
RESTRICTIONS ON THE TRIALS,
BECAUSE THERE'S NO ASSAY FOR THE
RESERVOIR THAT'S ALREADY BEEN
VALIDATED, IS PROBABLY NOT THE
WAY TO GO.
I THINK YOU CAN START WITH THE
TRIAL, BY THE TIME YOU ACTUALLY
HAVE THE SPECIMENS, THE ASSAYS
CAN BE THERE.
I DON'T THINK YOU CAN WAIT UNTIL
YOU HAVE A VALIDATED ASSAY
BEFORE WE START DOING THE TRIALS
IN THOSE SETTINGS.
BUT I THINK MORE IMPETUS WHEN
YOU'VE GOT THE STUDIES ALREADY
GOING IN MY VIEW.
THE ONE COMMENT I WANTED TO MAKE
ABOUT THE PRESENTATIONS THAT I'M
ABSOLUTELY IN AGREEMENT THAT'S
JUST A FINAL POINT, WAS JUST TO
NOTE A COMMENDATION FOR THE
IMMUNITY IN EARLY LIFE CONCEPT.
SO THE DOD OBVIOUSLY, YOU KNOW,
IN THE ABSENCE OF CHILD
SOLDIERS, WE DO NOT MAKE
VACCINES FOR CHILDREN, BUT THE
CONCEPT, RIGHT?
I MEAN, WE ALL KNOW VERY WELL,
YOU KNOW, THE IMPROVEMENT IN
IMMUNITY, I MEAN, NOT EVEN JUST
IN YOUNG VERSUS OLDER
INDIVIDUALS, BUT WHEN THERE'S A
LONG GAP TWEE BETWEEN PRIMES AND
BOOSTS, SO ONE CAN, IN A PUBLIC
HEALTH CONCEPT, EASILY IMAGINE
IN VERY HIGH RISK SETTINGS, YOU
KNOW, WHERE YOU MIGHT HAVE
CHILDHOOD VACCINATIONS AND
SUBSEQUENT BOOSTS, PRE-SEXUAL
DEBUT, THAT COULD FIT IN WELL
WITH ESTABLISHED, YOU KNOW,
PUBLIC HEALTH VACCINATION
STRATEGIES IN SOME OF THE AREAS
OF THE WORLD WHERE HIV HAS SORT
OF HIT THE HARDEST.
SO SCIENTIFICALLY, I THINK IT'S
VERY COMELL COMPELLING AND EVENO
BECAUSE OF ITS POTENTIAL PUBLIC
HEALTH TRANSLATABILITY, AND JUST
WANTED TO COMMEND DATES ON THE
ISSUANCE OF THAT NEW CONCEPT.
>> IF YOU DON'T MIND, MARY, I'LL
MAKE A COUPLE OF COMMENTS.
JULIE, I THINK YOU'RE ABSOLUTELY
RIGHT ON THE ASSAYS THAT WE ARE
IN THIS PROCESS OF VALIDATION
AND RE-VALIDATION, AND THE
HURDLE TO GET OVER A CLIA
CERTIFIED ASSAY SO YOU COULD USE
IT IN A CLINICAL TRIAL, THE
RETURN OF DATA IS A MAJOR HURDLE
THAT HAS TO BE CONQUERED.
THAT'S WHERE WE'RE AT.
THROWING MONEY AT THE PROBLEM BY
GIVING LABS SOME ADDITIONAL TIME
TO GO MAKE ADDITIONAL PRIMERS, I
DON'T THINK IS GOING TO HELP.
WE'VE PUT OUT -- THERE WAS SOME
SBIR ACTIVITIES ON SOME OF THIS,
BUT IT'S ALL IN PROCESS.
YOU HAVE ABSOLUTELY DESCRIBED
EXACTLY THE THOUGHT BEHIND THE
EARLY IMMUNITY THAT'S EXACTLY
WHAT WE'RE THINKING ABOUT, IS
THIS IDEA THAT VACCINATIONS IN
YOUTH OR PREADOLESCENT, THAT
THEY NEED TO BE ADOLESCENT OR
OLDER, THIS IDEA OF REST AND
BOOST WILL BE REALLY, REALLY
IMPORTANT.
SO MAYBE YOU SHOULD TALK TO PHIL
ABOUT SEEING IF WE COULD WORK
TOGETHER ON THIS ONE TOO.
>> YES, DR. SLEASMAN.
THANKS.
>> I JUST WANTED TO ASK A QUICK
QUESTION, SORT OF ACROSS THE
INITIATIVES, AND HOW ARE WE
LOOKING AT NOVEL ANALYTICS?
THE DATA ANALYSIS PARTICULARLY
OF BIG DATA, ARTIFICIAL
INTELLIGENCE AND THE USE OF
THESE TYPES OF TOOLS PROBABLY IS
SOMETHING THAT IS -- SHOULD BE
WOVEN INTO ALL OF THESE
APPLICATIONS.
FOR ME, THE RATE LIMITING STEP
FOR MANY OF THESE THINGS WE DO
HAS BECOME THE ANALYTICAL STEP,
BECAUSE IT BECOMES SO
COMPLICATED AND SO SPECIALIZED
AND THE WORKFLOW HAS REALLY
SLOWED DOWN AT THAT LEVEL, AND
IS THERE A WAY TO SPEED THAT UP
ACROSS THE BOARD.
>> ALL GOOD COMMENTS.
THANK YOU.
DR. TURNBULL, I THINK THAT'S IT
FOR THE ROOM.
>> OKAY, THANK YOU,
DR. GLENSHAW.
ANY OTHER MEMBERS ON ZOOM WOULD
LIKE TO MAKE A COMMENT OR HAVE A
QUESTION?
PLEASE RAISE YOUR HAND.
DR. NAGHAVI?
>> OH, I THINK IT'S GREAT THAT
THE ASSAYS THAT WE ARE -- I
MEAN, BEING DEVELOPED TO
ELIMINATE THE RESERVOIRS, BUT
I'M JUST WONDERING HOW MUCH
EFFORT ARE THEY PUTTING IN IN
IDENTIFYING THE RESERVOIRS?
BECAUSE WE STILL DON'T
UNDERSTAND WHAT ALL THESE
RESERVOIRS ARE.
LIKE FOR EXAMPLE, IN THE CNS,
RIGHT?
SO WITHOUT UNDERSTANDING THE
RESERVOIRS, FOCUSING JUST ON
ELIMINATING THEM, IT KIND OF A
BIG -- I MEAN, LACKING KNOWLEDGE
FOR ME, GAP FOR ME, SO I WAS
JUST WONDERING IF ANYONE HAS ANY
COMMENTS ON THAT.
DO WE HAVE A SPECIFIC -- FOR
IDENTIFYING RESERVOIRS?
>> YES, WE'VE HAD MAJOR PROGRAMS
ON RESERVOIR IDENTIFICATION
TRACKING, USE OF NON-HUMAN
PRIMATES, SPECIFICALLY WITH THE
BARCODED VIRUSES TO REALLY
UNDERSTAND WHERE THE RESERVOIR
IS, AND WHERE IT'S GOING.
