Catalyzing Interdisciplinary Research on HIV-Associated Co-occurring Conditions

For this topic, OAR is interested in facilitating interdisciplinary research including implementation science to advance the understanding of the common factors underlying HIV-associated co-occurring conditions, supporting early prevention, integrated whole-person care, improved health and quality of life for people living with or impacted by HIV across the lifespan.

NCCIH supports research on complementary and integrative health (CIH) approaches for symptom management in people living with HIV/AIDS. HIV/AIDS is a chronic, multisystem condition with complex symptoms (e.g., pain, fatigue, neurocognitive and mental health challenges) well suited for Whole Person Health approaches.

Priorities include:

• Testing CIH interventions (e.g., mind–body, natural products) to address symptom clusters and improve function and quality of life.
• Elucidating biological, behavioral, and psychosocial mechanisms (e.g., inflammation, neuroimmune, stress) and identifying biomarkers and patient characteristics.
• Integrating CIH into HIV care through pragmatic and hybrid effectiveness-implementation studies and scalable delivery models.
• Evaluating risks (e.g., drug–herb interactions), synthesizing evidence, and developing guidance for informed decision-making.

NCI is interested in advancing understanding of the risks, development, progression, prevention, diagnosis, and treatment of cancer in people with HIV (PWH) and in the testing and implementation of bundled cancer/HIV interventions for PWH. Cancer is a leading cause of morbidity and mortality in PWH. PWH have increased incidence of certain cancers, are diagnosed earlier and with higher stage disease; have worse overall and cancer-specific survival; and are less likely to receive cancer treatment than those without HIV. Example topics include:

• Studies to characterize contributions of HIV infection on the development and pathogenesis of HIV-related tumors.
• Studies to discover and develop new biomarkers, diagnostics and therapeutics to improve prevention, diagnosis, treatment, and outcomes in PWH. 
• Studies to identify factors that influence cancer disparities for PWH, including studies to improve adoption, implementation and sustainment of effective interventions for HIV and cancer. 

NHLBI is interested in mechanisms and pathways that contribute to HIV-associated heart, lung, blood and sleep (HLBS) comorbidities and interventions that improve care, including research to evaluate implementation of such interventions. Priorities include:

• Combined effects of aging, HIV, and ART on associated HLBS conditions
• Aging- and HIV-related changes in hematopoiesis, including changes in hematopoietic stem cells and their niche
• Impact of sleep deficiency and sleep-disordered breathing on the pathogenesis of HIV-associated cardiopulmonary and cardiometabolic diseases
• Vascular contribution to cognitive impairment and dementia
• Implementation strategies that improve uptake and sustainability of HLBS evidence-based interventions
• Mechanistic studies to reduce the effects of HIV and aging on HLBS comorbidities, including traditional risk factors and sex differences
• Novel methods to detect subclinical HIV-related HLBS conditions and strategies to mitigate clinical disease

NIA is interested in supporting projects that advance understanding of and address HIV-associated co-occurring conditions in midlife and older age through basic and intervention research spanning the NIH Stage Model from basic science (Stage 0) and intervention development and refinement (Stage 1) through implementation (Stage V). Areas of interest include, but are not limited to:

• Understanding the etiologies and pathogenesis of these conditions, including the roles of chronic immune activation and antiretroviral and other drug toxic effects;
• Optimizing medications and care-coordination, and behavioral and social interventions to improve health outcomes, function, and quality of life; and
• Developing, testing, implementing, and scaling evidence-based interventions that address poor outcomes.

Heavy alcohol use, including Alcohol Use Disorders, has complex interactions with both behavioral risk and organ pathophysiology among People Living with HIV. It is also an additional risk factor for exacerbation of co-occurring complications across the lifespan. It accelerates physiological and physical vulnerability, impacts medication adherence including toxicities, and complicates care for people with HIV. Research should improve: 

•  Understanding the pathophysiology of alcohol associated comorbidities,
•  Development of biomedical/behavioral approaches to restore alcohol-induced organ dysfunction and 
• Implementation of interventions to address alcohol, and associated mental health, substance use, comorbidities, coinfections, and complications in vulnerable populations to improve quality of living and prolong life. 

