Alcohol and AIDS: A New Decade

Grantsmanship Workshop XIX International AIDS Conference

Rome, Italy

Kendall J. Bryant, Ph.D. , NIAAAAlcohol and AIDS Research

National Institutes of Health

NIAAA Vision Statement for prevention and treatment of HIV/AIDS

To support and promote the best science on alcohol and health:– Improving the diagnosis, prevention, and treatment of

alcohol use disorders to reduce new HIV infections and improve treatment outcomes

– Increasing the understanding of normal and abnormal biological functions and behavior relating to alcohol use and HIV infection

– Enhancing the quality of health and health care delivery in domestic and international settings to reduce morbidity and mortality

Prevention of New Infections

• Multilevel Ecological Research• Behavioral Risk Reduction: High-risk groups, Social

Networks, and Concurrency, Event-Level Factors• Alcohol Interventions include Brief Motivational,

Cognitive Behavioral, and Pharmacotherapy in At-Risk Populations

• NIAAA FY2010 P01 Integrative Behavioral Prevention Research

• International HIV Prevention in Venue Based Settings (R01)

Multilevel Models

Alcohol Use: One of many issues in HIV+ patients life

Neurologic Effects

Immunologic Effects

Liver Damage

Depression

Substance Abuse

Treatment

HIV Treatment

Alcohol Use

Neuropathogenesis andPain ManagementHCV coinfection,HBV and chronic viral loadOther drugs Quality of LifeAccess to treatment

NIAAA Portfolio : Funded 2010/11 Funded Initiatives

• Alcohol Pharmacotherapy for HIV+ • Centers for Integrative Research (P60, Consortiums)• Multilevel Preventive Interventions – Design and Testing• High-Risk Populations for Infection and Transmission:

Migrant Workers, Cross-Border Settings, Youth• Interagency Agreements for Collaborative Women and

Pediatric Cohorts• Developing International Networkers Alcohol HIV

Researchers• Targeted Initiatives: District of Columbia, Baltimore

New Models for Studying Progression and Aging

Implementation and Operations Research

• Develop Models of Interaction of Alcohol and HIV Prevention and Treatment Access and Uptake (and Comparative Effectiveness)

• Develop Models for Clinical Decision Making in Specific Settings for Patients, Providers, and Policy Makers

• Develop Identification, Screening, and Intervention Models (Seek, Test, and Treat) for Spectrum of Alcohol Use Disorders

Algorithm for integrating alcohol screening and treatment into clinical care of HIV patients

International Prevention