ADDITIONALLY, THERE'S A VERY
SPECIFIC INSTITUTE THAT WE
COLLABORATE WITH THAT IS
DEDICATED TO -- AND MY COLLEAGUE
HERE FROM NIMH AND -- ARE JOINED
AT THE HIP ADDRESSING THESE
ISSUES OF NEUROAIDS AND THE --
SO VERY ACTIVE PROGRAMS.
>> GREAT.
>> ANY OTHER COMMENTS FROM THE
MEMBERS ON ZOOM?
DR. GLENSHAW, ANY ADDITIONAL
COMMENTS IN THE ROOM?
>> I DON'T THINK SO, MA'AM.
>> OKAY.
OUR FINAL UPDATE FOR TODAY WILL
COME FROM THE HIV CLINICAL
GUIDELINES WORKING GROUPS OF
OARAC.
THESE INCLUDE BOTH GUIDELINES
AND PANEL UPDATES.
WE HAVE FOUR PRESENTERS TODAY.
DRS. HENRY MASUR, ALICE PAU,
ROHAN HAZRA, AND BILL
KAPOGIANNIS.
DR. MASUR IS THE CHIEF OF THE
CLINICAL CARE MEDICINE
DEPARTMENT AT THE CLINICAL
CENTER AT NIH.
HE'S THE FOUNDING EDITOR OF THE
NIH CDC IDSA GUIDELINES FOR
MANAGEMENT OF OPPORTUNISTIC
INFECTIONS IN ADOLESCENTS, AND
ADULTS WITH HIV.
HE'S THE CO-AUTHOR OF THE
TEXTBOOK "AIDS THERAPY" AND IS
THE PAST PRESIDENT OF IDSA.
DR. PAU IS THE PRINCIPAL
INVESTIGATOR FOR RESEARCH
INTERESTS IN HIV TREATMENT
FAILURE AND DRUG RESISTANCE.
SHE HAS BEEN A CRITICAL MEMBER
OF THE U.S. DEPARTMENT OF HEALTH
AND HUMAN SERVICES ADULT AND
ADOLESCENT ANTIRETROVIRAL
GUIDELINES PANEL SINCE 1998 AND
BECAME THE EXECUTIVE SECRETARY
OF THE PANEL IN 2004.
SHE IS A COED TORE OF T OF THE
DEPARTMENDEPARTMENT OF HEALTH AN
SERVICES PANEL ON TREATMENT AND
PREVENTION OF OPPORTUNISTIC
INFECTION.
DR. HAZRA WAS APPOINTED AS THE
DREDIRECTOR OF NICHD, DIVISION F
EXTRAMURAL RESEARCH IN MARCH OF
2022.
HE PROVIDES SCIENTIFIC
LEADERSHIP FOR DOMESTIC AND
INTERNATIONAL RESEARCH, RESEARCH
TRAINING, AND CAREER DEVELOPMENT
PROGRAMS RELATED TO THE
EPIDEMIOLOGY, DIAGNOSIS,
TRANSMISSION, TREATMENT AND
PREVENTION OF HIV AND ITS
COMPLICATIONS, AS WELL AS OTHER
SELECTED PATHOGENS IN INFANTS,
CHILDREN, ADOLESCENTS AND
PREGNANT PEOPLE.
AND DR. KAPOGIANNIS WAS
INTRODUCED EARLIER IN THE
AGENDA.
DR. MASUR, WE WILL START WITH
YOU.
>> THANKS VERY MUCH,
DR. TURNBULL, AND I'M SURE
YOU'LL BE SHOWING MY POWERPO
POWERPOINTS.
SO THE FIRST GUIDELINE WE'RE
GOING TO TALK ABOUT AS
DR. TURNBULL MENTIONED IS THE
GUIDELINE FOR THE PREVENTION AND
TREATMENT OF OPPORTUNISTIC
INFECTIONS.
I THINK ALL THE GUIDELINES HERE
ARE PARTICULARLY PLEASED TO BE
ABLE TO PRESENT THESE UPDATES
BECAUSE OF THE MANY THINGS THAT
O.A.R. SUPPORTS, THIS IS ONE OF
THEIR MANY CONTRIBUTIONS OF HIGH
IMPACT, BOTH IN THE UNITED
STATES AND GLOBALLY.
WE'RE ALSO PLEASED THAT WE THINK
THAT THESE ARE CONSIDERED AS
DEFINITIVE BECAUSE I THINK
THEY'RE WELL RESEARCHED AND
THEY'RE WELL DOCUMENTED IN TERMS
OF THE STRENGTH OF THE EVIDENCE.
THIS NEXT SLIDE IS THE SAME
SLIDE THAT YOU'VE SEEN BEFORE.
WE JUST WANT TO EMPHASIZE THAT
ALL THE GUIDELINES ARE WIDELY
USED WHICH I SUGGESTS THAT THEYE
STILL NEEDED EVEN 30 YEARS AFTER
THE EPIDEMIC AND SPECIFICALLY
FOR THE ADULT OPPORTUNISTIC --
YOU CAN SEE WE HAVE ALMOST 500
PAGE VIEWS FROM BOTH THE UNITED
STATES AND GLOBALLY SO WE THINK
THESE STILL HAVE A MAJOR PLACE
AS A SOURCE OF INFORMATION FOR
CLINICIANS.
WE HAVE 30 GROUPS THAT MEET ON
SPECIFIC CONTENT AREAS.
THEY MEET THROUGHOUT THE YEAR,
REVIEW THE LITERATURE, AND WE
HAVE ROLLING UPDATES SO THAT
WHEN SOMETHING IS RELEVANT AND
NEEDS TO BE UPDATED FOR A
SPECIFIC CHAPTER, WE WILL UPDATE
ONE OR MORE CHAPTERS AS NEEDED.
SINCE YOU LAST MET, THE MAJOR
UPDATE HAS BEEN TO CHAGAS
DISEASE, IF CLINICIANS IN THE
U.S. SEE A CASE OF CHAGAS RYES -
THEY GET SOME IDEA AS TO WHAT
THE CURRENT MANAGEMENT IS.
SO THE PARTICULAR UPDATE FOCUS
ON THE EPIDEMIOLOGY AND SOME
CHANGES IN THE FDA LABELING AND
AVAILABILITY OF NITROFIRIMOX.
WE HAVE MANY OTHER SECTIONS
WHICH ARE EITHER JUST PUBLISHED
OR ABOUT TO BECOME.
WE'VE REVISED THE WAY OUR TABLES
ARE PRESENTED AND YOU CAN SEE
WHAT'S RECENTLY PUBLISHED IN
THOSE SECTIONS ON THE LEFT.
IN THE VERY NEAR FUTURE, YOU'RE
GOING TO SEE UPDATES ON MPOX, ON
SYPHILIS, ON HPV, ON
IMMUNIZATION, WHICH IS REALLY A
COMPILATION OF RECOMMENDATIONS
FROM INDIVIDUAL CHAPTERS, AND
THERE WILL BE NEW INFORMATION ON
MPOX.
ONE THING WE'VE WRECK HE NIEZED
OVER THE PAST YEAR IS PROGRESS
HAS BEEN SLOWER THAN WHAT WE
WANT.
WE WANT OUR DEADLINE TO BE
CURRENT -- WE'VE TRIED TO STREAM
LIKE THIS.
