Highlights: April 2026 NIH Office of AIDS Research Advisory Council Meeting

Advancing clinical trials network strategy, navigating NIH funding and peer review changes, and health disparities research

The National Institutes of Health (NIH) Office of AIDS Research Advisory Council (OARAC) convened its 71st meeting virtually on April 13.

OARAC provides advice to the NIH Office of AIDS Research (OAR) on the planning, coordination, and evaluation of research and other HIV-related activities conducted or supported by NIH.

Key meeting highlights included an update on NIH-wide funding strategy and peer review reforms, a presentation of recommendations from the HIV clinical trials networks (CTN) external review, an update from the HIV clinical guidelines working groups, and a focused examination of HIV health disparities research priorities. The meeting also featured updates from NIH advisory councils and ongoing initiatives in neuroHIV and implementation science.

Report: Office of AIDS Research Director

• Leslie Marshall, Ph.D., Acting Deputy Director, OAR, NIH

Dr. Marshall delivered the Director’s report on behalf of Geri Donenberg, Ph.D., highlighting ongoing clearance of the NIH Strategic Plan for HIV and HIV-Related Research and a related NIH-wide strategic planning effort for FY 2027-2031. An NIH Request for Information (RFI) has been released to solicit public input on priorities spanning research areas, workforce capacity, and operations.

She provided updates on NIH and OAR leadership transitions, including changes in senior roles and continued efforts to strengthen cross-agency coordination. Budget updates emphasized that the FY 2026 NIH HIV research budget remains level at approximately $3.28 billion, while the FY 2027 President’s Budget proposes a significant reduction. The final budget will be determined by Congress.

OAR exercised less than 2 percent transfer authority (~$61 million) to strategically reallocate funds towards priority areas, including implementation science, aging with HIV, and co-occurring conditions. These decisions were data-driven and aimed at accelerating research in areas with growing public health impact.

Dr. Marshall also highlighted OAR’s continued investment in early career investigators (ECIs), including expanded engagement activities, office hours, and collaborations across NIH institutes and centers. Additional updates included progress in HIV and pharmacy research and an overview of two implementation science efforts that are now overseen by OAR: the Adolescent HIV Prevention and Treatment Implementation Science Alliance (AHISA) and the PEPFAR-supported Local Implementation Science (LISN) network.

NIH Funding Strategy and Peer Review

• Jon R. Lorsch, Ph.D., Deputy Director, Office of Extramural Research, NIH
• Ross D. Shonat, Ph.D., Director, Division of Physiological and Pathological Sciences, Center for Scientific Review, NIH

NIH leadership presented a new unified funding strategy that emphasizes a holistic approach to funding decisions, moving beyond reliance on numerical peer review scores alone. The strategy prioritizes scientific merit, alignment with the NIH mission, portfolio balance, workforce sustainability, and equitable distribution of funding.

The discussion highlighted the elimination of strict paylines for some institutes and increased consideration of contextual factors such as investigator career stage and existing funding. Council members raised concerns about transparency, funding uncertainty, and potential impacts on ECIs.

Updates to peer review processes include the transition to standard receipt dates for HIV-related applications beginning in 2027, eliminating separate AIDS submission cycles to improve efficiency and study section integration. Council discussion underscored ongoing challenges, including declining funding rates, reviewer burden, and the need for clarity on how the new policies will be implemented.

HIV Clinical Trials Networks External Review Recommendations

• Marguerita Lightfoot, Ph.D., Ronald Naito-John McAmulty Professor in Health Equity, Oregon Health & Science University-Portland State University School of Public Health

Dr. Lightfoot presented recommendations from the external review of the NIH-supported HIV CTNs. The working group emphasized that the CTNs are a critical national and international research infrastructure that must be preserved and strengthened.

