Letter from the Director

We have accomplished stunning successes in the prevention and treatment of HIV in less than 40 years, transforming this once fatal disease into a manageable chronic condition. Groundbreaking advances have deepened our understanding of basic virology, human immunology, and HIV pathogenesis, while other studies have identified individual, interpersonal, social, and structural drivers of transmission and medication adherence. From these findings, we have developed an impressive HIV toolbox replete with effective biomedical and behavioral strategies to prevent acquisition and transmission, achieve viral suppression, and facilitate long healthy lives for people with HIV.

But the recent resurgence of syphilis and other sexually transmitted infections underscores the tenuousness of our gains, and not all populations have benefitted equally from these successes. Individual, interpersonal, organizational, and structural factors impact whether effective strategies will reach the populations most in need; be feasible, acceptable, and appropriate for the context, culture, and setting; and be implemented with fidelity, disseminated broadly, and sustained over time. HIV comorbidities (e.g., mental health distress, substance use, and intimate partner violence) also remain significant barriers to access, reach, and adoption of effective interventions, continuing to drive incident infections, poor antiretroviral therapy (ART) adherence, and low uptake and persistence of pre-exposure prophylaxis (PrEP).

We are at a pivotal moment in the epidemic. Without continued investments, we risk losing the gains we fought so hard to achieve. And yet, we need new strategies to ensure all populations benefit equally from lifesaving interventions. Only by working in partnership with community members can we strengthen access to effective biomedical and behavioral interventions. And, while basic science and clinical trials are essential to discover more efficient interventions with fewer side effects and less burdensome regimens, maybe even a cure, growing the foundation of implementation science research in HIV is vital to achieve health equity, which in turn is essential for epidemic control.

I am honored as the new Director of OAR to join the many dedicated scientists, advocates, community members, and others who are working together to reach the UNAIDS 95-95-95 targets—in which 95 percent of people with HIV know their status, 95 percent of people who know their status are receiving HIV treatment, and 95 percent of people receiving treatment are virally suppressed—and ensure the health and well-being of people with, or affected by, HIV.

With sincere appreciation,

Geri R. Donenberg, Ph.D.
Associate Director for AIDS Research and
Director, Office of AIDS Research
National Institutes of Health

Director's Biography