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Highlights: June 2024 NIH Office of AIDS Research Advisory Council Meeting

The 66th meeting of the NIH Office of AIDS Research Advisory Council (OARAC), broadcast via NIH VideoCast, featured updates on the Fiscal Year (FY) 2026 NIH HIV/AIDS Professional Judgment Budget and the new NIH Strategic Plan for HIV and HIV-Related Research; a presentation from Mr. Francisco Ruiz, M.S., new Director of the White House Office of National AIDS Policy (ONAP); and updates in perinatal HIV research and responses, including a community perspective.

OARAC provides advice to the NIH Office of AIDS Research (OAR) on the planning, coordination, and evaluation of research and other HIV/AIDS activities conducted or supported by NIH.

Report From the OAR Acting Director

OAR Acting Director Diana Finzi, Ph.D., provided updates on the FY26 Professional Judgment Budget, which will be released in the coming weeks and will be structured to align with the goals of the next NIH Strategic Plan for HIV and HIV-Related Research. Dr. Finzi provided updates on new NIH leadership changes relevant to the HIV research program: Kathleen Neuzil, M.D., as Director of the NIH Fogarty International Center and NIH Associate Director for International Research, and Shelli Avenevoli, Ph.D., as Acting Director of the National Institute of Mental Health (NIMH). She also recognized Mr. Ruiz, who spoke later in the meeting, as the new ONAP Director.  

Dr. Finzi provided updates on several OAR engagements:

Upcoming engagements:

Recent engagements:

Dr. Finzi ended her remarks by welcoming presentations on perinatal HIV from guest speakers and highlighting the continued need for research to prevent perinatal HIV transmission.  

FY26-30 NIH Strategic Plan for HIV and HIV-Related Research

OAR Senior Policy Advisor Rachel Anderson, Ph.D., updated OARAC on the development of the FY26-30 NIH Strategic Plan for HIV and HIV-Related Research, which is expected to launch during the summer of 2025.

As part of the process to develop the new plan, OAR issued a request for information (RFI) earlier in 2024 to gather input on HIV research priorities from interested constituents. Dr. Anderson discussed how the responses, in addition to other sources of information, will inform the new plan, along with next steps.

A New Framework and Corresponding Objectives

The new plan proposes a framework of three broad research goals and one capacity goal with corresponding objectives. These four strategic goals were presented at the February 2024 OARAC meeting. Dr. Anderson outlined the corresponding objectives for each goal.

  • Goal 1: Enhance discovery and advance HIV science through fundamental research.
    Objectives: 
    • HIV biology, virology, immunology, and pathogenesis
    • Pathogenesis of HIV-associated comorbidities, coinfections, and complications
    • Epidemiologic aspects of HIV infection, coinfections, and comorbidities
    • Behavioral and social factors and processes
  • Goal 2: Advance the development and assessment of novel interventions for HIV prevention, treatment, and cure.
    Objectives: 
    • Preclinical and translational research
    • Clinical trials and other intervention studies of promising HIV prevention, treatment, comorbidities, and cure strategies
    • New and integrated models of HIV prevention, treatment, care, comorbidities, and cure research and services
  • Goal 3: Optimize public health impact of HIV discoveries through translation, dissemination, and implementation of research findings.
    Objectives:
    • Implementation science and translational research
    • Community-engaged and community-led HIV research
    • Dissemination and communication of HIV science
  • Goal 4: Build research workforce and infrastructure capacity to enhance sustainability of HIV scientific discovery.
    Objectives:
    • Workforce capacity strengthening
    • Research infrastructure and capacity
    • Methods and technologies

Next Steps

As the next step in the process, three OAR task forces will be formed in the summer of 2024. These task forces will review the framework, objectives, and proposed funding priorities from all sources of input. Each task force will include OARAC members, as well as other external subject matter experts reflecting a broad range of expertise in HIV science, clinical experience, and lived experience with HIV. The task forces will be charged with developing recommendations that will be shared at the next OARAC meeting in October.

