AIDS Research at the NIH: A Critical Review

* NIEHS should expand studies of the effects of various 01 drugs on cells and cytokine expression.
11/14. National Center for Nursing Research (NCNR)
NCNR was established in 1986. Its current director is Ada Sue Hinshaw, PhD, whose trained in both
nursing and sociology. NCNR supports research and training in three major areas: (1) health promotion
and disease prevention, (2) understanding and ameliorating the effects of acute and chronic illness, and
(3) improving patient care and the environment in which it is delivered. NCNR also supports pre- and postdoctoral research training and career development for nurse-scientists and other experienced investigators.
NCNR's small intramural research program is devoted almost entirely to HIV infection and AIDS. With the
National Advisory Council on Nursing Research and others in the field, NCNR has developed a National
Nursing Research Agenda, whose priorities include: Low birth weight: mothers and infants; HIV infection:
prevention and care; Long-term care for older adults; Symptom management; Health promotion for children
and adolescents. In FY 1991, NCNR's AIDS budget was $2,545,000. NCNR requested $6.8M for AIDS
next year, but the President offered just $3.3M, which is below the level of current services. NCNR's AIDS
programs in 1991 included about $1M in basic science research (immunology, behavior, prevention),
$300,000 in transmission/natural history, and $1.1M in training. NCNR's AIDS program focuses on four
major areas: (1) physiological aspects of nursing care, (2) psychosocial aspects of nursing care, (3) delivery
of nursing care and (4) prevention of transmission.
For FY 1991, NCNR funded twenty awards in the areas of physiological aspects and delivery of nursing
care to people with HIV; psychosocial aspects of the same; and prevention of transmission of HIV, hepatitis
B and other pathogens. These programs are difficult to evaluate because the abstracts for many of the
awards are not available in the DRG, OAR, CRISP databases [training grants are not abstracted in these
databases]. The NCNR was among the more refractory of the institutes in terms of information sharing
during this project. NCNR's prevention and education programs are geared towards women, adolescents
and young adults. In conjunction, with NIA, NICHD and USAID, NCNR is participating in an international
behavioral research program. As part of this effort, NCNR has funded a grant to develop an AIDS
prevention program in Chile utilizing the country's network of health care clinics.
NCNR runs a small intramural program in collaboration with NIAID and the NIH Clinical Center to assess
the physiological and psychological effects of HIV infection. Studies completed or currently underway
included investigations of myopathy; nutritional problems, such as weight loss, decreased appetite and
malnutrition; compliance with IND regimens; and quality of life issues for people with HIV infection. These
studies are carried out at the NIH Clinical Center.
Future plans. NCNR requested a substantial increase for its FY 1993 budget in order to expand existing
programs and fund new ones. NCNR's top priorities for FY 1993 were:
1. Expansion of NCNR intramural research on symptom management (an additional $750,000);
2. Expansion of intramural research on quality of life (an additional $250,000) for people with HIV.
3. Two new grants on symptom management and quality of life for $1.1 million;
4. $201,000 for nursing research training initiatives;
5. $264,000 to evaluate the efficacy of universal precautions;
6. $1.1 M to fund four research project grants studying high-risk behavior and educational interventions
in women and people of color; and
7. Four new AIDS FTEs (for a total of 11).

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