Director’s Report to the National Advisory Council on Drug Abuse Director’s Report to the National Advisory Council on Drug Abuse May 16, 2007

Director’s Report to the National Advisory Council on Drug Abuse Director’s Report to the National Advisory Council on Drug Abuse Budget Update Recent NIDA Activities What’s NIH?

NIDA BUDGET (Thousands) IncreaseOver Prior Year IncreaseOver AIDSAIDS TOTALTOTAL NonAIDSNonAIDS $693,282 $313, Actual $1,006, % $698,976 $299, Actual $998, % 2007 C.R. $699,349 $300,073 $999,422 $699,349 $300,073 $999, % 2008 P.B. $699,908 $300,457 $1,000, % $699,908 $300,457 $1,000, %

RPG* Funding, Unsolicited and Solicited * Research Projects are part of research grants, limited to activity codes R01, R03, R15, R21, R22, R23, R29, R33, R34, R35, R36, R37, R55, R56, P01, P42, PN1, UC1, U01, U19 and DP1. No NLM awards are considered to be research projects. Solicited awards are responses to Requests for Applications (RFA’s). Funding (in billions)

* Research Projects are part of research grants, limited to activity codes R01, R03, R15, R21, R22, R23, R29, R33, R34, R35, R36, R37, R55, R56, P01, P42, PN1, UC1, U01, U19 and DP1. No NLM awards are considered to be research projects. Solicited awards are responses to Requests for Applications (RFA’s). Success Rates of Solicited and Unsolicited Competing RPG* Applications

I/C’s are arrayed by percent of funding for new RPG’s spent for responses to program announcements in FY 2006

NIDA Dashboard New PIs Medicinal Chemists -- Recruitment -- Training Medicinal Chemists -- Recruitment -- Training Collaborations ? ? ? ? ? ?

FY 2008 Budget Hearings March 1, House Appropriations Subcommittee on Labor, HHS and Education Hearing on FY 2008 President’s Budget Request for SAMHSA, NIDA, NIAAA and NIMH March 6, House Appropriations Subcommittee on Labor, HHS and Education Hearing on FY 2008 President’s Budget Request for NIH March 1, House Appropriations Subcommittee on Labor, HHS and Education Hearing on FY 2008 President’s Budget Request for SAMHSA, NIDA, NIAAA and NIMH March 6, House Appropriations Subcommittee on Labor, HHS and Education Hearing on FY 2008 President’s Budget Request for NIH March 19, 2007 – Senate Appropriations Subcommittee on Labor, HHS and Education Hearing on FY 2008 President’s Budget Request for NIH March 26, 2007 – Senate Appropriations Subcommittee on Labor, HHS, and Education FY 2008 Budget for Mind, Brain and Behavioral Research March 19, 2007 – Senate Appropriations Subcommittee on Labor, HHS and Education Hearing on FY 2008 President’s Budget Request for NIH March 26, 2007 – Senate Appropriations Subcommittee on Labor, HHS, and Education FY 2008 Budget for Mind, Brain and Behavioral Research

IC Directors’ Retreat – May 17-18, 2007 Roadmap II IC Directors’ Retreat – May 17-18, 2007 Roadmap II Top 5 Topics Strategic Planning Groups 1) Microbiome 2) Protein Capture/Proteome Tools 3) Phenotyping Services, Tools 4) Inflammation 5) Epigenetics 1) Microbiome 2) Protein Capture/Proteome Tools 3) Phenotyping Services, Tools 4) Inflammation 5) Epigenetics a) Training/Careers b) Health Disparities c) Science of Science d) Pharmacogenomics a) Training/Careers b) Health Disparities c) Science of Science d) Pharmacogenomics

Epigenetic Mechanisms Regulate How Genetic Information Is Expressed Across Development, Tissue, Environment and Disease States Epigenetics Epigenetics + Disease Citations for Epigenetics l DNA Methylation – silences gene l Histone Modification – methylation, acetylation, or phosphorylation l Non coding RNA l DNA Methylation – silences gene l Histone Modification – methylation, acetylation, or phosphorylation l Non coding RNA

Epigenetic Marks Are Altered in Common Brain Disorders Including Addiction Epigenetic Marks Are Altered in Common Brain Disorders Including Addiction

