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Research

Research Overview

Over the past several decades, researchers have learned a lot about the human immunodeficiency virus (HIV) and the disease it causes, acquired immunodeficiency syndrome (AIDS).  But still more research is needed to help the millions of people whose health continues to be threatened by the global HIV/AIDS pandemic. Researchers, many supported by the National Institutes of Health (NIH) and other U.S. government agencies, are working to better understand HIV and how it causes disease; find new tools to prevent HIV infection, including a vaccine; develop new and more effective treatments for people infected with HIV; and, hopefully, find a cure. These research findings will continue to play a critical role in providing the scientific foundation to achieve the goals of the National HIV/AIDS Strategy.

In Fiscal Year 2011, the U.S. government spent approximately $2.7 billion on HIV/AIDS research. This represented approximately 10 percent of the total Federal investment in HIV/AIDS prevention, care, and treatment, including funds for global HIV/AIDS activities.

Within the U.S. government, responsibility for HIV research primarily rests with NIH and is carried out in laboratories and clinics on the NIH campus in Bethesda, Maryland, and through a vast network of supported research at universities, medical centers, and clinical trial sites around the globe. However, the Centers for Disease Control and Prevention (CDC), Department of Defense, Department of Veterans Affairs (VA), Department of Health and Human Services’ Health Resources and Services Administration, and U.S. Agency for International Development (USAID) also support important HIV/AIDS research initiatives. Read more about Federal agencies engaged in HIV/AIDS research activities. Read recent AIDS.gov blog posts about HIV/AIDS research.

Research activities at NIH and elsewhere span a variety of topics, described below.

Basic Science Research

A foundation of all HIV/AIDS research is scientific inquiry into the basic biology of HIV, the body’s immune response to HIV infection, and potential targets for prevention and therapeutic strategies. Such research explores how HIV infects individual cells and causes disease and helps identify new opportunities to either stop the virus or enhance the immune system response to infection. Read more about NIH’s Basic HIV Science Research.

Prevention Research

Researchers are looking at many different ways to prevent the spread of HIV. This includes:

• Microbicides—Scientists are investigating and testing chemical barriers, such as microbicides—gels, foams, or creams—that people can use in the vagina or in the rectum during sex to prevent HIV transmission. Currently, women make up half of all people worldwide living with HIV. Many women are not in a position to refuse sex or negotiate condom use with their male partners, leaving them vulnerable to HIV infection. To provide women with an HIV prevention tool they can initiate, researchers are testing microbicides that can be applied inside the vagina to prevent sexual transmission of HIV and other sexually transmitted infections. Scientists are also researching microbicides that can be applied rectally to prevent HIV infection among men who have sex with men. Read about the Microbicide Trials Network.
• Vaccines—Currently, there is no vaccine available to prevent HIV infection.  Scientific advances in defining how the human immune system may protect itself against HIV are evolving and leading to a pipeline of promising new candidate vaccines, intensifying the hope for an effective vaccine. HIV vaccines represent the best long-term hope for ending the HIV pandemic and HIV vaccine research is a top priority for NIH and its partners around the world. Read about the HIV Vaccine Trials Network.

• Pre-exposure prophylaxis (PrEP)—Another significant area of HIV prevention research is examining whether providing a daily dose of antiretroviral medicines to people who are not infected with HIV but who are at high risk of becoming infected can prevent HIV infection. This strategy—known as pre-exposure prophylaxis (PrEP)—is based on the concept that blocking HIV’s ability to multiply once someone is exposed to the virus may prevent the infection from taking hold.

Other key areas of prevention research are ways to prevent HIV transmission from mother to child and intervention strategies for injection and non-injection drug users to reduce the risk of HIV.  Read more about NIH’s HIV prevention research. Read about CDC’s HIV prevention research.

Research on the Next Generation of HIV/AIDS Treatments

One of NIH’s greatest success stories is that its research led to the development of numerous antiretroviral drugs to treat HIV/AIDS, turning what was once a uniformly fatal disease into a manageable chronic condition for many. Currently, there are 31 Food and Drug Administration-approved antiretroviral drugs available to people infected with HIV. Although these medications have enabled people infected with HIV to lead longer and healthier lives, drug resistance, tolerability, and toxicity remain issues for some patients. The National Institute of Allergy and Infectious Diseases (NIAID) is working to find new and more effective therapeutic products, drug classes, and combinations, as well as safe and effective treatments for dangerous AIDS-related co-infections, such as hepatitis, malaria, and tuberculosis. Read more about NIH’s HIV drug research.

Research on HIV Complications, Side Effects, and Co-infections

While people living with HIV who are receiving long-term antiretroviral therapy are living longer managing HIV as a chronic condition, some are experiencing treatment failure, drug toxicities, side effects, and drug resistance. Therefore, another area of important research is investigating health complications associated with long-term HIV disease or antiretroviral therapy including malignancies, cardiovascular and metabolic complications, and premature aging.

Research on Behavioral Interventions

HIV prevention is not a one-size-fits-all approach. To be successful, one must understand and address the sociocultural factors that contribute to HIV risk or protection among various communities. Researchers are developing and testing behavioral interventions focused on men, women, and adolescents at high risk for HIV infection as well as interventions geared toward people infected with HIV to reduce their risk of transmitting HIV to others. The strategies under investigation are multifaceted and include HIV counseling, testing for HIV and other sexually transmitted diseases, substance abuse and mental health screenings, and referral for medical treatment and care. Other studies are examining factors that support adherence to HIV treatment.

Health Disparities Research

HIV-related health disparities, their role in disease transmission and acquisition, and their impact on treatment access and effectiveness are another important area of research. This includes research on disparities among racial and ethnic populations in the United States; disparities between developed and resource-constrained nations; and disparities based on gender, age, or sexual identity.

Last revised: 01/30/2012