Welcome to the Alcohol and HIV/AIDS Research Program 

NIAAA ribbon logo HIV AIDS

Logo NIH NIAAA               NIH Office of AIDS Research

HIV/AIDS and Alcohol

Extraordinary progress in HIV/AIDS research has led to the development of interventions and medications to reduce transmission and has transformed an almost inevitably fatal disease into a preventable and treatable disorder. People with HIV/AIDS can achieve their full potential and normal life expectancy if antiretroviral therapy (ART) is initiated promptly and continued for life. Nonetheless, alcohol misuse can compromise the treatment and prevention of HIV, which remains a serious public health concern worldwide.
 
Scientists have learned that alcohol use contributes to the spread of HIV/AIDS in many ways, e.g., weakening the immune system, increasing sexual risk behaviors, and raising someone’s vulnerability to HIV infection. Furthermore, the rate of hazardous alcohol use among people living with HIV/AIDS (PLWHIV) is approximately twice that of the general population. Alcohol and tobacco use remain the primary substance use comorbidities with the greatest health impact among those living with HIV, resulting in liver and cardiac failure, cancers, and persistent organ and tissue inflammation. Comorbid hepatitis C virus (HCV) and tuberculosis (TB) further complicate treatment and increase mortality among PLWHIV who continue to drink. Research studies indicate that the HIV care continuum, including early identification through HIV testing, immediate treatment initiation, and medication adherence, are critical for health of HIV-positive people and for preventing new infections. Importantly, each of these stages may be adversely affected by alcohol misuse.   
 

Learn more about alcohol and HIV/AIDS

 

NIH Alcohol-HIV/AIDS Research Areas

Alcohol misuse facilitates HIV infection, accelerates disease progression, and hastens the deaths of those who have progressed to AIDS, but the mechanisms for these interactions are not well understood. Alcohol can exacerbate HIV-associated comorbid conditions, such as tuberculosis and hepatitis C virus, and it has been linked to the development of other diseases in HIV-infected individuals. Alcohol also contributes to age-related medical problems, including cardiovascular dysfunction, peripheral neuropathies, and neurocognitive impairments in HIV-positive individuals. In addition, little is known about how alcohol affects the effectiveness of HIV treatment and prevention medications.

The NIH Overarching HIV/AIDS Research Priorities for AIDS Funding support cross cutting basic research, health disparities, behavior and social science research, and training to:

  • Reduce the Incidence of HIV/AIDSTrans NIH HIV/AIDS research priorities FY2018 Trans-NIH Plan
  • Implement Next Generation HIV Therapies
  • Research Toward a Cure
  • HIV-associated Comorbidities, Complications, and Coinfections

A full description of the NIH HIV/AIDS research priorities can be found in the FY2018 Trans-NIH Plan.

Additional information is available at the NIH HIV/AIDS Research Priorities and Guidelines for Determining AIDS Funding.

 

Alcohol HIV/AIDS Research Priorities

  • Reduce incidence and improve prevention strategies among individuals who drink, including research on effectiveness of preventive strategies under development (i.e., vaccines and microbicides)
    • Improve the uptake and consistent use of PrEP, PEP, and strategies to improve HIV testing and entry to treatment for women and men who drink across a range of severity, including multi-level interventions and measures that impact at the population level
  • Implement the next generation of HIV therapies with better safety and ease of use (over the lifespan) for individuals who demonstrate toxicities related to past and/or current alcohol use patterns
    • Development/testing of HIV treatments (long-lasting, less toxic, and fewer complications)
    • Understand the barriers to implementation of treatment as prevention within the clinical cascade
    • Assess treatment outcomes in the populations of interest (who drink across a range of severity)
  • Facilitate research toward a cure for HIV/AIDS (identification, control of viral reservoirs)
    • Novel strategies for research toward a cure related to delayed care and increased inflammatory response among people living with HIV who misuse alcohol
  • HIV-associated comorbidities and co-infections (targeting interventions to alcohol users)
    • Prevention and treatment of HIV-associated comorbidities, coinfections, and related complications of particular significance for drinkers’ morbidity and mortality, including HCV, TB, HBV, and hepatic, cardiovascular, and neurological disorders
    • HIV/alcohol translational research that addresses health and behavioral/social issues clearly linked with HIV (transmission acquisition, pathogenesis, mobility and mortality, stigma, adherence) and examines them in the context of HIV, such as other infectious pathogens and diseases, non-infectious pathogens and diseases, other substance use/addiction, and mental health disorders
  • Cross cutting areas/Foundational research
    • Basic behavioral and biological research, health disparities in key populations exposed to alcohol (e.g., men who have sex with men, newly infected, minorities, and young women in both domestic and international settings)
    • Cross training of HIV and alcohol researchers in use of new tools/techniques and research capacity building
       

Strategic Plan 2017 to 2021

The NIAAA Strategic Plan 2017-2021

The NIAAA AIDS funding supports research to investigate relationships between alcohol misuse and alcohol use disorders (AUD) and co-occurring conditions and to develop interventions to prevent and treat them. Considering the serious adverse consequences associated with alcohol misuse by people with HIV, NIAAA will support research to:

