NIH GUIDE, Volume 26, Number 3, January 31, 1997


P.T. 34



  Drugs/Drug Abuse 


  Behavioral/Social Studies/Service 


National Institute on Drug Abuse




The National Institute on Drug Abuse (NIDA) announces the

availability of funds to supplement existing NIH research project

grants for the study of issues related to drug abuse and HIV/AIDS.

Funding will be available through administrative and competing







The HIV/AIDS epidemic has demonstrated an increasing association with

drug abuse, through transmission of the HIV by contaminated drug

injection equipment, high risk sexual behavior with an infected drug

user, and perinatal exposure of newborns from infected drug-abusing

mothers.  The proportion of cases attributed to injection drug use

alone has steadily increased from 12 percent in 1981 to 32 percent in



Clearly, the drug abuse links to the AIDS epidemic warrant a strong

Federal research effort.  The NIDA has responded to that challenge by

building a multi-disciplinary program of research including, but not

limited to: improved strategies to reduce drug-abuse related

behaviors that are linked to the transmission of HIV, research on the

epidemiology of drug-abuse related HIV disease, as well as studies of

the biological and behavioral factors that influence HIV infection

and disease progression.


Areas of Interest


In an effort to improve and expand its research on drug abuse-related

aspects of HIV/AIDS, NIDA will consider requests from current

grantees to expand and/or enhance ongoing research to include

HIV/AIDS issues.  The primary intent of this program is to encourage

grantees who have not focused on AIDS-related issues to do so;

however projects which do will also be eligible.  Grantees are

especially encouraged to examine ongoing projects which may not have

been designed to examine AIDS-related issues for HIV/AIDS relevance.


Current areas of research supported by NIDA that are considered

HIV/AIDS-related include the following:


Natural History and Epidemiology


o  Studies to determine the incidence and prevalence of HIV infection

and AIDS among drug abusers, their sexual partners, and their

newborns, including monitoring the trends in HIV infection and

AIDS-related diseases.


o  Research on the natural history of HIV/AIDS in the above

populations, including the dynamics of HIV transmission in sexual and

drug using networks.


o  Research on the nature and extent of HIV risk behaviors and

factors that affect risk in the above populations.


o  Research to develop improved survey designs, including interview

protocols and measurement instruments, and new biostatistical

techniques, to better measure and characterize HIV risk behaviors and

transmission.  Also of interest are studies to develop improved

methods to measure reliability, validity, and estimation error.


o  Studies of the epidemiology and natural history of infectious

diseases commonly transmitted by drug injection and/or sexual

behavior associated with drug use, e.g. hepatitis, endocarditis,

syphilis, or gonorrhea, which may serve to elucidate HIV infection.


o  Studies of the nature, extent, and progression of drug use and

abuse, which include assessment of knowledge and attitudes regarding

HIV/AIDS, and/or the incidence, prevalence, and nature of

drug-related HIV risk behaviors.


Etiology and Pathogenesis


o  Studies to define the role of drugs of abuse and related compounds

or drug abuse treatment medications on susceptibility, onset, and

progression of HIV disease.


o  Studies to further develop and utilize experimental models to

study the effects of drugs of abuse on the pathogenesis of lentivirus



o  Studies of drugs of abuse and other factors contributing to

HIV-related malignancies and other diseases, e.g., the role of

nitrite inhalants and Kaposi's sarcoma.


o  Studies to investigate the role of drugs of abuse and related

endogenous substances and other biological and environmental factors

in modulating HIV-induced neuroAIDS.


o  Studies to identify and elucidate the role of drug abuse on immune

susceptibility and development and progression of AIDS-related

opportunistic infections, e.g., "smoking" drugs of abuse and

bacterial pneumonias.


o  Studies of the role of patterns of drug abuse in HIV/AIDS

progression among women, in perinatal transmission of HIV and the

effects on the fetal and neonate nervous system, immune system, and



o  Studies of the effects of drugs of abuse and drug treatment

medications on immune function, which may increase our knowledge of

the immune dysfunction characteristic of HIV infection.


o  Studies of the interactions between drugs of abuse, the immune

system, the hypothalamic-pituitary axis, and the central nervous



o  Basic and clinical research on neurobiologic, neurologic,

neuropsychological, and psychiatric consequences of drug abuse that

have relevance for understanding the natural history of

HIV/AIDS-related dementia in drug users.


o  Studies of unique receptor systems, e.g. opioid and cannabanoid,

of immune cells and subsequent induction of immune cell responses

including cytokine responses and other host factors.


o  Studies of structure-activity relationships of receptor ligands

that modulate immune function.




o  Research to test the feasibility of enhancing recruitment of HIV

infected drug users, their sexual partners, and infants into

HIV/AIDS-therapeutics clinical trials.


o  Research to improve health services provided to and long-term

therapeutic strategies designed for HIV-infected drug users, their

sexual partners, and children, including studies of:


a.  strategies to improve adherence with HIV medications;

b.  recruitment and retention of HIV-infected drug users into

HIV/AIDS treatment;

c.  delivery of linked medical and drug abuse treatment services

through drug abuse treatment programs and/or other health services

delivery programs;

d.  strategies to improve adherence with tuberculosis detection and



o  Research that investigates interactions between approved and

investigational medications for drug addiction and HIV





o  Research on behavioral and/or biomedical aspects of delivery of

HIV vaccine candidates to drug users.


o  Research to determine how drugs of abuse modulate immune responses

against HIV.


o  Research to recruit injection drug users and other drug users at

high risk of HIV infection into clinical trials of vaccines.