ONE OF THE PROBLEMS IS THAT
SINCE WE'RE CO-SPONSORED BY CDC,
BY HIBMAN IDSA, THERE ARE THREE
DIFFERENT GROUPS THAT NEED TO
LOOK AT THESE RECOMMENDATIONS.
SO THAT WE'VE TAKEN A CLOSE LOOK
AT WHAT OUR PROCESS IS, WE'VE
TRIED TO STREAMLINE THIS AND
EVEN WITH THIS, FROM THE TIME
THAT A NEW CHAPTER IS SUBMITTED,
BY THE TIME IT'S REVIEWED BY
THESE PROFESSIONAL GROUPS AS
WELL AS SOME OF OUR CONTENT AR
AREAS IN PHARMACOLOGY AND
PREGNANCY, 16 WEEKS IS ABOUT THE
FASTEST WE CAN GO.
WE'RE ALWAYS LOOKING FOR WAYS TO
MAKE THIS FASTER BECAUSE, AGAIN,
WE REALIZE THAT CURRENCY IS ONE
OF THE IMPORTANT FEATURES OF
THESE GUIDELINES.
15 AGAIN, THIS IS JUST FOR YOUR
INFORMATION NOW THAT WE ARE
FOCUSED ON HOW TO MAKE THESE
MORE CURRENT.
SO WITH THAT, I'LL TURN IT OVER
TO ALICE PAW, BUT AG PAU, BUT AE
VERY APPRECIATIVE OF THE SUPPORT
WHICH GIVES US -- TO MAKE THIS
POSSIBLE AND ADVICE TO MAKE
THESE POSSIBLE AND ADVICE THEY
GIVE --
>> WE'VE HAD A SLIGHT AGENDA
CHANGE.
>> OKAY.
>> SO AFTER YOUR PRESENTATION,
WE'RE GOING TO GO TO DR. HAZRA
NOW.
>> ALL RIGHT, GOOD.
>> SO DR. HAZRA, OVER TO YOU.
>> ALL RIGHT.
THANK YOU VERY MUCH.
I'M JUST GOING TO GIVE AN
OVERVIEW OF THE PEDIATRIC
GUIDELINES.
WE DO USUALLY AN ANNUAL UPDATE
SO THIS WAS OUR REPORT ON THAT.
WE USUALLY TRY TO AIM TO UPDATE
SOMETIME IN THE SPRING, TWO
MONTHS OR SO AFTER KROI, WE WANT
TO LOOK TO CROIX AS ANY
LATEBREAKING DATA THAT WE CAN
INCLUDE AND THEN DO OUR
PUBLICATIONS WE PUBLISHED JUST A
COUPLE MONTHS AGO, APRIL 11TH OF
2023.
JUST TO REMIND YOU FROM THE LAST
OARAC MEETING, WE ALSO HAVE
SEVERAL SECTIONS THAT WE DEVELOP
AND REVIEW AND PUBLISH JOINTLY
WITH THE PERINATAL GUIDELINES.
THAT SPECIFICALLY WAS AROUND THE
INFANT FEEDINGS, REMEMBER WE HAD
THE SESSION ON THAT LAST SPRING.
SO THOSE FOUR SECTIONS WERE
PUBLISHED AS PART OF THE FULL
PERINATAL GUIDELINES UPDATE ON
JANUARY 31ST, BUT WE ALSO THEN
UPDATED THOSE FOUR SECTIONS IN
OUR GUIDELINES AS WELL.
SOME OF THE OTHER UPDATES WE
MADE, NSK IN FACT, I THINK IN
COLLABORATION WITH THE PEDIATRIC
GUIDELINES WAS REALLY TO CLARIFY
THAT RAPID INITIATION OF ART
SHOULD BE RECONSIDERED IF A
CHILD HAS A PARTICULAR -- IN
THIS CASE -- IN THE CLINICAL AND
LABORATORY MONITORING OF THE
PEDIATRIC HIV SECTION, WE
ACTUALLY HAD A TABLE FOR MANY
YEARS ON CD4 CELL COUNTS AND
PERCENTAGES IN HEALTHY CHILDREN
AND DISTRIBUTION BY AGE.
THAT HAD BEEN TAKEN OUT SEVERAL
CYCLES AGO, AND I THINK FOUND --
WE GOT FEEDBACK THAT PEOPLE WERE
MISSING THAT, SO WE'VE ADDED
THAT TABLE BACK IN.
THEN WE'VE ALSO ADDED GUIDANCE
ABOUT VIRAL LOAD MONITORING FOR
ADOLESCENTS INITIATING
LONG-ACTING -- OF COURSE WE
DEVELOPED GUIDELINES FOR
CHILDREN AND ADOLESCENTS PRIOR
TO PUBERTY, AND THEN THE
ADOLESCENT ADULT GUIDELINES DEAL
WITH PUBERTY.
AND SO THERE'S SOMETIMES
INFORMATION THAT WE SHARE ACROSS
WITH THE ADULT GUIDELINES AS
WELL, AND ONE OF THE THINGS I
THINK THAT WE NOTE IS THAT WHILE
THE CABOTEGRAVIR AND -- STUDIES
WERE DONE IN THIS IDEAL
POPULATION THAT ALREADY WAS
SUPPRESSED, THAT FRANKLY THE ONE
USE FOR INJECTABLES MAY WELL BE
IN ADOLESCENTS THAT ACTUALLY
NEED A NEW REGIMEN, SOMETHING
LIKE AN INJECTABLE TO ACTUALLY
ACHIEVE GOOD ADHERENCE.
SO WE TALKED ABOUT THAT, AND
AGAIN, THIS IS ONE OF THOSE
AREAS WHERE THERE'S NOT
NECESSARILY DATA THAT'S
INFORMING IT, BUT IT'S REALLY
THE EXPERT OPINION OF MANY OF
THE MEMBERS ALLOWED US TO PUT
THAT IN.
THEN, OF COURSE, UNFORTUNATELY,
YOU KNOW, CHILDREN AND YOUTH
WITH HIV ARE NOT IMMUNE TO WHAT
WE'RE SEEING THROUGHOUT THE
COUNTRY, WHICH IS A SUBSTANTIAL
INCREASE IN MENTAL HEALTH
CHALLENGES THAT ACTUALLY
PREDATED THE PANDEMIC AND NOW
JUST CONTINUE, SO WE'VE ADDED
ISSUES AROUND AGE-APPROPRIATE
SCREENING FOR SUICIDALITY IN THE
CARE OF CHILDREN AND ADOLESCENTS
WITH HIV.
AS PART OF INCLUDING
CABOTEGRAVIR HERE, WE UPDATED
THE CENTRAL NERVOUS SYSTEM
TOXICITY SECTION, AND OF COURSE
WITH ALL THE DIFFERENT CHANGES
IN APPROVALS AND GATHERING OF
EVIDENCE, THERE ARE ALWAYS
CHANGES THAT NEED TO BE MADE IN
THE MANAGEMENT OF CHILDREN
RECEIVING ART SECTION TO
INCORPORATE THE MOST RECENT
SWITCH OPTIONS IN LINE WITH
AVAILABLE DATA AND APPROVALS.
THEN FINALLY, WE HAVE, OF
COURSE, AN EXTENSIVE DRUG
SECTION WHERE WE REALLY GO INTO
A LOT OF DETAIL AROUND DOSING OF
THESE AGENTS IN PEDIATRICS,
ESPECIALLY WHEN THERE'S ACTUALLY
NOT GOOD DATA.
