Enhancing Support for the Next Generation of HIV Researchers

Over the past 40 years, substantial progress has been made in preventing and treating HIV and AIDS; however, the pandemic is far from over. 

Approximately 38 million people globally have HIV, and in 2020 approximately 1.5 million people became newly infected.¹ In the United States, an estimated 1.2 million people have HIV, and in 2019 approximately 34,800 people became newly infected.²

Moreover, HIV prevalence and incidence are not distributed equally around the world and within the United States. Disparities in transmission risk, health outcomes, and death exist by race, ethnicity, sex, gender, age, and region and reflect ongoing structural inequalities in access to HIV research and its outputs.

To reach the goals of the Ending the HIV Epidemic in the U.S. (EHE) initiative, the science community must remedy disparities and further advance scientific discovery and its application in equitable and effective ways, that include focused efforts to enhance the pipeline, diversity, and sustainability of the HIV research workforce. OAR is committed to these efforts, as stated in Goal 4 of the NIH Strategic Plan for HIV and HIV-Related Research: to “build human resource and infrastructure capacity to enhance sustainability of HIV research discovery and the implementation of findings by a diverse and multidisciplinary workforce.” As a key element of this commitment, OAR is developing and implementing a multipronged initiative to increase the cadre of early career, next-generation HIV investigators—including NIH-defined Early Stage Investigators (ESIs) and Early Established Investigators—across disciplines and institutions.  

As a first step, OAR conducted a portfolio analysis for fiscal years (FYs) 2015–2020 which found that, although the number of ESIs receiving their first grants at the NIH overall has increased since the inception of the NIH Next Generation Researchers Initiative policy in 2017, the number of HIV-focused ESIs receiving grants remained flat or decreased over this time frame. These data prompted OAR to take immediate action to identify the variables and determinants that contribute to a decline even in the presence of policies aimed to support early career investigators.

In early 2021, OAR convened a series of four virtual listening sessions with HIV research early career investigators to hear directly from them about the challenges and opportunities they face. Three sessions involved investigators who had received R01-equivalent funding in FYs 2018, 2019, or 2020, respectively; and one involved investigators who had not successfully competed for R01-equivalent NIH funding despite submitting multiple applications in FYs 2017, 2018, or 2019. Each session included between 10 and 21 early career investigators from diverse institutions and a small number of staff from OAR and NIH.

Key themes that arose during these sessions included—

• A need for greater diversity in mentors and for mentoring specifically about grant writing and peer review processes.
• Interest in more exposure to and earlier involvement in NIH study section and grant review processes.
• The need for greater flexibility (e.g., protected time and budget) in NIH funding mechanisms and research career pathways.
• The benefits of being connected to NIH research networks, such as the Centers for AIDS Research and HIV Prevention Trials Network.  
• The desire to have an NIH-supported network of peers from different institutions who could compare notes, share information, and support each other.
• The need for leaders in the field of HIV research and academia to acknowledge and address the wide range of adverse effects of the COVID-19 pandemic on research careers. 

Following these listening sessions, OAR convened an Expert Panel consultation involving 19 senior HIV investigators and experienced mentors from a variety of academic institutions. The framework for the Expert Panel discussion was based on a set of questions derived from the feedback received during the early career investigator sessions. The questions addressed obstacles to ensuring a robust pool of early career investigators in HIV research; examples of existing efforts and successful programs; and opportunities to enhance support for and engagement of diverse early career investigators in HIV research careers. 

The Expert Panel made a number of suggestions that are similar to the comments from the early career investigators, such as—

• Modify policies related to specific funding mechanisms—such as the R- and K-series—to allow greater flexibility in mentoring and time allocation.
• Update NIH practices related to peer review of applications from early career investigators, such as dedicated study sections.
• Develop funding strategies to engage early career investigators from underrepresented minority populations and under-resourced institutions.
• Enhance support for and replication of successful training programs for early career investigators.

Based on the input from these sessions, OAR is working with the NIH Institutes, Centers, and Offices to implement a number of actions to develop and support HIV-focused early career investigator initiatives; identify meritorious but unfunded HIV research applications from early career investigators; continue engagement with early career investigators and mentor stakeholders; focus on inclusion of underrepresented minority groups and under-resourced institutions; and host a symposium to bring together HIV-focused early career and senior investigators and OAR and NIH program officials.  

On June 5, the NIH joined colleagues around the world to commemorate the 40th anniversary of the landmark CDC Morbidity and Mortality Weekly Report (MMWR) that first recognized the syndrome of diseases later named AIDS. Now is the time to recommit to end the HIV epidemic and support the early career investigators who will be instrumental to achieving that goal.

I look forward to working with all stakeholders to ensure that the NIH enhances its development and support of a robust, diverse, and inclusive HIV research workforce in the coming years.

OAR is in the process of developing a new webpage to support a diverse next generation of HIV investigators and will launch the page soon. To learn more, and see that content, I encourage you to visit the OAR website for updates.  

Maureen M. Goodenow, Ph.D.
Associate Director for AIDS Research and
Director, Office of AIDS Research
National Institutes of Health

¹ UNAIDS Fact Sheet 2021, https://www.unaids.org/en/resources/documents/2021/UNAIDS_FactSheet
² HIV.gov Statistics, https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics

Read last month’s blog.