Timeline for Epigenetics Program RM/IC Projects Technology Development RFA#3 Data Management Center Mapping Centers JUMPSTART FY08FY09FY10FY11FY12 RFA#1 RFA#4 RFA#2 FY13FY14FY15FY16FY17 24 comprehensive reference epigenomes Cell/tissue variation assessed New Ab reagents for epigenomics Public resource (cells/tissue, data, tools) International Consortium Standardization Reagents (Abs) Establish/maintain public data resource (via NCBI) New tools for data integration, analysis, and viewing Develop/adapt new tools, application to RM and IC projects RFA1RFA2RFA3RFA4RFA5 Co-fund up to 15 IC-based programs RFA1 RFA2 RFA3RFA4 FY07 TRANSITION to ICs

National Institute on Drug Abuse Special Populations Office Division of Basic Neurosciences & Behavior Research Division of Basic Neurosciences & Behavior Research Office of Extramural Affairs Office of Extramural Affairs Office of Planning & Resource Management Office of Planning & Resource Management Office of Science Policy & Communications Office of Science Policy & Communications Intramural Research Program Intramural Research Program Division of Epidemiology, Services & Prevention Research Division of Epidemiology, Services & Prevention Research Division of Pharmacotherapies & Medical Consequences of Drug Abuse Division of Pharmacotherapies & Medical Consequences of Drug Abuse Center for the Clinical Trials Network Center for the Clinical Trials Network Teresa Levitin, PhD Donna M. Jones (Acting) Donna M. Jones (Acting) Timothy Condon, PhD Betty Tai, PhD David Shurtleff, PhD Frank Vocci, PhD Wilson Compton, MD, MPE Barry Hoffer, MD, PhD Office of the Director Nora D. Volkow, MD Director Timothy P. Condon, Ph.D. Deputy Director Donna M. Jones Executive Officer (Acting) Division of Clinical Neuroscience & Behavioral Research Division of Clinical Neuroscience & Behavioral Research Joseph Frascella, PhD Director, AIDS Research

Success Rates for AIDS Extramural and Non-AIDS Extramural Percent

Strategies of NIDA’s Investment on AIDS 1.NIDA Staff Meetings to identify priority areas March 12, 2007 April 9, Scientific Meeting of Experts May 8-9, NIDA Staff Meetings to identify priority areas March 12, 2007 April 9, Scientific Meeting of Experts May 8-9, 2007 Uncommitted Funds FY06 FY07 FY08 FY09 FY10 $40M $58M $65M ~$60M

Changing Nature of the HIV Epidemic

Infrastructure: facilitate access to existing cohorts (ALIVE, MLS) proteomic analysis animal models Innovative research: Avant-Garde Award (equivalent to Pioneer Award) International: Create clinical and basic research networks Training: e.g., Invest Fellows/China/CTN Integrate research with NIAID international networks Infrastructure: facilitate access to existing cohorts (ALIVE, MLS) proteomic analysis animal models Innovative research: Avant-Garde Award (equivalent to Pioneer Award) International: Create clinical and basic research networks Training: e.g., Invest Fellows/China/CTN Integrate research with NIAID international networks HIV/AIDS Mechanisms

National Institute on Drug Abuse Special Populations Office Division of Basic Neurosciences & Behavior Research Division of Basic Neurosciences & Behavior Research Office of Extramural Affairs Office of Extramural Affairs Office of Science Policy & Communications Office of Science Policy & Communications Intramural Research Program Intramural Research Program Division of Epidemiology, Services & Prevention Research Division of Epidemiology, Services & Prevention Research Division of Pharmacotherapies & Medical Consequences of Drug Abuse Division of Pharmacotherapies & Medical Consequences of Drug Abuse Center for the Clinical Trials Network Center for the Clinical Trials Network Teresa Levitin, PhD Timothy Condon, PhD Betty Tai, PhD David Shurtleff, PhD Frank Vocci, PhD Wilson Compton, MD, MPE Barry Hoffer, MD, PhD Division of Clinical Neuroscience & Behavioral Research Division of Clinical Neuroscience & Behavioral Research Joseph Frascella, PhD Director, AIDS Research DESPR Office of the Director Nora D. Volkow, MD Director Timothy P. Condon, Ph.D. Deputy Director Donna M. Jones Executive Officer (Acting) Office of Planning & Resource Management Office of Planning & Resource Management Donna M. Jones (Acting) Donna M. Jones (Acting)

Convergence of HIV Seroprevalence Among Injecting and Non-injecting Drug Users Current Injectors Non-Injectors HIV Prevalence 13% CI 12-15% 12% CI 9-16% Drug Treatment Program (n= ) Respondent-Driven Sampling (n= ) Current Injectors Non-Injectors 15% CI 11-19% 17% CI 12-21% Source: Des Jarlais et al AIDS, 21: , 2007.