  • Determine how current and past alcohol use in the context of HIV infection and other co-infections affects development and progression of organ and tissue injury, with a focus on the gut, liver, lung, and brain, and translate these findings into strategies for limiting alcohol-related organ and tissue injury in HIV-positive individuals
  • Improve understanding of how alcohol affects disease progression and tissue and organ injury in HIV-positive individuals taking antiretroviral medications
  • Identify and model mechanisms through which alcohol contributes to infectious and noninfectious diseases and mental health conditions among HIV-positive individuals, as well as to frailty among HIV-infected older adults
  • Elucidate how the interaction of HIV, HIV medications, and alcohol affects the brain
  • Evaluate the effectiveness and implementation of culturally appropriate interventions to reduce HIV transmission and improve HIV medication compliance and overall health outcomes by reducing alcohol misuse among people living with HIV
  • Use electronic health technologies, including mobile devices, to improve the effectiveness, accessibility, and use of interventions for AUD and co-occurring disorders, including HIV/AIDS

NIAAA is committed to ensuring that all people benefit from alcohol research advances and will support studies to better understand health disparities and develop interventions for high-risk vulnerable population groups, such as young women, or men who have sex with men, who account for more than half of all new HIV infections each year in the United States.

 

Funded NIAAA HIV/AIDS Research

Consortia for HIV/AIDS and Alcohol Research Translation (CHAART)

The Consortia for HIV/AIDS and Alcohol Research Translation (CHAART) involves researchers at The Johns Hopkins University, Yale University, Brown University, Boston University, the University of Alabama, the University of Washington, and several Florida-based institutions. All are studying large-scale cohorts. These consortia build on an infrastructure already in place and promote collaboration between multiple universities. The consortia members share data on critical variables and outcome information for their interventions. They also share their intervention research outcomes with a centralized operations research center located in New York City. The operations research center includes mathematical researchers who model and simulate AIDS and alcohol interactions and then validate them against real-world outcomes. They will help translate research into a database of practical models that the medical community can implement in populations living with HIV/AIDS.  

Collaborating institutions and consortia include:
 
 

Other major HIV cohort studies supported by NIAAA

  • The Pediatric HIV/AIDS Cohort Study (PHACS) network, sponsored by the NICHD, with co-funding from NIAID, NIDA, NIDCD, NIMH, NHLBI, NIDCR, NINDS, and NIAAA, is a longitudinal cohort study established to address two critical pediatric HIV research questions: the long-term safety of fetal and infant exposure to ART and the effects of perinatally acquired HIV infection in adolescents.
  • The Veterans Aging Cohort Study (VACS), supported by NIAAA in collaboration with the Department of Veterans Affairs, is a prospective, observational cohort study of HIV-positive veterans and an age/race/site-matched control group of HIV-negative veterans in care in the United States. Researchers seek to understand the role of comorbid medical and psychiatric disease in determining clinical outcomes of HIV infection.
  • The Center for AIDS Research (CFARs) Network of Integrated Clinical Systems (CNICS), supported by NIAID and NHLBI, is the first electronic medical records-based research network poised to integrate clinical data from the large and diverse population of HIV-infected persons. CNICS provides research infrastructure to support HIV clinical outcomes and comparative effectiveness research using data collected at one of eight CFAR sites (Case Western Reserve University, the University of Alabama at Birmingham, the University of California San Francisco, the University of Washington, the University of California San Diego, Fenway Health/Harvard University, the University of North Carolina Chapel Hill, and Johns Hopkins University). 
     

Learn more about HIV/AIDS and NIAAA Research

    

Resources


 

Contact

 

Name

Division

Contact Information

Our Staff    
Alcohol and HIV/AIDS Research, National Institute on Alcohol Abuse and Alcoholism (NIAAA)    

Kendall Bryant, PhD       

Director, HIV/AIDS Research, NIAAA

Phone: 301-402-0332

Email: kendall.bryant@nih.gov

 

 

 

Tatiana Balachova, PhD 

Senior Scientist, IPA, HIV/AIDS Research, NIAAA

Phone: 301-443-5726

Email: tatiana.balachova@nih.gov

 

Division Contacts

 

 

John Matochik, PhD  

Division of Neuroscience and Behavior

Phone: 301-451-7319

Email: jmatochi@mail.nih.gov

 

 

 

Li Lin, PhD 

Division of Metabolism and Health Effects

Phone: 301-443-1275

Email: linli@mail.nih.gov

 

 

 

Joe Wang, PhD 

Division of Metabolism and Health Effects

Phone: 301-451-0747

Email: wangh4@mail.nih.gov

 

 

 

 

Deidra Roach, MD

Division of Treatment and Recovery Research 

Phone: 301-443-5820

Email: droach@mail.nih.gov

 

 

 

Robert C. Freeman, PhD

Division of Epidemiology and Prevention Research

Phone: 301-443-8820

Email: rfreeman@mail.nih.gov

 

 

 

Daniel Falk, PhD

Division of Medications Development  

 

Phone: 301-443-0788

Email: falkde@mail.nih.gov

 

 

 

Last reviewed January 2018