THAT WE'RE SOMETIMES OFTENTIMES
LIMITED TO JUST SOMEWHAT LIMITED
PHARMACOKINETIC DATA WITHOUT
LARGE TRIALS, SO WE'VE UPDATED
THROUGHOUT THERE, AND THEN
IMPORTANTLY, ABOUT HOW DO YOU
ADMINISTER CERTAIN OF THESE
AGENTS, AND SO HERE WITH
BIKTARVY, WE'RE ABLE TO PROVIDE
INFORMATION ABOUT SPLITTING OR
DISSOLVING THE TABLET BUT THAT
CLEARLY SAYING BASED ON THE DATA
IN ADULTS THAT CRUSHING TABLETS
IS NOT RECOMMENDED.
THE RALTEGRAVIR SECTION NOW --
WE'VE UPDATED THAT AS WELL.
WE HAD THREE NEW PANEL MEMBERS
THAT WE WELCOMED IN THIS CYCLE,
SO MARY TANNER IS OUR NEW
REPRESENTATIVE FROM CDC WHO
REPLACED A LEGEND IN PEDIATRIC
HIV, STEVE NESHEIM, WHO RETIRED
JUST OVER A YEAR AGO, SO MARY IS
OUR NEW CDC REPRESENTATIVE.
WE ALSO HAD IN THE PRIOR CYCLE A
VIROLOGIST WHO ALSO HAD BEEN ON
THE PANEL FOR QUITE SOME TIME,
PAUL POLEMBO, RETIRE, SO REALLY
SPECIFICALLY LOOKED FOR AND
SOLICITED FOR SOMEONE WITH
EXPERTISE IN VIROLOGY,
IMMUNOLOGY AND DIAGNOSTICS.
SO REALLY, REALLY PLEASED THAT
NICOLE TOBIN CAN BE THERE.
I THINK SHE'S AT UCLA, SO
UNIVERSITY OF CALIFORNIA
LOS ANGELES THERE.
AND THEN FINALLY, SOMEONE FROM
OUR INSTITUTE, WHO'S A NEW
MEDICAL OFFICER IN THE OLD
BRANCH OF BILL AND MINE,
FRANKLIN YATES IS ALSO ON THE
PANEL AS WELL.
AND THEN THIS SLIDE IS REALLY
SOMETHING.
I THINK FOR THOSE OF YOU WHO
HAVE BEEN IN THE FIELD OF
PEDIATRIC HIV, YOU'RE LOOKING AT
PROBABLY OVER A HUNDRED YEARS OF
SERVICE COLLECTIVELY OF FOLKS
THAT HAVE STEPPED DOWN, AND
REALLY JUST SOME REALLY GIANTS
IN OUR FIELD.
SO PAT FLYNN HAD BEEN ON THE
PANEL FOR ALMOST 20 YEARS, AND
SHE HAS NOW STEPPED DOWN, THOUGH
SHE FORTUNATELY IS STAYING ON
THE PERINATAL PANEL.
LINDA LEWIS, CURRENTLY AT CHAI,
SHE WAS INVOLVED IN SOME OF THE
EARLY STUDIES THAT WERE DONE IN
THE NCI INTRAMURAL PROGRAM,
RITONAVIR -- SHE HAS BEEN ON THE
PANEL AGAIN FOR A GENERATION AS
WELL.
SO SHE HAS STEPPED DOWN.
MARK MIROCHNICK HAS BEEN ON AND
HAS PROVIDED TREMENDOUS SERVICE
WITH RESPECT TO PHARMACOLOGY IN
PREMATURE INFANTS, NEONATES AND
INFANTS AS WELL, SO REALLY A
VERY DIFFICULT ROLE TO REPLACE.
DIFFICULT EXPERTISE TO REPLACE,
BUT ALSO REALLY CRITICAL
EXPERTISE BECAUSE WHEN WE TALK
ABOUT LIMITED DATA FOR
PHARMACOKINETICS IN CHILDREN,
IT'S EVEN MORE LIMITED IN
NEONATES AND ESPECIALLY IN
PREMANPREMATURE INFANTS AS WELL.
LUCKILY HIS WIFE IS STAYING ON
THE PANEL SO WE KNOW HOW TO
REACH HIM ABOUT PARTICULAR
QUESTIONS, BUT A REAL LOSS FOR
THE PANEL.
PATRICK JEAN-PHILLIPE HAS BEEN
ON THE PANEL FOR I THINK 15
YEARS, HE IS STEPPING DOWN.
THEN THE QUEEN HERSELF, LYNNE
MOFENSON, SHE BASICALLY FOUNDED
THESE GUIDELINES.
SHE WAS ACTUALLY INVOLVED IN
GUIDELINES PRIOR TO THAT AS
WELL.
AS 0706 SHOWED THAT AZT WAS ABLE
TO REDUCE TRANSMISSION BY ABOUT
70%, RIGHT AWAY THERE WAS NEED
FOR A GUIDELINE ABOUT HOW DO YOU
ROLL THAT OUT, AND LYNNE WAS
INVOLVED IN THAT AS WELL.
FOR THOSE OF US WHO KNOW HER,
IT'S QUITE SOMETHING FOR HER TO
SAY I THINK I'M READY TO STEP
AWAY, SO SHE'S STEPPED AWAY FROM
THE GUIDELINE BUT SHE ALSO WILL
BE STAYING ON THE PERINATAL
GUIDELINE.
BUT AGAIN I'M IN AWE OF THIS
SLIDE BECAUSE THIS IS REALLY --
AS I SAID, IF YOU WANT TO ADD IT
UP, OVER 100 YEARS OF SERVICE TO
THE GUIDELINES, AND WE CAN JUST
SEE THE IMPACT THAT THAT ALL HAS
HAD, RIGHT, WITH RESPECT TO THE
FACT THAT WE'RE NOW BASICALLY
CAN SAY WE'VE ELIMINATED
PEDIATRIC HIV IN THIS COUNTRY,
AND THAT WE WERE TALKING ABOUT
INFANTS AND CHILDREN BORN WITH
HIV BEING ABLE TO LIVE
POTENTIALLY A NORMAL LIFESPAN,
AND IT REALLY IS A TRIBUTE TO
PEOPLE LIKE THEM AND THEN THOSE
THAT THEY'VE INSPIRED AS WELL.
I THINK WITH THAT, THAT'S MY
LAST SLIDE AND I'LL TURN TO
BILL.
>> THANK YOU, DR. HAZRA.
NEXT WE'LL TURN TO
DR. KAPOGIANNIS.
>> THANK YOU, IVY.
AND THANK YOU, ROHAN.
WHAT A TERRIFIC WAY TO END YOUR
PRESENTATION.
I REALLY WANT TO ECHO THE
SENTIMENTS YOU SHARED.
I MEAN, FOR THE LUMINARIES ON
THAT SLIDE IN PEDIATRIC HIV,
WHAT A TREMENDOUS EFFORT AND
ACCOMPLISHMENT.
SO MY THANKS TO THEM AS WELL.
