This is a competitive renewal of the Birmingham ACTU, established in 1992 at the UAB AIDS Outpatient (1917) Clinic, and is submitted in conjunction with the ACTG Group application led by Robert T. Schooley, MD (PI). The Birmingham ACTU has been a national leader in the development and implementation of clinical trials that link therapeutics and pathogenesis, a high priority of the ACTG recompetition. Investigators from UAB have assumed leadership positions within the ACTG and have played a pivotal role in the establishment and performance of the Group's Scientific Agenda. This application builds on the experience of the Birmingham ACTU and adds investigators from Emory University as important new contributors to the ACTG effort through the establishment of a subunit at the Ponce de Leon Clinic in Atlanta. The primary focus of the UAB/Emory ACTU is to: (i) Establish collaborative studies within the ACTG which focus on the clinical significance and therapeutic implications of recent insights into HIV pathogenesis elucidated at our site; (ii) Further development improved therapeutic approaches in the treatment of cytomegalovirus, mycobacterial, human papilloma virus, herpes-related viruses, mycoplasma, and cryptococcal disease, areas where UAB/Emory investigators have made critical contributions and have unique expertise; (iii) Improve access of women and minorities to ACTG-related clinical trials through the 1917 Women's Clinic and the Women's Clinic at the Ponce de Leon Center and through targeted outreach programs to HIV-infected African Americans, the most rapidly growing population of HIV-infected patients, especially in the Southeastern United States; and (iv) Contribute to the overall mission and Scientific Agenda of the ACTG through active participation in Group activities and provision of leadership within key administrative committees. Our current level of performance, scientific contributions, history of leadership within the Group, geographic location within the most rapidly growing population of newly acquired HIV disease (Southeastern United States), and our unique expertise in critical areas of the Group's scientific focus makes the UAB/Emory ACTU an ideal site for the conduct of clinical trials through the ACTG network.
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