researchers (primarily neuroscientists) to work in partnership with researchers from the AIDS clinical trials units (ACTUs), the Multicenter AIDS Cohort Study (MACS), and the Women and Infants Transmission Study (WITS) on studies of HIV infection of the CNS. The overarching goal of AIDS-related neuroscience research is to understand the pathogenetic mechanisms involved in HIV-associated brain dysfunction. This encompasses clinical and laboratory research studies aimed at understanding the biology of HIV infection of the CNS and the mechanisms of brain dysfunction at the organismic, cellular, and molecular levels. Investigations cross many disciplines and range from clinical studies dealing with natural history, disturbed physiology, and neuroimaging, as well as clinical virology and immunology, to fundamental laboratory studies involving animal and cell culture models, as well as biochemical and molecular research.
Neurobehavioral research generally is more clinically directed and aims at defining and understanding the effects of HIV and various treatment on the neurodevelopment of infected and at-risk infants and children, and the neuropsychological, neuropsychiatric and neurological sequelae of HIV infection in infected and at-risk adults. This research involves methodological development, direct study of clinical presentation and natural history, and assessment of antiviral therapy and other interventions.
NIMH also has supported psychoneuroimmunology research in its AIDS program. This discipline focuses on the relationship between the brain (including its behavioral state) and the immune system. Its potential application to AIDS is supported by the hypothesis that behavioral states may modulate immune defenses against HIV and thereby alter the response to HIV exposure and the rate of progression to AIDS in those infected.
Through its AIDS research centers and investigator-initiated research grants, NIMH has supported behavioral epidemiology research to identify specific populations at risk for HIV/AIDS and to understand the specific highrisk behaviors of various populations, including homosexual and bisexual men, heterosexual women and men, adolescents, injection drug users and their partners, people with severe mental illness, and the homeless. Not only is behavioral epidemiology critical for understanding risk factors associated with HIV transmission and disease progression, it is essential to the development and evaluation of preventive AIDS interventions.