I HAVE PROBABLY A SHORTER
PRESENTATION BECAUSE I DIDN'T
WANT TO GO TOO MUCH INTO THE
DETAILS, BUT REALLY WANTED TO
SAY FIRST AS THIS SLIDE HAS TIME
TO SETTLE, WE PUBLISH OUR
PEDIATRIC GUIDELINES KIND OF
SIMILAR TO DR. MASUR'S APPROACH
IN THAT THEY'RE ROLLING UPDATE,
AND SO WE HAVE -- WE PUBLISHED
THOSE AND I'M ABOUT TO SHOW A
COUPLE OF THE SECTIONS THAT ARE
COMING UP AT THE END OF THIS
MONTH.
WE ALSO COLLABORATIVELY WORK
WITH THE OTHER PANELS, INCLUDING
THE PEDIATRIC ANTIRETROVIRAL
GROUP AND THE PERINATAL GROUP,
AND AS ROHAN ARTICULATED TO MAKE
SURE THAT WE HAVE HARMONY ACROSS
SECTIONS THAT OVERLAP OR HAVE
OVERLAPPING POTENTIAL FOR OUR
RECOMMENDATIONS.
SO TO THE END OF -- GOING BACK
TO THE POINT I WAS TRYING TO
MAKE WITH THIS SLIDE IS THAT WE
UNDERTOOK -- SINCE THE LAST
UPDATE I PROVIDED AROUND THIS
TIME LAST YEAR, YOU MAY RECALL I
MENTIONED THAT WE UNDERTOOK A
RESCOPE OF THE GUIDELINE LOOKING
AT ALL THE 25 OPPORTUNISTIC
INFECTION SECTIONS AND THOSE
THAT INCLUDED
VACCINE-PREVENTABLE DISEASES AND
RECOMMENDATIONS, ET CETERA, AND
INCLUDED A BROAD CONSULTATION
WITH THE PEDIATRIC HIV AND
INFECTIOUS DISEASE COMMUNITY
THAT LED TO IMPLEMENTATION OF A
PLAN THAT HAD BEEN BROUGHT TO
O.A.R. AT THAT TIME AND APPROVED
BY YOU ALL TO RESCOPE THE
GUIDELINE TO MORE ALIGN WITH
CURRENT EPIDEMIOLOGY AND IN
PEDIATRICS AND HIV AND THE
PROVIDERS CARING FOR THOSE
CHILDREN, AND SO WE ARE UNDERWAY
IN IMPLEMENTING THAT AND ONE OF
THOSE RECOMMENDATIONS WAS THAT
WE NEEDED MORE EDITORIAL HANDS
AND THERE YOU HAVE IT ON THIS
SLIDE, BY A LOT OF -- WE HAVE
UNDERGONE A TWOFOLD INCREASE IN
SIZE OF THE LEADERSHIP GROUP.
TO INTRODUCE SOME OF THE NEWEST
PANEL MEMBERS, BECAUSE I THINK
SOME OF THE INDIVIDUALS ON THAT
PRIOR SLIDE, WE DID INTRODUCE
BEFORE.
SO THESE MEMBERS, YOU HAVE NOT
HEARD FROM ME LAST YEAR.
THIS IS TO REPLACE EXPERTISE
THAT -- DR. DIANNE CLARKE
RETIRED FROM OUR PHARM-D
PERSPECTIVE AND PARTICULARLY THE
TABLES ADDRESSING TOXICITIES OF
ANT RETROVIRALS AND INTERACTIONS
WITH OTHER ANTIINFECTIVES AND
PARTICULARLY THERE'S ANOTHER
ADDITION THAT WILL TABLE ON
DRUG-DRUG INTERACTIONS
THEMSELVES, AND SO WE HAVE
BROUGHT ABOARD TWO VERY HIGHLY
QUALIFIED INDIVIDUALS, DR. SUSAN
CARR AND DR. JULIE RICHARDSON
WHO ARE BOTH FROM ST. JUDE'S
CHILDREN'S RESEARCH HOSPITAL,
AND REALLY ARE GOING TO BE THE
LEAD -- CO-LEADS OF THESE
SECTIONS.
AND THEN WE HAVE DR. KEVIN
O'CALLAGHAN FROM THE CENTERS FOR
DISEASE CONTROL AND PREVENTION,
HE WILL BE TAKING ON THE LEAD
AUTHORSHIP OF THE SYPHILIS
SECTION.
ADDITIONALLY WANT TO MENTION DRR
OF THE PEDIATRIC HIV SOCIETY AND
PART OF THE PEDIATRIC AND
RETROVIRAL GUIDELINES.
HE IS THE LIAISON BETWEEN OUR
GROUPS AND IN HELPING ACHIEVE
SOME OF THE -- SPECIFICALLY I DO
WANT TO CALL OUT SOME ACTIVITY
ON THE SARS-COV SECTIONS THAT WE
ARE GOING TO BE ADDING, THERE IS
A SECTION FOR CHILDREN AND WE
HAVE A BROADER BOARD EXPERTISE.
LASTLY DR. FRANKLIN YATES, A
CLEEJ FROM NICHD, WHO IS A
LEADERSHIP GROUP MEMBER WITH ME
ON THIS PANEL.
SO GETTING TO THE MEAT OF THE
SECTION UPDATES THAT I
MENTIONED, AP ANTICIPATE TO HAVE
PUBLICATION BY THE END OF JUNE,
THE SITE LOW MELLOW VIRUS,
PUBLICATIONS IN 2013, SO THE
UPDATE HERE ARE THEIR
RECOMMENDATIONS TO TEST INFANTS
EXPOSED TO HIV FOR CONGENITAL
CMV INFECTION BECAUSE OF THE
HIGH RISK OF TRANSMISSION IN
MOTHERS WITH HIV.
AND THEN ALSO HARMONIZING THE
CONGENITAL CMV TREATMENT
RECOMMENDATIONS FOR THOSE WITH
CMV INFECTION, HOPEFULLY
PRESENTING WITHIN THE FIRST
MONTH TO START IV ENPSY -- THE
PEDIATRICS RED BOOK
RECOMMENDATIONS.
SO THE OTHER SECTION IS THE LONG
AWAITED MTB SECTION, AGAIN
REFERENCING -- SO THE MAIN
UPDATES HERE ARE REALLY THREE
AREAS.
AROUND DIAGNOSTICS AND
CONGRUENCY WITH THE AAP GUIDANCE
RECOMMENDING THE INTERFATHER ON
GAMMA RELEASE ASSAYS TO DIAGNOSE
LTBI AND TODDLERS OVER 2.
AND THEN THERE ARE
RECOMMENDATIONS ON CHILDREN OVER
2 WITH HIV WHO HAVE LTBI ARE
THEN ABLE TO RECEIVE THE 12-DOSE
LTBI TREATMENT WITH -- AND -- AS
LONG AS THERE AREN'T SIGNIFICANT
DRUG-DRUG INTERACTIONS WITH THE
ANTIRETROVIRALS.
FINALLY RECOMMENDATIONS FOR
DOLUTEGRAVIR AND -- BASED
ANTIVIRAL REGIMENS IN THE
CONTEXT OF TB DISEASE FOR
CHILDREN WITH HIV OVER 20KGs
AND THOSE UNDER 20 RESPECTIVELY.