National Institute on Drug Abuse Special Populations Office Division of Basic Neurosciences & Behavior Research Division of Basic Neurosciences & Behavior Research Office of Extramural Affairs Office of Extramural Affairs Office of Science Policy & Communications Office of Science Policy & Communications Intramural Research Program Intramural Research Program Division of Epidemiology, Services & Prevention Research Division of Epidemiology, Services & Prevention Research Division of Pharmacotherapies & Medical Consequences of Drug Abuse Division of Pharmacotherapies & Medical Consequences of Drug Abuse Center for the Clinical Trials Network Center for the Clinical Trials Network Teresa Levitin, PhD Timothy Condon, PhD Betty Tai, PhD David Shurtleff, PhD Frank Vocci, PhD Wilson Compton, MD, MPE Barry Hoffer, MD, PhD Division of Clinical Neuroscience & Behavioral Research Division of Clinical Neuroscience & Behavioral Research Joseph Frascella, PhD Director, AIDS Research DCNBR Office of the Director Nora D. Volkow, MD Director Timothy P. Condon, Ph.D. Deputy Director Donna M. Jones Executive Officer (Acting) Office of Planning & Resource Management Office of Planning & Resource Management Donna M. Jones (Acting) Donna M. Jones (Acting)

Young caucasians are at elevated HIV risk when they engage in risky behaviors; whereas young AA are at high risk even when their behaviors are normative. Source: Hallfors et al Am J Public Health :125-32, Caucasian (n=6257) Few partners, low ATOD Few partners, low ATOD Binge drinking Binge drinking THC use THC use Multiple partners Multiple partners Sex money Sex money IDU MSM Drug use Drug use AA (n=2449) Prevalence HIV /STD National Longitudinal Longitudinal Study of Adolescent Health. 18 to 26 years old Sexual & Drug Behavior Patterns & HIV & STD: Racial Disparities

National Institute on Drug Abuse Special Populations Office Division of Basic Neurosciences & Behavior Research Division of Basic Neurosciences & Behavior Research Office of Extramural Affairs Office of Extramural Affairs Office of Science Policy & Communications Office of Science Policy & Communications Intramural Research Program Intramural Research Program Division of Epidemiology, Services & Prevention Research Division of Epidemiology, Services & Prevention Research Division of Pharmacotherapies & Medical Consequences of Drug Abuse Division of Pharmacotherapies & Medical Consequences of Drug Abuse Center for the Clinical Trials Network Center for the Clinical Trials Network Teresa Levitin, PhD Timothy Condon, PhD Betty Tai, PhD David Shurtleff, PhD Frank Vocci, PhD Wilson Compton, MD, MPE Barry Hoffer, MD, PhD Division of Clinical Neuroscience & Behavioral Research Division of Clinical Neuroscience & Behavioral Research Joseph Frascella, PhD Director, AIDS Research DBNBR Office of the Director Nora D. Volkow, MD Director Timothy P. Condon, Ph.D. Deputy Director Donna M. Jones Executive Officer (Acting) Office of Planning & Resource Management Office of Planning & Resource Management Donna M. Jones (Acting) Donna M. Jones (Acting)

Effects of Statins on the Interactions of HIV-1-Infected T Cells with Neurons With and Without ETOH on the Oxidative Stress Marker, Heat Shock Protein 70 (Hsp70) Effects of Statins on the Interactions of HIV-1-Infected T Cells with Neurons With and Without ETOH on the Oxidative Stress Marker, Heat Shock Protein 70 (Hsp70) 0.3% EtOH Statins Protect Human Neurons against EtOH- & HIV Type 1-Induced Oxidative Stress In Vitro Source: Acheampong et al. J Virol. 81: , Statins Protect Human Neurons against EtOH- & HIV Type 1-Induced Oxidative Stress In Vitro Source: Acheampong et al. J Virol. 81: , Ator, atorvastatin; Simva, simvastatin

