psychological, and social research to better understand transmission of HIV through sex and drug use.

5. The committee recommends that NIAAA, NIDA, and NIMH support research on AIDS risk and behavior change among seriously mentally ill men and women and people with other cognitive impairments, including those not in psychiatric treatment. Such research should be conducted in a range of geographic locations.

6. The committee recommends that the Public Health Service coordinate interagency efforts to monitor and respond to concurrent epidemics (such as drug use, violence, and infectious diseases) that will alter the course of the HIV epidemic.

Human behavior is determined by multiple factors in the individual and the environment, ranging from the micro-level molecular biological to the macro-level social and environmental. These factors often interact in mutually reciprocal relationships such that one factor both influences and is influenced by another.

Much has been learned from research on the psychosocial determinants of AIDS-related sexual and drug-using behaviors. However, research on the brain biology of sexuality and drug addiction has rarely been integrated into these studies, even though it may be critical for understanding and preventing highrisk behavior.

While impressive strides have been made in the area of sexuality, the brain, and behavior, much remains to be learned. Characterization of sexual dimorphism at the genomic, molecular, cellular, behavioral, and social levels is still in its early stages. In the absence of this basic information, the very existence of a biology of highrisk sexual behaviors—a central missing element in basic biomedical and neurobiological AIDS research—cannot be approached.

Some outstanding issues include: identifying the neurochemical molecular substrates, if any, associated with sexual risk taking; determining how insights from the studies of the neurobiology of sexuality would relate to highrisk sexual behavior and to sexually transmitted diseases, including AIDS; and determining how society might best integrate the study of the biology of sexuality

FRONT MATTER (R1-R18)

EXECUTIVE SUMMARY (1-38)

1 INTRODUCTION (39-44)

PART I RESEARCH FINDINGS AND OPPORTUNITIES (45-46)

2 UNDERSTANDING HIV TRANSMISSION (47-77)

3 UNDERSTANDING THE DETERMINANTS OF HIV RISK BEHAVIOR (78-123)

4 DISEASE PROGRESSION AND INTERVENTION (124-154)

PART II MANAGING THE AIDS RESEARCH PROGRAMS AT NIAAA, NIDA, AND NIMH (155-156)

5 THE CONTEXT OF AIDS PROGRAMS AT NIAAA, NIDA, AND NIMH (157-185)

6 RESEARCH FUNDING, PROGRAMS, AND PRIORITIES AT NIAAA, NIDA, AND NIMH (186-239)

7 LINKAGES BETWEEN RESEARCH AND SERVICES (240-256)

BIBLIOGRAPHY AND REFERENCES (257-296)

APPENDIXES (297-298)

A Grants Analysis Methodology (299-304)

B Abbreviations and Acronyms (305-308)

C Acknowledgments (309-314)

D Contributors (315-326)

INDEX (327-338)