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AIDS Research Volume 10, Number 3 May/June 1995

Institute of Medicine's (IOM) AIDS Research Recommendations

In a 360-page study mandated by Congress, the Institute of Medicine (IOM) makes 46 specific recommendations describing how NIDA and two other Federal agencies can broaden the scope of their AIDS-related behavioral studies. In the 1994 report, AIDS and Behavior: An Integrated Approach, the IOM commends NIDA on its record of AIDS research- multidisciplinary studies using various innovative combinations of pharmacologic, behavioral, and social approaches to improve the effectiveness of addiction treatment and outreach strategies for out-of-treatment addicts. The IOM recommended that the three Institutes- NIDA, the National Institute of Mental Health, and the National Institute on Alcohol Abuse and Alcoholism- intensify and coordinate their research into behaviors that contribute to the transmission of HIV, the virus that causes AIDS.

The IOM, with a membership of distinguished physicians and medical researchers, is a branch of the National Academy of Sciences, which advises Congress on health policy issues. Among the IOM's AIDS research recommendations are the following:

• Collaborate to sponsor and conduct a nationwide survey of the prevalence of HIV infection and the behavioral and other factors associated with its spread.

• Conduct studies of the social, psychological, and biological factors that affect HIV risk-taking behaviors.

• Continue to develop studies of high-risk settings for drug abuse, such as shooting galleries and crack houses, that may contribute to the spread of HIV and AIDS, and help implement prevention efforts in those settings.

• Expand basic research into the biology of sexuality as it relates to high-risk sexual behaviors and include studies of how the central nervous system controls sexual behavior.

• Support research into changes in AIDS risk behaviors among seriously mentally ill men and women and those with other cognitive impairments, including individuals not in psychiatric treatment.

• Continue supporting basic and applied research into the maintenance of behavior change, including how to prevent patients undergoing treatment for alcohol and drug abuse from relapsing.

• Expand basic research into the biology of substance abuse, including the function of dopamine systems, the mechanisms and components of addiction-euphoria, tolerance, sensitization, and withdrawal-and the role of opioid receptors in drug addiction and abuse.

• Design research to estimate the number of HIV infections averted by prevention efforts and the resulting savings in health care costs.

• Develop new funding programs and grant review procedures to encourage innovative, collaborative, and cross-disciplinary research proposals.

• Develop new initiatives to support research on the role of social, cultural, and structural factors in HIV and AIDS transmission, prevention, and intervention.

• Expand studies in the following behavioral and social science research areas: behavioral epidemiology research, cognitive science, cultural and ethnographic projects, intervention research, mental health research, behavioral aspects of technological interventions, organizational studies, cost-effectiveness research, and evaluation research.

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