Behavioral and Social Science Research


o  Research to develop, evaluate, and disseminate prevention

strategies to reduce the incidence of HIV infection related to drugs

of abuse, i.e. sharing of contaminated needles/syringes, high risk

sexual behavior associated with drug use, perinatal transmission in

drug-abusing mothers. These include:


a.  the study of community-based behavioral and social intervention

strategies to reduce needle-sharing and high risk sexual behavior

among injection drug users, crack cocaine users, and their sexual



b.  the study of behavioral aspects of other prevention and

intervention strategies, such as compliance with barrier methods,

vaccine, and HIV therapeutics regimens.


c.  prevention strategies targeting youth or other groups at high

risk for initiating injecting drug use and/or initiating sexual risk

behaviors in association with drug use.


o  Studies of the determinants of risk behaviors known to transmit

HIV and of the principles of behavioral change necessary to reduce

the risk of HIV transmission among injecting drug users and their

sexual partners, and non-injecting drug users who engage in high risk

sexual behaviors associated with their drug use.


o  Studies of treatment interventions for drug dependence that meet

all of the following criteria:


a.  designed to determine the efficacy or effectiveness of

psychosocial and/or pharmacological treatment interventions for drug

dependence that have a high probability of leading to reductions in

HIV transmission; and


b.  the target population must be at high risk for HIV infection as a

result of either drug injecting or sexual behavior associated with

their drug use, or be HIV seropositive drug users where the

intervention is intended to prevent further spread; and


c.  drug injection practices and/or sexual AIDS risk behaviors must

be assessed as part of the research design; and


d.  HIV risk reduction counseling is either (1) provided to research

subjects during the course of the study, or (2) included as part of

the intervention under study and evaluated as part of the research



o  Studies of the impact of HIV/AIDS on the drug abuse treatment

delivery system and on provision of HIV/AIDS services within drug

treatment programs, including those provided under managed care.


o  Studies of the cost, cost-benefit, and cost-effectiveness of

interventions to reduce HIV risk behaviors and prevent the

transmission of HIV.


o  Studies of the organization and management of services for

HIV-positive drug abusers, including studies of the barriers to

service access and utilization and strategies for overcoming them.


o  Research to enhance the effectiveness of other HIV prevention

interventions, such as studies of the recruitment of injecting drug

users and high-risk non-injecting drug users into drug abuse



o  Research to improve the understanding of basic principles of

behavior, behavior change, maintenance of behavior change, and

relapse that have implications for the prevention of HIV transmission

that is drug-related.


Information Dissemination


o  Research on mass media and other education strategies focused on

AIDS and drug abuse.


o  Studies of education strategies for clinical professionals

involved in HIV risk reduction and/or drug abuse and HIV/AIDS



Research Mentoring and Career Development


o  Support for mentoring and career development opportunities

designed to attract and support scientists and clinicians entering

the HIV/AIDS field from every level of the career path, and to expand

NIDA's research workforce to better represent the cultural, genetic

and age diversity of  drug-abusing populations and others at risk for



International Research Collaboration


o  Research support for collaborative national and international

research with a focus on drug abuse-related links to HIV/AIDS.




Budget/Administrative Issues


For FY 1997, approximately $2,500,000 will be available for the

funding of both administrative and competing supplements to existing

NIH research projects.  Subject to the availability of funds, similar

amounts will be made available in future years.


Competing supplements are provided for expansion of a project's scope

or the research protocol.  These are treated as new applications for

purposes of the review requirements and competition for funds, and

are reviewed in accordance with NIH standard procedures, i.e., peer

review/council review.  Competing renewal supplement requests must be

submitted in accordance with standard receipt dates; AIDS-related

project dates are January 1, May 1, and September 1.


Administrative supplements are provided to cover unanticipated cost

increases that are associated with achieving the objectives within

the original scope of a project, and include cost increases that

result from making modifications in the scope of a project in order

to take advantage of opportunities that would increase the value of

the project consistent with its originally approved objectives and

purposes.  Administrative supplemental funding is generally limited

to 25 percent of the Council-approved direct costs of the project or

$100,000, whichever is less.  These applications undergo program,

grants management, and budget review within NIDA and may be submitted

for the remainder of FY 1997, but no later than August 1, 1997.


Neither administrative or competing supplements may exceed the stated

life of the parent project.  Neither supplement may represent changes

in the basic goals or intent of the project or may alter the scope of

the parent grant.  AIDS-related supplement requests to either

non-AIDS or AIDS-related grants will receive expedited review,

according to Section 301 of the Public Health Service Act, (42 USC





Inquires concerning this notice are encouraged.  The opportunity to

clarify any issue or questions from potential applicants are welcome.


Direct inquiries regarding programmatic issues to:


Steven W. Gust, Ph.D.

Office on AIDS

National Institute on Drug Abuse

5600 Fishers Lane

Rockville, MD  20857

Telephone:  (301)443-6480



Direct fiscal inquiries to:


Gary Fleming, J.D.

Grants Management Branch

National Institute on Drug Abuse

5600 Fishers Lane

Rockville, MD  20857

Telephone:  (301) 443-6710




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