NIDA IRP Clinical Core support of the NIDA IRP HIV Clinical Program

点击翻译按钮获取中文摘要

The NIDA IRP HIV portfolio includes projects geared towards 1) reducing the incidence of HIV; 2) better understanding the link between HIV and substance use disorders (SUD);and 3) addressing HIV-associated health disparities, comorbidities, coinfections, and complications. NIDA IRP HIV projects seeking to reduce the incidence of HIV and supported by the NIDA IRP OCD include HIV testing, counseling, and referral to treatment for research participation at the NIDA IRP. Another NIDA IRP HIV project supported by the NIDA IRP OCD is designed to reduce the incidence of HIV and address HIV-associated health disparities, comorbidities, coinfections, and complications. In one project conducted by the NIDA IRP OCD via the NIDA IRP HIV portfolio, 243 HIV+ participants were drawn from a sample of 300 people recruited to a cross-sectional study in Baltimore, Maryland. The main results show that neither home neighborhood characteristics nor impulsivity and sensation seeking were strongly associated with HIV-medication adherence. Possible associations between self-control and medication adherence may merit further study, for example by additional assessment of executive function. In another study, 300 adults (61% male; 85% HIV-positive) from Baltimore, MD were included in an analysis investigating the potential association with emotional regulation. The main conclusion was that people with greater difficulty with emotion regulation reported more HIV-risk behavior related to drug use but not sexual behavior, and this relationship was not impacted by their home neighborhood environment. More dynamic assessments of environmental influences (e.g., activity space) may reveal differences not captured by the home neighborhood. The research work summarized above was recently presented at the 2022 College on Problems of Drug Dependence (CPDD) meeting by NIDA IRP staff and trainees and related papers are in preparation. Dedicated clinical care and research support for these studies in the NIDA IRP HIV Portfolio is provided by the NIDA IRP OCD, which includes 5 nurses, 2 PAs, one physician, 1 counselor, and 1 study coordinator. Additionally, the NIDA OCD, through resources dedicated specifically to the NIDA IRP HIV Portfolio, supports all laboratory testing, radiology, consult, inpatient, and emergency care needs of all participants in NIDA IRP HIV Portfolio studies through a contract with Johns Hopkins. The NIDA IRP OCD provides human subjects protection and participant safety monitoring through human regulatory support, oversees the Data Safety and Monitoring Board (DSMB), the Intramural Research Program Auditing Committee (IRPAC), and assists clinical investigators with regulatory compliance support of the NIDA IRP HIV Portfolio. Through contracts with outside vendors, the NIDA IRP OCD facilitates the advertising, outreach, and compensation efforts needed to generate unique specific advertising and recruitment materials for all potential candidates for NIDA IRP HIV Portfolio projects. The NIDA IRP OCD also provides participant screening and support services for all HIV Portfolio study candidates. Furthermore, the NIDA IRP OCD has recently hired a full-time Outreach Coordinator whose role includes outreach community, with a special emphasis on underserved populations. Of note, these are communities at higher risk of HIV and HIV-related comorbidities and complications. Finally, the NIDA IRP OCD is in the process of hiring a full-time Data Scientist / Biostatistician, whose roles will include the development of IRB-approved secondary analyses related to the NIDA IRP HIV Portfolio that take full-advantage of the HIV-related data collected during the past 2 decades in the NIDA IRP. These new efforts will include exploratory and hypothesis-driven projects aimed at conducting cutting-edge work that will focus on the intersection between HIV risky behaviors, HIV infection, HIV-related comorbidities (e.g., HCV, liver diseases, etc.) and SUD.