Highlights: September 2025 NIH Office of AIDS Research Advisory Council Meeting

Optimization of HIV clinical practice guidelines, OAR Director's update, Overcoming roadblocks to end HIV in the United States

The National Institutes of Health (NIH) Office of AIDS Research Advisory Council (OARAC) convened its 69th meeting virtually on September 18.

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 a discussion on optimizing HIV clinical practice guidelines developed by working groups convened by OARAC. This conversation garnered significant interest from OARAC members, other attendees, and the public. Additionally, the meeting featured a report from OAR Director Geri R. Donenberg, Ph.D., and a presentation focused on overcoming barriers to ending HIV in the United States.

Report From the OAR Director

• Geri R. Donenberg, Ph.D., Associate Director for AIDS Research and Director, Office of AIDS Research, NIH

Dr. Donenberg first announced key staffing changes within OAR. CAPT Mary Glenshaw, Ph.D., M.P.H. has been appointed as the new Associate Director of External Engagement. In this role, she will focus on outreach, coordination, and collaboration with federal partners and the community; overseeing functions and activities of OARAC; and optimizing clinical practice guidelines. Leslie Marshall, Ph.D., bringing expertise in basic science and a long history with NIH, has been appointed Acting Deputy Director of OAR. She will take on new operational, managerial, and scientific leadership activities. Rachel Anderson, Ph.D. has been named Acting Chief of Staff, a new position within OAR. She will lead planning efforts for the NIH-wide HIV research strategic plan and for OAR’s internal operations.

Dr. Donenberg provided an in-depth update on current efforts to elevate the role of implementation science in the NIH HIV research program to improve uptake and adoption of evidence-based interventions. She provided an overview of implementation science, which aims to bridge the gap between innovative discoveries and real-world applications, including its audiences, strategies, and target outcomes. OAR is leading a cross-NIH effort to assemble teams, assess the current portfolio, and catalyze implementation science—including through inclusive funding opportunities across institutes and centers to achieve HIV epidemic control. She highlighted the establishment of an internal working group within OAR, an NIH-wide Implementation Science Task Force, and comprehensive evaluations of the implementation science and HIV research portfolio to catalyze new research. Dr. Donenberg also provided a fiscal year (FY) 2026 NIH budget update.

She then highlighted recent OAR engagements, including participation in the IAS 2025 conference and the U.S. Conference on HIV/AIDS (USCHA), focused on aging with HIV. Dr. Donenberg also mentioned the importance of the Early Career Investigator Workshop, designed to provide updates on HIV priorities and policies, guidance on grant applications, and networking opportunities. Additionally, she announced an upcoming symposium on mentoring early career investigators conducting implementation science and HIV and aging, co-hosted with the National Institute on Aging (NIA) and the National Institute on Mental Health (NIMH).

Dr. Donenberg closed her updates with information on the FY 2026-2030 NIH Strategic Plan for HIV and HIV-Related Research. Developed with input from the community, scientific staff, external researchers, and portfolio analysis, the plan includes goals for basic science research, preclinical and clinical research, implementation research, capacity and workforce building, and operational efficiency. It emphasizes the NIH commitment to a comprehensive research program to achieve epidemic control and improve the health of people affected by HIV. The plan is now in the final stages of clearance.

HIV Clinical Practice Guidelines: Optimization and Opportunities to Inform Implementation Science

• Geri R. Donenberg, Ph.D., Associate Director for AIDS Research and Director, Office of AIDS Research, NIH

Dr. Donenberg provided an update on OAR's recent efforts to plan for the sustainability and optimization of the HIV clinical practice guidelines, which are developed by OARAC-convened panels with management, publication, and dissemination support from OAR. The guidelines are recommended for use by U.S. health care practitioners and inform clinical practice around the world to ultimately improve the health of people with, and affected by, HIV. 

OAR received passionate feedback from the HIV community affirming the guidelines’ importance and advocating for guidelines development and management to remain under the purview of the OARAC-convened panels and OAR. Dr. Donenberg expressed appreciation for the input; emphasized OAR’s continued commitment to the sustainability of the guidelines; and outlined a shift in OAR’s approach to sustain the guidelines under the continued leadership of OARAC, NIH, and OAR. She then discussed a new approach to optimize their quality, accessibility, and efficient development, production, and dissemination.