THEN FINALLY AND IMPORTANTLY, WE
REALLY NEED TO DO AN OVERALL OF
THE TWO SECTIONS THAT ARE
INTRODUCING THE GUIDELINE, THAT
THE SUMMARY AND THEN THE BLACK
GROUND AND RECOMMENDATIONS
RATING SCHEME SECTIONS THAT A
LOT OF HISTORICAL CONTEXT AND
INFORMATION THAT I THINK HAS
REALLY NEEDED TO BE UPDATED AND
HAS BEEN ARCHIVED AND
CONSOLIDATED INTO A SINGLE
SECTION THAT IS AN INTRODUCTION
TO MAKE IT MORE CONGRUENT WITH
HOW THE OTHER GUIDELINES ARE
FLOWING AND MAKE IT EASIER TO
FIND INFORMATION LIKE SEXUAL
MATURITY RATING SCHEMES AND
T-CELL COUNTS AND SEVERITY OF
IMMUNOSUPPRESSION.
SO THE TABLE FOR THAT IS EASY TO
ACCESS FROM ONE PLACE, SO THIS
INTRODUCTION IS ALSO COMING OUT
THE END OF THIS MONTH.
AND THEN FINALLY, THE TABLES
THAT GO ALONG WITH THE
APPROPRIATE SECTIONS THAT ARE
BEING UPDATED FOR PRIMARY AND
SECONDARY PROPHYLAX EASE AND
TPROPHYLAXIS ANDTREAT
TREATMENT ARE BEING UPDATED.
SO THAT IS IT.
>> THANK YOU, BILL.
AND FINALLY, DR. PAU?
>> THANK YOU.
THANK YOU FOR PLET LEATHE LETTIA
LITTLE BIT LATER TODAY.
I'M GOING TO GIVE A QUICK REPORT
OF WHAT HAPPENED SINCE THE LAST
REPORT WE DID IN OCTOBER, ON THE
ADULTS AND ADOLESCENTS ART
GUIDELINES.
THE LAST UPDATE WE HAD WAS MARCH
OF THIS YEAR, JUST A FEW MONTHS
AGO, WITH A FOCUS -- PRIMARILY
FOCUS ON LENACAPAVIR THAT WAS
APPROVED IN DECEMBER 2022,
PRIMARILY FOR PATIENTS WITH
MULTIPLE DRUG RESISTANCE HIV AND
WITH VIROLOGIC FAILURE.
THIS DOSE IS SUBCUTANEOUSLY
GIVEN EVERY SIX MONTHS, SO IT IS
THE LONGEST ACTING AGENT THAT IS
CURRENTLY FDA-APPROACHED.
BECAUSE OF THIS APPROVAL, A
NUMBER OF SECTIONS WERE UPDATED
WITH INFORMATION WITH REGARDS TO
THE USE OF IT, WITH REGARDS TO
POTENTIAL DRUG-DRUG INTERACTIONS
AND OTHER INFORMATION.
SO THE SECTIONS RELATING TO
VIROLOGIC FAILURE, DRUG
RESISTANCE TESTING, BASICALLY
INDICATING THAT THERE IS
CURRENTLY NO COMMERCIALLY
AVAILABLE TEST AVAILABLE TO
IDENTIFY WHETHER THERE'S ANY
GIGENOTYPIC RESISTANCE TO LEN
LENACAPAVIR.
WE ADDED THE INFORMATION IN THE
ADVERSE REACTIONS AS WELL AS THE
COST CONSIDERATION SECTION.
BY ADDING THE COST CONSIDERATION
SECTION WHICH COSTS ABOUT
$18,000 PER DOSE EVERY SIX
MONTHS, WE ALSO UPDATED THE
COSTS FOR ALL THE OTHER
ANTIRETROVIRAL DRUGS CURRENTLY
FDA-APPROVED AS WELL.
BECAUSE THERE'S THE POTENTIAL OF
DRUG-DRUG INTERACTIONS WITH THIS
AGENT, WE UPDATED WITH
INFORMATION ABOUT WHAT ARE THE
POTENTIAL PROBLEMS WITH
INTERACTIONS WITH THIS
LONG-ACTING LENACAPAVIR, AND THE
DRUG CHARACTERISTICS TABLE WAS
ALSO UPDATED AS WELL.
JUST LIKE ALL THE OTHER GROUPS,
FOR THE FIRST TIME IN THREE
YEARS, ACTUALLY, WE WERE ABLE TO
RECRUIT NEW MEMBERS DURING THE
PAN AT THE MIBG.
MESS OF US HAD BEEN VERY BUSY
WITH COVID-19, AND IT WAS
DIFFICULT FOR US TO BE ABLE TO
IDENTIFY NEW MEMBERS DURING THAT
PERIOD OF TIME, BUT THIS IS THE
YEAR WHERE WE WANT TO
REINVIGORATE THE GUIDELINES AS
WELL AS INCLUDING NEW MEMBERS
AND SENDING OFF SOME OF THE
MEMBERS THAT HAD GRACIOUSLY
AGREED TO STAY ON A LITTLE BIT
LONGER TERMS.
SO THE GROUPS THAT I LISTED HERE
INCLUDED MEMBERS THAT ARE --
WITH EXPERTISE IN ANTIRETROVIRAL
THERAPY, EXPERTISE IN WOMEN AND
HIV ADHERENCE, AS WELL AS
IMMUNOLOGY, WITH THE GOAL TO
REPLACE SEVERAL OF THE MEMBERS.
WHICH ARE INCLUDED IN HERE.
DR. RAJESH GANDHI FROM MASS
GENERAL AND HARVARD HAS BEEN ON
THE PANEL 10 YEARS NOW INSTEAD
OF EIGHT.
DR. TOM GIORDANO, WHOSE TERM IS
UP BY THE END OF THIS YEAR, OUR
ADHERENCE GROUP.
DR. PETER HUNT FROM UCSF, HIS
MAIN AREA OF EXPERTISE IS
IMMUNOLOGY.
DR. KELLER, HER EXPERTISE HAD
BEEN IN ART AS WELL AS WOMEN.
AS WELL AS DR. JEFF LENNOX AND
DR. PABLO TEBAS, BOTH OF WHICH
ARE EXPERTS IN ADULT
ANTIRETROVIRAL THERAPY.
WE HOPE TO BE ABLE TO SEND THEM
OFF IN SEPTEMBER OF 2023, WHEN
WE HAVE OUR FIRST IN THREE YEARS
FACE-TO-FACE MEETING.
SO THE UPCOMING EVENTS, WE HAVE
NOT HAD FACE-TO-FACE MEETING
SINCE MAY OF 2019.
WE WERE SUPPOSED TO HAVE ONE IN
MAY 2020, BUT THAT WAS CAN KAHN
SELLED BECAUSE OF THE PANDEMIC,
SO FOR THE FIRST TIME, WE WERE
ABLE TO MEET TOGETHER SO THAT
WOULD BE THE TIME WHEN WE WOULD
BE ABLE TO SEND OFF THE OLD
MEMBERS AS WELL AS WELCOMING THE
NEW MEMBERS.
EVEN THOUGH THE NEW MEMBERS HAD
ALREADY BEEN STARTING TO WORK
SINCE MAY.
IN FACT, BEFORE THIS CALL, I WAS
ON ANOTHER CALL WHERE WE'RE
TRYING TO WRITE A SECTION ON HIV
AND TRANSPLANT.