Complications include but are not limited to: 

• Cardiovascular disease
• Metabolic disorders
• Neurocognitive impairment
• Cellular and immune dysfunction 

NIAID is interested in research on coinfections impacting people with HIV (PWH) across the lifespan (infant through adult) . Multidisciplinary applications are encouraged that address the impact of stigma and other intersecting behavioral/biological/health system factors on the diagnosis, prevention and treatment of coinfections affecting PWH including:

• tuberculosis 
• viral hepatitis
• sexually transmitted infections

NIAMS seeks research on HIV-associated co-morbidities that impact the musculoskeletal system, skin, and systemic rheumatic diseases. NIAMS encourages studies that investigate how HIV infection, antiretroviral therapy, and host or viral factors contribute to the early onset, acceleration, or worsening of NIAMS-relevant comorbidities. These may include musculoskeletal pain; muscle diseases such as sarcopenia and cachexia; cartilage degeneration and osteoarthritis; osteoporosis, osteopenia, and fractures; arthritis and other rheumatic diseases; and dermatologic manifestations). NIAMS supports basic, translational, and clinical research to characterize the burden, trajectory, and risk of these conditions across the lifespan of people living with HIV. Priority is given to implementation science projects that develop, test, and scale multidisciplinary, whole-person care models that integrate musculoskeletal, rheumatic, and skin health into HIV prevention and treatment settings.

NIDA seeks interdisciplinary research on how drug use, addiction, and HIV interact to affect health and quality of life across the lifespan. Examples are: 
•Applications examining how HIV, antiretroviral therapy (ART), and polysubstance use affect brain function, behavior, mood, sleep, pain, and cognition
• Investigations on molecular, neurochemical, cellular, and circuit functions underpinning HIV and co-occurring substance use disorders (SUDs) 
• Studies on shared pathways linking substance use, HIV, stress, trauma, and mental health conditions
• Research on individual and community factors affecting HIV prevention, care engagement, and ART adherence, with focus on improving access to services in underserved populations 

• Integrated interventions addressing HIV, SUD, HCV, and co-occurring mental health conditions
• Basic, clinical, and translational research on treatment of SUD and overdose in people with HIV

NIDCR supports interdisciplinary research to advance approaches for addressing shared risk factors influencing the onset and progression of HIV-associated comorbidities in the oral and craniofacial complex across the lifespan. Areas of interest include but are not limited to:

• Elucidate mechanisms of HIV-related oral disease, including immune dysregulation, inflammation, and ART effects
• Identify biological, behavioral, and contextual risk factors linking oral and systemic comorbidities and co-infections (e.g , human pPapillomavirus -associated cancer, metabolic and inflammatory diseases)
• Develop and test interdisciplinary preventive, diagnostic, and treatment approaches, including probiotics, mucosal immunity modifiers, early cancer detection and management of oral and salivary gland complications 
• Integrate oral health into the multidisciplinary HIV care continuum to improve access to and outcomes of whole person HIV health care

NIDDK supports research across basic, clinical, and implementation science domains, including person-oriented co-morbidity research, to examine the impact of HIV on organs, tissues, and biological systems. Priorities include:

• basic, clinical, and implementation research in:
  • enteropathy and gastrointestinal homeostasis; 
  • liver diseases and viral hepatitis co-infections;
  • digestive diseases, nutrition, obesity, diabetes, and related complications; 
  • kidney, urologic, and hematologic diseases that may present differently or follow altered clinical courses in the context of HIV; and
• clinical research to:
  •  improve implementation and delivery of evidence-based care; and 
  • develop strategies to improve HIV diagnosis and progression.

Studies addressing social, behavioral, and environmental factors influencing HIV and comorbidities within diabetes, digestive diseases, and kidney diseases are of high priority, particularly regarding impacts on disease severity and treatment adherence.

NIMH is interested in research on:

• Interdisciplinary biological and behavioral approaches to understand adverse neuropsychiatric mechanisms underlying Central Nervous System comorbidities in people with HIV across the lifespan.
• How HIV biology, treatment exposures, and psychosocial burden converge on shared pathways driving neurocognitive and mental health disorders to inform early intervention and scalable whole-person care models.
• Multidisciplinary implementation research identifying barriers to neurocognitive and/or mental health diagnosis and treatment in people with HIV, with an emphasis on community engagement and sustainable care delivery.

 For this topic, ODP is particularly interested in innovative prevention research that uses rigorous study design, measurement, and analysis methods to test interventions, implementation strategies, and multidisciplinary care approaches to prevent co-occurring conditions in people with HIV across the lifespan.

The Office of Research on Women's Health (ORWH) is interested in research projects that address HIV-associated co-occurring conditions in women.