In recent months, OAR convened small group discussions on these topics with guidelines panels, professional societies, and service organizations, as well as individual meetings with partners. The effort continues this fall to assess the processes, content, impact, and dissemination strategies for creating, updating, and disseminating the guidelines.

Dr. Donenberg invited discussion on how the guidelines can inform implementation science and vice versa, ways to evaluate their impact, how they can inform NIH's HIV research priorities, and strategies for greater dissemination and systemic adoption. She highlighted the importance of understanding who uses the guidelines, how they are accessed, and what elements are most useful to healthcare providers and patients. This feedback will help integrate the guidelines more closely with the implementation science agenda and ensure they continue to support high-quality care and informed decision-making in HIV treatment and prevention.

Driving Change Through Research: Overcoming Roadblocks to End HIV in the United States

• Sandra A. Springer, M.D., Professor of Medicine, Section of Infectious Diseases, Yale School of Medicine

Dr. Springer discussed overcoming roadblocks to end HIV in the United States, emphasizing the importance of considering social contexts and needs in HIV service delivery strategies. She highlighted the necessity of shared decision-making, tailored intervention strategies addressing whole-person health, and creative, multi-faceted approaches to implementation research.

Dr. Springer presented research findings on the integration of HIV care with medication treatment for substance use disorders, which improves viral suppression. She discussed the U.S. Ending the HIV Epidemic (EHE) plan, the challenges in accessing healthcare, and the need to offer integrated services closer to where people live. Dr. Springer also highlighted the development of a mobile retail pharmacy and clinic to improve medication access and provide integrated care. She emphasized the importance of policy changes to facilitate the implementation of these strategies.

Dr. Springer shared her research on using mobile health (mHealth) units and the first mobile retail pharmacy to deliver HIV prevention and treatment services directly to the community. Her studies include a Type 1 implementation effectiveness trial that compares linkage to HIV care outcomes from mHealth units versus peer navigators among individuals involved in the criminal justice system who use drugs. She also highlighted disparities in access to care between Medicaid expansion and non-expansion states; the importance of addressing housing instability, transportation, and other sociostructural factors; and the need for policies to support innovative approaches. Dr. Springer’s work demonstrates the potential of mHealth interventions to facilitate comprehensive, integrated care in underserved populations to improve health outcomes.

Updates and Next Meeting

• Gregory Greenwood, Ph.D., M.P.H., Deputy Director, Division of AIDS Research (DAR), NIMH, NIH
• Rohan Hazra, M.D., Director, Division of Extramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH
• Alice K. Pau, Pharm.D., Staff Scientist/Clinical Pharmacist, NIAID, NIH
• Henry Masur, M.D., Chief, Critical Care Medicine Department, Clinical Center, NIH

Dr. Greenwood provided updates on collaborative initiatives, including a notice of funding opportunity (NOFO) led by the Health Resources and Services Administration (HRSA) to address stigma in HIV care, and a request for applications (RFA) led by NIMH’s DAR to leverage multimodal artificial intelligence (AI) for HIV clinical care. He also discussed a new initiative to define mechanisms and roles of T-cells in HIV central nervous system reservoir seeding, persistence, and neuropathogenesis. Additionally, he highlighted the importance of the National NeuroHIV Tissue Consortium (NNTC) as a critical research resource.

Dr. Hazra provided updates on the guidelines for the use of antiretroviral agents in pediatric HIV infection, including revisions to sections on preventing HIV transmission during infant feeding, diagnosis of HIV in infants and children, and antiretroviral management of infants exposed to HIV. He emphasized the collaboration with the perinatal clinical guidelines panel and the focus on optimal care for adolescents.

Dr. Pau discussed the guidelines for antiretroviral agents in adults and adolescents with HIV, highlighting updates on laboratory monitoring, initiation of antiretroviral therapy, suboptimal CD4 recovery despite viral suppression, and cost considerations. She also mentioned new sections on cardiovascular and metabolic complications and the importance of statin therapy for primary prevention of cardiovascular diseases in people with HIV.

Dr. Masur provided updates on the guidelines for opportunistic infections in adults and adolescents with HIV, including recently published updates on various infections and upcoming revisions to sections on toxoplasmosis, pneumocystis pneumonia, and the varicella-zoster virus. He emphasized the importance of these guidelines for clinicians in the United States and the high usage of the guidelines.

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

The next OARAC meeting will be scheduled soon. OARAC welcomes public comments via email to [email protected].