Fiscal Year 2024 NIH HIV/AIDS Professional Judgment Budget: Advancing Science and Enhancing Partnerships

Cross-posted from NIH Office of AIDS Research Director’s Blog

The NIH Office of AIDS Research (OAR) was established 35 years ago to catalyze, convene, coordinate, and communicate HIV/AIDS research across NIH, the U.S. Department of Health and Human Services (HHS), other government agencies, academia, and the community.

While domestic and international HIV/AIDS initiatives saved millions of lives, these advances did not reach all who could take advantage of HIV diagnoses, prevention, and treatment.

In 2020, an estimated 1.1 million people were living with HIV in the United States and six dependent areas, 30,635 were diagnosed with new HIV infection, and 18,400 with HIV died (due to any cause). Stigma and barriers to accessing HIV prevention and treatment services persist and contribute to continuing high HIV prevalence among Black/African American and Hispanic/Latino populations, especially men who have sex with men (MSM).^1,2 In addition, access to HIV-related health services is limited by socioeconomic status and geographic location, worsening the HIV burden in certain U.S. states and territories.³

There are concerns that the world’s financial commitment to address HIV/AIDS may be waning, particularly at a time when public health attention has been focused on responding to the COVID-19 pandemic. Allowing the HIV/AIDS pandemic to rebound would be catastrophic, not only for the communities affected by HIV, but also for the state of global health in the 21st century.⁴

Each year, OAR is legislatively mandated to develop the NIH HIV/AIDS Professional Judgment Budget, which highlights accomplishments in HIV/AIDS research during the prior year and estimates the amount of additional funds needed to advance progress in priority areas of science, as outlined in the FY 2021–2025 NIH Strategic Plan for HIV and HIV-Related Research.⁵ The FY 2024 NIH HIV/AIDS Professional Judgment Budget requests $3.673 billion, an increase of $479 million, or 15 percent, over the FY 2022 enacted budget of $3.194 billion for NIH HIV/AIDS research.

NIH-funded HIV/AIDS research has produced remarkable scientific discoveries, clinical advances, innovative programmatic approaches, and cross-disciplinary outcomes. Additional resources requested in the FY 2024 NIH HIV/AIDS Professional Judgment Budget are essential to capitalize on those advances and stimulate further innovation in the following areas, with several highlighted scientific opportunities:

Expand basic biomedical and behavioral research:

• Evaluate novel HIV vaccine candidates utilizing mRNA and self-amplifying RNA (saRNA) delivery technologies.
• Assess antibody-mediated approaches for HIV prevention.
• Elucidate barriers to curing HIV at the molecular, cellular, and tissue levels.
• Accelerate the development of therapeutics to target viral reservoirs.
• Increase the uptake of long-acting pre-exposure prophylaxis (PrEP).

Understand the biological, behavioral, and social conditions associated with effects of HIV across the lifespan:

• Launch and expand studies on the biological and psychosocial consequences of chronic HIV-associated coinfections and comorbidities.
• Implement new methods and technologies to improve HIV prevention and treatment.
• Promote community and clinical implementation strategies that integrate evidence-based interventions.
• Develop culturally appropriate public health communications to combat misinformation and disinformation.

Strengthen the capacity and diversity of the HIV/AIDS research workforce:

• Expand the pool of diverse early career HIV/AIDS investigators.
• Improve and upgrade infrastructure and equipment at institutions conducting HIV/AIDS research, particularly those with limited resources.

This FY 2024 NIH HIV/AIDS Professional Judgment Budget outlines the level of support needed to accelerate critical, high priority HIV/AIDS research and implement strategies to fill crucial implementation gaps, seize emerging scientific opportunities, and enable cutting-edge scientific discoveries that will have a population-level impact.

NIH is recognized worldwide for its steadfast support of the HIV/AIDS research enterprise. Sustained financial support from the NIH HIV/AIDS research enterprise has saved millions of lives in the past 40 years. Continued investment is critical to prevent a global rebound of the HIV/AIDS pandemic. We must continue to work with our domestic and international partners to translate scientific discovery into action, encourage a holistic response to the HIV/AIDS pandemic, and stimulate innovation.

Ending the HIV pandemic is an ambitious but feasible goal.

 Originally published on 2/6/23

1 - Centers for Disease Control and Prevention. HIV Surveillance Report, 2020; vol. 33. May 2022. Accessed October 14, 2022. www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2020-updated-vol-33.pdf (PDF, 10.9 MB).

2 - Centers for Disease Control and Prevention. Clusters of Rapid HIV Transmission Among Gay, Bisexual, and Other Men Who Have Sex with Men – United States, 2018-2021. Morbidity and Mortality Weekly Report (MMWR). 71(38); 1201-1206. September 2022. Accessed November 20, 2022. https://www.cdc.gov/mmwr/volumes/71/wr/mm7138a1.htm

3 - What is Ending the HIV Epidemic in the U.S.? HIV.gov. Updated July 1, 2022. Accessed October 14, 2022. www.hiv.gov/federal-response/ending-the-hiv-epidemic/overview

4 - Bekker LG, Alleyne G, Baral S, et al. Advancing global health and strengthening the HIV response in the era of the Sustainable Development Goals: the International AIDS Society-Lancet Commission. Lancet. 2018;392(10144):312-358. doi:10.1016/S0140-6736(18)31070-5. pubmed.ncbi.nlm.nih.gov/30032975

5 - National Institutes of Health Office of AIDS Research. FY 2021–2025 NIH Strategic Plan for HIV and HIV-Related Research. 2020. Accessed October 14, 2022. oar.nih.gov/sites/default/files/NIH_StrategicPlan_FY2021-2025.pdf (PDF, 4.60 MB).