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World AIDS Day provides an annual opportunity to unite global efforts to end the HIV pandemic, show support for people with HIV, and remember those we have lost to the pandemic. This year, the White House Office of National AIDS Policy (ONAP) marked the World AIDS Day observance with the release of the National HIV/AIDS Strategy 2023 Interim Action Report.
The report details progress toward meeting the goals of the current National HIV/AIDS Strategy for the United States 2022-2025 (NHAS), which was released by President Biden on World AIDS Day in 2021 and provides a roadmap for the nation to accelerate efforts to end the HIV epidemic in the United States. The new NHAS 2023 Interim Action Report outlines key activities undertaken by federal agencies and highlights the critical role of ongoing research as part of the strategy to end the HIV epidemic in the United States by 2030.
The report emphasizes the incredible amount of work that is taking place across the federal government to address HIV, but also details how much lies ahead. Indeed, transformational research advances in HIV prevention and treatment have marked some of the most significant accomplishments in science and public health. But this progress is not reaching all communities equally. Staggering health disparities place a disproportionate impact of HIV on minoritized racial and ethnic groups and diverse sexual and gender populations. As the report outlines, future HIV research must address these issues to ensure all communities have equitable access to effective, evidence-based HIV testing, prevention, treatment, and care services.
Below are highlights from the report that underscore how the NIH HIV research program contributes to the national strategy to end the HIV epidemic. I look forward to building on these successes to ensure no community is left behind.
- Ongoing NIH-funded research continues to lead to results that are improving the lives of people with HIV. Earlier this year, results from the NIH-supported REPRIEVE trial showed that statins can reduce major cardiovascular events by more than one-third in people with HIV. Statin use was associated with a 20 percent reduction of major adverse cardiovascular events and premature deaths. As a result, the findings are expected to directly influence clinical guidelines and standards of care for an aging population of people with HIV and add to the growing literature that demonstrates that people with HIV experience higher cardiovascular risk than the general population.
- The NIH Office of AIDS Research (OAR) HIV and Aging Signature Program, launched in 2022, catalyzes interdisciplinary research and training to meet the increasing health needs of people aging with HIV. In fiscal year (FY) 2022, NIH provided support for nearly 340 research projects related to HIV and aging. In addition, a virtual NIH workshop in September 2023 and a follow-up panel discussion at the 2023 U.S. Conference on HIV/AIDS surveyed the landscape of current research at the intersection of HIV and aging and explored how federal agencies, researchers, health providers, the HIV community, and advocates can work together to prioritize research to improve the lives of people aging with HIV.
- In FY22, NIH supported 69 early stage investigators studying HIV, an 8 percent increase over FY21. The OAR Early Career Investigator Signature Program aims to improve outreach to the next generation of HIV investigators and increase training and capacity-building programs. The OAR Workshop for Early Career Investigators in HIV, held in April 2023, drew more than 500 attendees to facilitate networking and share information about the NIH HIV research funding process.
- NIH supports research to address stigma and discrimination that exacerbates HIV-related disparities and inequities. The NIH Stigma and Discrimination Research toolkit provides resources for researchers, partner federal agencies, community groups, and other partners to help integrate stigma research into policy and programs. In addition, NIH established a Stigma Working Group, with representation from across the U.S. Department of Health and Human Services, focused on stigma and discrimination research with particular attention on HIV-related intersectional stigma.
- NIH supports syndemics research to investigate interactions between epidemics and the social and structural determinants of health. This research seeks to understand the complex interactions between behavioral, economic, and environmental factors that influence the HIV epidemic. In FY22, NIH sponsored a supplement in the American Journal of Public Health on the importance of addressing intersectional HIV-related stigma and discrimination.
- NIH works with other federal agencies, including the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA), in the Interagency Federal Implementation Science Workgroup to coordinate research and program activities, determine priorities for NIH-funded research related to the Ending the HIV Epidemic in the U.S. (EHE) initiative, and collaborate to address critical gaps in order to meet evolving and urgent needs in communities. Several agencies participated in an NIH-hosted national EHE meeting in September 2022 to share best practices and research findings.
- Implementation research is critical to prevent new HIV infections and improve health outcomes among people with HIV. NIH supports implementation research projects to develop strategies that translate evidence-based interventions into real-world settings to maximize HIV testing and linkage to care, initiate treatment as early as possible, and improve treatment adherence and retention. In FY22, NIH supported more than 370 implementation research projects totaling $160 million in funding, a 26 percent increase in funding over FY21.
As I reflect on the tremendous progress in HIV research, I have hope that, with continued commitment and partnerships among the federal government, researchers, and community, we will reach the finish line to achieve the domestic goals established in our national strategy to help end the global HIV pandemic.
Watch the on-demand NIH VideoCast of the NIH World AIDS Day 35 Event: Achieving Excellence and Equity in HIV Research to learn more about how the NIH HIV research program is addressing HIV-related inequities. To learn more about recent advances in HIV research, read the NIH World AIDS Day