Key recommendations focused on:

• Maintaining a balanced research portfolio across prevention, treatment, cure, and co-occurring conditions
• Expanding integration of implementation science into clinical trials
• Strengthening cross-network coordination and collaboration
• Enhancing partnerships with federal agencies and community-based care settings
• Preserving and expanding international research capacity
• Embedding community engagement as a core component of research design

The working group identified 12 priority areas and 33 recommendations, with a strong emphasis on bridging the gap between scientific discovery and real-world impact. NIH leadership noted that these recommendations are being incorporated into upcoming notices of funding opportunity (NOFOs) and future CTN recompetition planning.

Updates: NIH Advisory Council Representatives

• Gregory Greenwood, Ph.D., M.P.H., Deputy Director, Division of AIDS Research, National Institute of Mental Health, NIH
• Robert Eisinger, Ph.D., Acting Director, Division of AIDS, National Institute of Allergy and Infectious Diseases (NIAID), NIH

Dr. Greenwood highlighted a new initiative targeting the central nervous system as a critical barrier to HIV cure, emphasizing gaps in understanding HIV reservoirs in the brain and the need for targeted immunotherapy research.

Dr. Eisinger presented plans for recompetition of the HIV CTNs, reaffirming support for the four core networks focused on therapeutics, maternal and pediatric HIV, prevention, and immune-base strategies such as vaccines. The updated structure maintains key components including leadership and operations centers, laboratory centers, data management centers, and clinical trial units, with awards anticipated in 2027.

Updates: HIV Clinical Guidelines Working Groups of OARAC

• Alice K. Pau, Pharm.D., Staff Scientist/Clinical Pharmacist, NIAID, NIH
• Nahida Chaktoura, M.D., Chief, Maternal and Pediatric Infectious Disease Branch, Division of Extramural Research, National Institute of Child Health and Human Development, NIH
• Henry Masur, M.D., Chief, Critical Care Medicine Department, Clinical Center, NIH

Representatives from OARAC’s clinical guidelines panels provided updates on ongoing efforts to sustain and modernize federally supported guidelines.

• Adult and Adolescent ARV Guidelines: Dr. Pau introduced new leadership and panel members, with updates planned for 2026, including integration of “knowledge gaps” sections to inform future research priorities.
• Perinatal HIV Guidelines: Dr. Chaktoura provided recent updates including expanded guidance on pre-exposure prophylaxis (PrEP) during pregnancy and breastfeeding, hepatitis co-infection management, and evolving antiretroviral recommendations.
• Adult and Adolescent Opportunistic Infections Guidelines: Dr. Masur discussed ongoing rolling updates across more than 30 infections with high utilization globally. He also discussed plans to incorporate research gaps into future updates.

Discussion emphasized the continued importance of guidelines as a bridge between research evidence and clinical practice.

Health Disparities Discussion

• Monica Webb Hooper, Ph.D., Acting Director, National Institute on Minority Health and Health Disparities, NIH

Dr. Webb Hooper provided an overview of NIH’s commitment to HIV-related health disparities research within a broader unified strategy. She emphasized that disparities research remains a priority and highlighted the need for rigorous, data-driven, and solution-oriented approaches.

Key themes included:

• Advancing from descriptive to intervention-focused disparities research
• Emphasizing precision in defining populations and measurable outcomes
• Expanding implementation science to improve uptake of effective interventions
• Addressing multilevel drivers of disparities, including biological, behavioral, and structural factors

Examples of ongoing NIH-supported studies demonstrated efforts to improve prevention uptake, treatment adherence, and health outcomes in disproportionately affected populations.

Updates and Next Meeting

• Melissa Herrera, M.P.H., Public Health Analyst, OAR, NIH
• Luis Montaner, D.V.M., D.Phil., Executive Vice President and Director, HIV Cure and Viral Diseases Center, Herbert Kean, M.D. Family Professor, The Wistar Institute

NIH advisory council representatives provided updates on emerging research priorities, including neuroHIV, immunotherapies, aging with HIV, and implementation science.

Council discussions highlighted concerns about funding uncertainty, the importance of sustaining international research, challenges in community engagement, and the need to support the next generation of HIV researchers.

The full meeting will be available on NIH VideoCast, and meeting minutes will be posted on the OAR website.

The next OARAC meeting will be on June 25. OARAC welcomes public comments via email to [email protected].