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Challenges in HIV/AIDS Research |
Director's Perspective
Vol. 20, No. 6 (July 2006) |
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By NIDA Director Nora D. Volkow, M.D. The HIV/AIDS epidemic has always been a moving target for health and prevention planners, with infection rates rising in some population groups as they level off or fall in others. Recently, the disease has spread most rapidly among women, minorities, lower income groups, and young men who have sex with men (MSM). Of particular concern to NIDA are the heavy burden of HIV among African-Americans and the growing importance of heterosexual activity associated with drug use as a source of viral transmission. To elucidate the current dynamics, NIDA has developed two new initiatives: Health Disparities in HIV/AIDS: Focus on African Americans (PA-06-069) and Non-injection Drug Abuse and HIV/AIDS (PAS-06-054). AFRICAN-AMERICANS: HIGHER PREVALENCE, WORSE PROGNOSISPeople from all racial and cultural backgrounds contract HIV/AIDS, but in the United States, African-Americans carry a disproportionate burden of the disease. Although they make up only 12 percent of the U.S. population, African-Americans accounted for half of the new AIDS cases diagnosed in 2003. Of persons diagnosed with AIDS since 1995, a smaller percentage of African-Americans (60 percent) than Whites (70 percent) were alive 9 years after diagnosis. NIDA-supported investigators have identified some contributing factors:
NIDA's African-American initiative will support research to further illuminate the causes of the HIV disparities affecting African-Americans, as well as research on:
NONINJECTION DRUG USE AND HIV/AIDSSince the early years of the epidemic, NIDA-supported research contributed to a decline in the proportion of HIV/AIDS cases attributable to injection drug use. Now, NIDA is also focusing attention on ways that noninjection drug use—more prevalent by far—may contribute to new HIV infections. We know that drug abuse affects judgment and may lead to high-risk sexual encounters that increase transmission rates. There also is evidence that, regardless of the route of exposure, drugs have immunological effects that may increase the risk of HIV transmission and disease sequelae. To further advance scientific understanding of the relationships, we support studies that help explain how, where, why, and among whom HIV/AIDS is spreading through noninjection drug use and associated high-risk sexual behavior; and studies that develop effective prevention and treatment interventions.
Volume 20, Number 6 (July 2006) |
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