THE WORK IS UNDERWAY.
WE HOPE TO BE ABLE TO PRESENT TO
THE PANEL ABOUT THIS SECTION IN
SEPTEMBER.
NSKS, THIS SECTION WAS SUPPOSED
TO BE WRITTEN UP IN TWEB 20, AND
EVERYTHING WAS PUT ON HOLD
BECAUSE OF THE PANDEMIC, BUT WE
ARE NOW DIGGING OUT AND TRYING
TO BE ABLE TO PUT THIS TOGETHER.
ALONG WITH THAT, THERE'S A
NUMBER OF SECTIONS THAT ARE
BEING UPDATED AT DIFFERENT
STAGES AT THIS POINT, INCLUDING
EARLY, ACUTE AND RECENT, SHOULD
I BE IN OLDER PEOPLE, WOMEN,
ADOLESCENTS, HIV 2 INFECTION,
SUBSTANCE USE AND HIV, AS WELL
AS DRUG-DRUG INTERACTION.
ONE THING I DIDN'T MENTION HERE
IS THAT WE ALONG WITH THE FULL
OTHER GUIDELINES GROUP IN 2020,
WE PUT TOGETHER A SECTION ON
COVID-19 AND HIV, SPECIFICALLY
FOCUSED ON SOME OF THE AREAS
THAT WE -- AT THAT TIME IN 2020,
THOUGHT TO BE IMPORTANT,
INCLUDING NEEDING TO TRIAGE
PATIENTS WITH HIV AND THEY
SHOULD NOT BE DENIED THERAPY IF
NECESSARY, WHAT TO DO IN
PATIENTS WHO CANNOT BE IN
PERSON, HAVE TO DO TELEHEALTH
AND FILLING PRESCRIPTION, ZO SON
AND SO FORTH, AND BECAUSE OF THE
FACT THAT THE PANDEMIC EMERGENCY
IS OVER AND THERE IS THE
COVID-19 TREATMENT GUIDELINES IN
WHICH MANY OF THE GUIDELINES
PANEL MEMBERS ARE ALSO PART OF,
AND ALSO WRITE UP THE SECTION ON
COVID-19 AND IMMUNOFLORESCENT,
WE DECIDED WITH THE CONCURRENCE
OF THIS GROUP AS WELL AS THE
OTHER GUIDELINES PANELS, TO
RETIRE THE SECTION THAT IS
CURRENTLY ONLINE IN THE HIV INFO
WEBSITE, AND REFER CLINICIANS TO
THE SECTIONS IN THE NIH COVID-19
TREATMENT GUIDELINES, COVID-19
AND HIV.
AND I THINK THAT'S ALL I HAVE.
>> THANK YOU, DR. PAU.
AND THANK YOU TO ALL THE OTHER
PRESENTERS.
WE ARE NOW OPEN FOR DISCUSSION.
LET'S START WITH THE ZOOM
MEETING ATTENDEES.
IF YOU HAVE A QUESTION OR A
COMMENT, PLEASE USE THE ZOOM
RAISE YOUR HAND FEATURE.
I DON'T SEE ANY HANDS IN THE --
FROM THE ZOOM ATTENDEES.
DR. GLENSHAW, ARE THERE ANY
QUESTIONS OR COMMENTS IN THE
ROOM?
>> YES.
THANKS, DR. TURNBULL.
DR. SLEASMAN?
>> YES, I JUST WANTED TO FOLLOW
UP, IF YOU REMEMBER LAST MEETING
IN MARCH, WE HAD A LOT OF
DISCUSSION ON THE CHANGING
GUIDELINES IN BREASTFEEDING FOR
HIV INFECTED WOMEN.
HAVIS THERE ANY FOLLOW-UP ON TH?
HOW MUCH ARE THE GUIDELINES
BEING UTILIZED?
IS THERE ANY WAY TO TRACK THAT,
ANY CHANGE IN POLICY AND HOW HAS
THAT AFFECTED -- I KNOW A LOT OF
MY COLLEAGUES ARE GOING AROUND
GIVING TALKS, SO -- SOME GOOD
HAS COME OUT OF IT.
>> I KNOW INTERNALLY, RIGHT, WE
WORKED CLOSELY WITH HRSA AND --
RIGHT, AND THEY WERE CREATING
THE DIFFERENT MATERIALS,
TRAINING PEERLS.
I KNOW CDC WAS ALSO GOING TO BE
UPDATING THEIR WEBSITE.
I DON'T KNOW IF WE'VE GOTTEN AN
UPDATE, BUT THEY WERE GOING TO
GO THROUGH, BECAUSE THIS WAS
THROUGHOUT THEIR WEBSITE THAT
IT'S WRITTEN THERE.
I KNOW ON THE PERINATAL OUTLINE
THAT TED AND OTHERS HELPED
OVERSEE, THEY UPDATED THEIR
SCRIPTS AND THINGS LIKE THAT
TOO.
BUT GOOD QUESTION, I THINK, YOU
KNOW, FOR US TO SORT OF FIGURE
OUT WHAT ELSE IS HAPPENING.
THE OTHER THING I HAVE HEARD
TOO, IN FACT, YOU KNOW, RESEARCH
PROPOSALS ALSO ON NOW MONITORING
WHAT'S HAPPENING AS WELL.
SO I THINK THERE WILL BE SOME
PROJECTS FROM THAT STAIN -- SEEE
CAN SYSTEM A ADVE SYSTEMATIZE TN
AND THEN BEING ABLE TO MONITOR.
SO GOOD POINT, JOHN.
>> THOSE ARE GREAT POINTS,
ROHAN.
THE ONLY THING I WOULD SAY FROM
OUR STANDPOINT IS WE'D BE ABLE
TO CAPTURE THE DATA FROM THE
BACK END FR THAT WE'RE ABLE TO
PROVIDE FROM OUR FOLKS AT --
WHICH PAGES ARE COMING UP MOST
OR IF THIS PARTICULAR --
>> ONE ADDITIONAL COMMENT ON
THAT, WE DID HEAR IT WOULD BE
VERY USEFUL FOR PROVIDERS TO
HAVE JOB AIDS AND SORT OF QUICK
REFERENCES AROUND THE SPECIFIC
TOPIC AROUND FEEDING RATHER THAN
ONLY PATIENT FACING MATERIALS,
WHICH IS WHAT WE INTEND TO
CREATE, SO THAT'S SOMETHING WE
NEED TO WORK ON.
DR. TURNBULL, I THINK THAT'S THE
END OF THE COMMENTS FROM THE
ROOM.
I WOULD JUST LIKE TO SAY A NOTE
OF THANKS TO THE VOTING MEMBERS
FOR PROVIDING THE NOTATIONAL
VOTE TO ARCHIVE THE COVID AND
HIV GUIDELINES AS DR. PAU
MENTIONED.
THEY ARE ARCHIVED AND STILL
ACCESSIBLE, BUT THE CURRENT PAGE
REFERS THE USER OVER TO THE
BROADER COVID GUIDELINES WITH
THE HIV SECTION.
SO THANK YOU ALL FOR GOING THAT
DIRECTION.
FOR VOTING THAT
DIRECTION.
DR. TURNBULL?
>> YES, DR. GLENSHAW.
I DON'T SEE ANY ADDITIONAL
COMMENTS IN THE ZOOM.