National Institute on Drug Abuse Special Populations Office Division of Basic Neurosciences & Behavior Research Division of Basic Neurosciences & Behavior Research Office of Extramural Affairs Office of Extramural Affairs Office of Science Policy & Communications Office of Science Policy & Communications Intramural Research Program Intramural Research Program Division of Epidemiology, Services & Prevention Research Division of Epidemiology, Services & Prevention Research Division of Pharmacotherapies & Medical Consequences of Drug Abuse Division of Pharmacotherapies & Medical Consequences of Drug Abuse Center for the Clinical Trials Network Center for the Clinical Trials Network Teresa Levitin, PhD Timothy Condon, PhD Betty Tai, PhD David Shurtleff, PhD Frank Vocci, PhD Wilson Compton, MD, MPE Barry Hoffer, MD, PhD Division of Clinical Neuroscience & Behavioral Research Division of Clinical Neuroscience & Behavioral Research Joseph Frascella, PhD Director, AIDS Research Update from Dr. Betty Tai this morning Update from Dr. Betty Tai this morning Office of the Director Nora D. Volkow, MD Director Timothy P. Condon, Ph.D. Deputy Director Donna M. Jones Executive Officer (Acting) Office of Planning & Resource Management Office of Planning & Resource Management Donna M. Jones (Acting) Donna M. Jones (Acting) CCTN

1,000,000 people in USA are infected with HIV – 40,000 new cases each year – 25 % of persons with HIV are unaware they are infected – ¼ of persons who test HIV+ fail to return to receive results CDC now recommends offering routine HIV testing to persons at risk for HIV 1,000,000 people in USA are infected with HIV – 40,000 new cases each year – 25 % of persons with HIV are unaware they are infected – ¼ of persons who test HIV+ fail to return to receive results CDC now recommends offering routine HIV testing to persons at risk for HIV Integrating HIV Rapid Testing and Counseling into Drug Treatment FDA approved blood from a finger stick or oral fluid 20 minutes $12-15/kit can be done by counselors FDA approved blood from a finger stick or oral fluid 20 minutes $12-15/kit can be done by counselors HIV Rapid Test

National Institute on Drug Abuse Special Populations Office Division of Basic Neurosciences & Behavior Research Division of Basic Neurosciences & Behavior Research Office of Extramural Affairs Office of Extramural Affairs Office of Science Policy & Communications Office of Science Policy & Communications Intramural Research Program Intramural Research Program Division of Epidemiology, Services & Prevention Research Division of Epidemiology, Services & Prevention Research Division of Pharmacotherapies & Medical Consequences of Drug Abuse Division of Pharmacotherapies & Medical Consequences of Drug Abuse Center for the Clinical Trials Network Center for the Clinical Trials Network Teresa Levitin, PhD Timothy Condon, PhD Betty Tai, PhD David Shurtleff, PhD Frank Vocci, PhD Wilson Compton, MD, MPE Barry Hoffer, MD, PhD Division of Clinical Neuroscience & Behavioral Research Division of Clinical Neuroscience & Behavioral Research Joseph Frascella, PhD Director, AIDS Research DPMCDA Office of the Director Nora D. Volkow, MD Director Timothy P. Condon, Ph.D. Deputy Director Donna M. Jones Executive Officer (Acting) Office of Planning & Resource Management Office of Planning & Resource Management Donna M. Jones (Acting) Donna M. Jones (Acting)

Injectable Sustained-Release Naltrexone for Opioid Dependence Treatment Sustained release naltrexone produced a robust, dose-related increase in treatment retention and in drug-free urines in heroin dependent subjects (n=60) Source: Comer et al., Arch Gen Psychiatry. 63: , Sustained release naltrexone produced a robust, dose-related increase in treatment retention and in drug-free urines in heroin dependent subjects (n=60) Source: Comer et al., Arch Gen Psychiatry. 63: , 2006.

