Alcohol use contributes to morbidity and mortality associated with HIV by (a) reducing antiretroviral therapy adherence, (b) worsening virologic outcomes and immune functioning, (c) exacerbating liver dysfunction, and (d) exacerbating neurocognitive deficits associated with HIV. In addition, alcohol use among both HIV-infected and uninfected individuals is implicated in high-risk sexual behavior that leads to HIV transmission. The Brown University Alcohol Research Center on HIV (ARCH) was funded by NIAAA in 2010 to conduct integrated interdisciplinary research on alcohol and HIV that can inform clinical approaches to caring for people living with HIV and efforts to prevent HIV transmission, as well as to serve as a regional and national resource for collaborative research on alcohol and HIV interactions. Through collaborations with the Lifespan/Tufts/Brown Center for AIDS Research and local hospitals, Fenway Health, UMass-Boston, Columbia University, University of Florida, and UCSD, we have been conducting state-of-the-art research on the combined effects of alcohol and HIV on brain structure and function and on the effects of behavioral alcohol intervention on alcohol use, sexual risk behavior, virologic outcomes, liver function, and neurocognitive function in HIV-infected men who have sex with men. The addition of two Resource Cores (U24AA022000; U24AA022003) to the ARCH have further broadened this collaborative research with a particular emphasis on two strengths at Brown, sexual minority health and mechanisms of behavior change; these cooperative agreements with NIAAA involve collaborations with Yale University, Harvard, University of Pittsburgh, University of Alabama-Birmingham, and Johns Hopkins University. This renewal application seeks to build on the progress made through the Brown ARCH expanding the scope of our research around our tightly integrated core themes. The ARCH is comprised of an Administrative Core (which also handles postdoctoral training and pilots), three Research Components, and Virology and Biostatistics Cores. Research activities address overlapping hypotheses regarding key variables (alcohol use, virology, hepatic function, neurocognitive function, and high-risk sexual behavior) and interrelationships among these variables using diverse methods including neuroimaging, biomarker analysis, behavioral interventions, technology-assisted interventions, and human laboratory-based behavioral research. These activities provide an integrated body of innovative alcohol-HIV research that can yield far greater total public health impact than any or all of them could if conducted independently. Further, the ARCH serves as a nexus for integration of alcohol-HIV science across proposed components, pilot projects, and complementary studies within Brown including investigators from all four departments in the Brown University School of Public Health and four additional departments in the Medical School. Finally, the ARCH serves as a bridge between the deep pool of investigators at Brown focusing on alcohol and HIV and investigators at the other NIAAA-funded Consortiums for HIV/AIDS and Alcohol-Related Outcomes Research.
By increasing understanding of how excessive alcohol consumption and interventions to reduce excessive drinking can impact HIV-related health outcomes and sexual behavior that transmits HIV, this program project can contribute greatly to efforts to improve the health of those living with HIV and to reduce the spread of HIV.
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