SO I GUESS WE'RE GOING TO MOVE
FORWARD WITH THE PUBLIC
COMMENTS, CLOSING REMARKS AND
MEETING ADJOURNMENT.
>> YES, MA'AM.
WE DO HAVE A COUPLE OF PUBLIC
COMMENTS.
>> OKAY.
SO JUST LET ME SAY, YOU KNOW,
THANK EVERYONE AGAIN.
AS WE BEGIN TO CLOSE, THIS IS
REALLY THE TIME THAT HAS BEEN
ALLOTTED FOR PUBLIC COMMENT.
SO MY QUESTION TO DR. GLENSHAW
IS, DR. GLENSHAW, HAVE YOU
RECEIVED ANY COMMENTS FOR
TODAY'S MEETING?
>> AS A MATTER OF FACT, YES.
WE HAVE.
WE HAVE TWO PUBLIC COMMENTS THAT
HAVE COME IN.
I'LL BE HAPPY TO SHARE THEM IN
JUST A MOMENT.
BEFORE I DO THAT, JUST A COUPLE
OF NOTES FOR THE FOLKS IN THE
ROOM AND ON THE ZOOM.
IN THE ROOM, YOU'LL FIND A
CONFLICTS OF INTEREST FORM IN
YOUR FOLDER.
IF YOU COULD KINDLY JUST SIGN TO
CONFIRM NO CONFLICTS WERE
PRESENTED FOR YOU TODAY, AND
PLEASE RETURN THAT TO EITHER
CORETTE OR MYSELF.
AND IF THERE ARE ANY TRAVEL
NEEDS AS YOU DEPART, PLEASE SEE
JANAYA WHO IS IN THE LOBBY.
SO DR. TURN B TURNBULL, I'LL GOD
AND START THE PUBLIC COMMENTS
NOW.
>> YES.
>> OKAY.
THE FIRST IS FROM A PERSON NAMED
DAVID KIWANA.
WHO IS FROM THE ASHOWAD
CHRISTIAN CHARITABLE
ORGANIZATION FOR VENERABLE
GROUPS OF CHILDREN, YOUTH AND
WIDOWS, DISABLED PERSONS AND
PEOPLE LIVING WITH HIV IN
UGANDA, CASANDA DISTRICT, IN THE
K IGA LAMA PARISH.
THIS PERSON SAYS ACCESS TO
HEALTH SERVICES AND FACILITIES
FOR THOSE PEOPLE AND THOSE ON
ARV ARE A REALLY BIG PROBLEM IN
OUR COMMUNITY.
THROUGH YOUR SUPPORT AND
PARTNERSHIP, WE HOPE TO CREATE
AN IMPACT.
AND FURTHER STATES THAT,
CREATING AWARENESS PROGRAMS FOR
YOUNG GIRLS AND YOUNG ADULT IN
UGANDA IN THE CASANDA DISTRICT
WHERE THEY ARE MOST VULNERABLE
IS NEEDED.
THE SECOND PUBLIC COMMENT IS
FROM JEWE JULESLEVIN.
HE STATES I'M WATCHING VET
INTERESTING AND IMPORTANT
DISCUSSIONS TODAY.
I WOULD LIKE TO THANK THE
O.A.R., BILL KAPOGIANNIS AND --
AND THANK THE NIH WOMEN'S
PROGRAM.
THANK YOU ALSO TO DR. KASSAYE
FOR HER COMMITMENT TO THE WIHS
COHORT.
HE STATES, INDEED MANY OF US
OLDER AND PARTICULARLY ELDERLY
PERSONS LIVING WITH HIV ARE
SUFFERING SEVERE EFFECTS OF
AGING WITH HIV, INCLUDING
PHYSICAL AND MENTAL IMPAIRMENT
AND DISABILITY.
IT'S PAINFULLY OBVIOUS TO MANY
OF US ELDERLY AND OLDER PERSONS
WITH HIV THAT WE ARE NOT GETTING
OUR CARE NEEDS MET.
YOUR RECOGNITION OF THIS PROBLEM
IS IMPORTANT.
WOMEN WHO DO -- WOMEN DO
EXPERIENCE WORSE RACE OF
COMORBIDITIES AND DECLINE AS
THEY AGE.
I HAVE SUGGESTED BEFORE THAT WE
NEED IMPLEMENTATION RESEARCH TO
HELP PROVIDE BETTER CARE, AND I
THINK DR. KASSAYE DISCUSSED THIS
TOO.
WE COULD, FOR EXAMPLE, PROVIDE A
SUPPORT PROJECT FOR WOMEN AND
MEN TO BETTER EVALUATE AND
MONITOR CARE FOR HEART DISEASE
AND BONE DISEASE AS ONE EXAMPLE.
IMPLEMENTATION STUDIES OF
GERIATRIC SCREENINGS AND SUPPORT
HIV CLINICS WOULD ALSO BE
USEFUL.
HE CLOSES BY SAYING THOUSANDS OF
PERSONS WITH HIV ARE OVER 65 NOW
AND NEED IMMEDIATE INTERVENTIONS
AS THEY ARE NOT RECEIVING THEM.
IMPLEMENTATION RESEARCH IS A
GREAT WAY TO INSERT GERIATRIC
CARE AND SCREENINGS INTO HIV
CLINICS.
AND THAT CONCLUDES OUR PUBLIC
COMMENT.
>> THANK YOU, DR. GLENSHAW.
DR. KAPOGIANNIS, I TURN IT OVER
TO YOU FOR CLOSING REMARKS.
>> THANK YOU, DR. TURNBULL.
WELL, WHAT A FANTASTIC AND
INFORMATIVE MEATING.
INFORMATIVE MEETING.
REALLY APPRECIATE EVERYBODY,
YOUR CONTINUED AND VALUABLE
FEEDBACK AND THE DI VE DIVERSITF
PERSPECTIVES IN YOUR ENGAGEMENT
IS REALLY CRITICAL TO MOVING THE
NIH HIV RESEARCH AGENDA FORWARD
AND REALLY THANK YOU SO MUCH FOR
ALL OF THIS.
I ALSO WANT TO THANK OUR
COLLEAGUES AT O.A.R. AND THE
STAFF WHO HELPED BRING THIS
MEETING TOGETHER, PARTICULARLY
TO DR. GLENSHAW, HERE, FOR
REALLY HELPING ORGANIZE AND
STRUCTURE EVERYTHING SO NICELY.
AND LASTLY, THANK YOU,
DR. TURNBULL, FOR A TERRIFIC JOB
AND YOUR SERVICE AS CHAIR OF
OARAC.
REALLY, WELL-RUN MEETING AND
MUCH APPRECIATE ALL OF YOUR
EFFORT.
THANK YOU, AND NOW BACK TO YOU.
>> THANK YOU SO VERY MUCH,
DR. KAPOGIANNIS.
AND EVERYONE IN ATTENDANCE AT
THE MEETING TODAY.
AS MY FINAL WORDS FOR THIS
CLOSING OUT OF TODAY'S MEETING,
TODAY'S MEET SOMETHING NOW
OFFICIALLY ADJOURNED.
THANK YOU ALL FOR ATTENDING, AND
HAVE A GOOD REST OF YOUR DAY.
THANK YOU.
>> THANK YOU.