ONAP Vision

Mr. Ruiz, who was named ONAP Director in April 2024, discussed how ONAP’s values—equity, accountability, innovation, inclusivity, accessibility, adaptability, and collaboration—serve as a platform and direction for the office’s efforts to implement the National HIV/AIDS Strategy for the United States 2022-2025. According to newly released Centers for Disease Control and Prevention (CDC) HIV surveillance report for 2018-2022, there was an overall 12 percent decline in new HIV infections in the United States from 2018-2022; Mr. Ruiz noted that these findings indicate that prevention strategies are working. However, he explained that disparities continue based on race and ethnicity and sex, with 37 percent of new HIV infections in Black/African American people and 81 percent in people assigned male at birth in 2022. Data also show significant geographic disparities, with 49 percent of new infections occurring in the South in 2022. Mr. Ruiz explained how ONAP demonstrates values by ensuring equitable access to HIV services, with outreach to groups experiencing higher rates of HIV or adapting HIV prevention programs for rural areas in the South, for example.

Mr. Ruiz continued by highlighting ONAP’s 2024 priorities—to center science, or modernize policies to ensure they are based on current scientific knowledge; to accelerate progress in the federal HIV response; and to advance equity and access. Mr. Ruiz ended his remarks with a call to action, encouraging OARAC members and meeting attendees to recommit to efforts to end the HIV epidemic.

Issues in Perinatal HIV Transmission and Response

Mauricio Martins, Ph.D., Associate Professor, The Herbert Wertheim University of Florida Scripps Institute for Biomedical Innovation and Technology, presented basic and translational research on the use of immunoglobulin-based HIV biologics to prevent perinatal transmission. Ms. Kimberly Canady, a public health educator and consultant, who was born with HIV in the 1980s provided a community perspective. Both presentations generated robust, insightful discussion among attendees.

According to Dr. Martins, 90 percent of pediatric HIV cases are acquired perinatally, most often during breastfeeding/chestfeeding,1 making the time from birth until a child weans critical to prevent pediatric HIV. Although antiretroviral therapy (ART) is effective in preventing perinatal transmission, issues such as undiagnosed HIV in pregnant people, drug toxicity and resistance, poor adherence, and stigma make it unlikely that oral ART interventions alone will stop perinatal transmission.

As a potential solution, Martins’ research team is investigating delivery of HIV broadly neutralizing antibodies (bNAbs) to prevent HIV transmission in infants and children. Martins’ research hypothesized that bNAb inoculation at birth through adeno-associated virus (AAV) vectors could theoretically provide HIV immunity throughout infancy, preventing perinatal transmission via breastfeeding. In nonhuman primate models with HIV, Martins’ research showed a substantial delay in virus rebound with early ART initiation in addition to delivery of HIV bNAbs. With continued research, Martins suggested that delivery of HIV bNAbs could be key to sustained virologic remission in children with HIV.

Ms. Canady provided her perspective as a long-term survivor who was born with HIV in 1986. Ms. Canady described her experience as a child and adolescent in the early stages of the HIV epidemic before availability of ART. She noted that there are currently 13,000 people in the United States with perinatally acquired HIV. As the first people born with HIV are now in their 30s and 40s, Ms. Canady noted this population will continue to age and experience HIV- and age-related complications. She called on OARAC members and meeting attendees to prioritize research to address the medical, mental health, and social needs of long-term survivors with HIV.

Updates and Next Meeting

The meeting closed with updates from:

The full meeting is available on NIH VideoCast, and meeting minutes will be posted on the OAR website.

The next OARAC meeting is scheduled for October 24, 2024. An agenda and additional details will be available on the OAR website. OARAC welcomes public comments via email to OARACinfo@nih.gov.

1 Note: The term “breastfeeding” is used to describe feeding a child one’s own milk (either direct feeding or with expressed milk). When counseling individuals with HIV about infant feeding, it is important to assess and use their preferred terminology; some transgender men and gender diverse individuals may prefer using the term “chestfeeding” rather than “breastfeeding.” We urge providers to consult community-based resources for more information about inclusive, affirming language around gender in health care settings.

This page last reviewed on July 11, 2024