Brain Imaging Drug Use Prevention Messages (R21) (RFA-DA ) – 16 Applications DCNBR and DESPR Brain Imaging Drug Use Prevention Messages (R21) (RFA-DA ) – 16 Applications DCNBR and DESPR

Mechanisms of Drug Abuse Interactions with HIV Neuropathogenesis (R01--RFA-DA ) – 14 Applications (R21--RFA-DA ) – 13 Applications Mechanisms of Drug Abuse Interactions with HIV Neuropathogenesis (R01--RFA-DA ) – 14 Applications (R21--RFA-DA ) – 13 Applications Extinction and Pharmacotherapies for Drug Addiction (R01--RFA-DA ) Applications (R03--RFA-DA ) Applications Extinction and Pharmacotherapies for Drug Addiction (R01--RFA-DA ) Applications (R03--RFA-DA ) Applications

Design, Synthesis, and Preclinical Testing of Potential Treatment Agents for Drug Addiction (R01) (RFA-DA ) – 30 Applications Design, Synthesis, and Preclinical Testing of Potential Treatment Agents for Drug Addiction (R01) (RFA-DA ) – 30 Applications Development of Immunotherapeutic Products for the Treatment of Methamphetamine Addiction (U01) (RFA-DA ) – 5 Applications Development of Immunotherapeutic Products for the Treatment of Methamphetamine Addiction (U01) (RFA-DA ) – 5 Applications

Recent and Upcoming Meetings, Conferences and Events Recent and Upcoming Meetings, Conferences and Events

The Addiction Project’s Audience is estimated to be over 50 million impressions…and counting The Addiction Project’s Audience is estimated to be over 50 million impressions…and counting Including… HBO Channels – over 13 million viewers HBO on Demand – nearly 1 million orders DVD – more than 30,000 sold Companion Book – over 7,000 sold Podcasts – over 380,000 downloads Online – hbo.com/addiction, AOL & cable affiliate websites – over 600,000 video streams & 2.9 million page views Local & National Outreach Parties & Screenings – over 32,000 people attended TV Media Coverage: 35 million viewers (including The Oprah Winfrey Show, Good Morning America, The View, Lou Dobbs, Larry King Live…) Including… HBO Channels – over 13 million viewers HBO on Demand – nearly 1 million orders DVD – more than 30,000 sold Companion Book – over 7,000 sold Podcasts – over 380,000 downloads Online – hbo.com/addiction, AOL & cable affiliate websites – over 600,000 video streams & 2.9 million page views Local & National Outreach Parties & Screenings – over 32,000 people attended TV Media Coverage: 35 million viewers (including The Oprah Winfrey Show, Good Morning America, The View, Lou Dobbs, Larry King Live…)

Timothy P. Condon, Ph.D. Deputy Director, NIDA Gregory Brigham, Ph.D. CRO, Maryhaven Dennis McCarty, Ph.D. Oregon Health Sciences University

ACNP American College of Neuropsychopharmacology Liaison Committee American College of Neuropsychopharmacology Liaison Committee Opportunities and Impediments to Drug Development for Alcoholism and Other Substance Abuse The National Press Club Washington, D.C. May 20, 2007 Opportunities and Impediments to Drug Development for Alcoholism and Other Substance Abuse The National Press Club Washington, D.C. May 20, 2007

Proportion of Clients Abstinent Abstinence Rates Following Behavioral Treatment for Marijuana Dependence Abstinence Rates Following Behavioral Treatment for Marijuana Dependence Source: Kadden, RM, Litt, MD, Kabela-Cormier, E and Petry, NM, Addictive Behaviors, 32, pp , 2007.

NABI Biopharmaceuticals Recently Announced Positive Results of It’s Phase IIb Trial of NicVax® NABI Biopharmaceuticals Recently Announced Positive Results of It’s Phase IIb Trial of NicVax® Double-blind, placebo-controlled and dose ranging study: 2 antigen doses (200mcg and 400 mcg per injection) NicVAX® (Nicotine Conjugate Vaccine) Patients who showed continuous abstinence between weeks had significantly higher antibody levels than those who did not quit at both the beginning and at the end of the assessment period Among the top 30% of antibody responders who received the drug 24.6% showed continuous abstinence from smoking between weeks compared to 13.0% of controls This Phase IIb trial is continuing after all patients received a booster at six months; secondary endpoints will be assessed at 12 months Double-blind, placebo-controlled and dose ranging study: 2 antigen doses (200mcg and 400 mcg per injection) NicVAX® (Nicotine Conjugate Vaccine) Patients who showed continuous abstinence between weeks had significantly higher antibody levels than those who did not quit at both the beginning and at the end of the assessment period Among the top 30% of antibody responders who received the drug 24.6% showed continuous abstinence from smoking between weeks compared to 13.0% of controls This Phase IIb trial is continuing after all patients received a booster at six months; secondary endpoints will be assessed at 12 months NicVAX high-antibody responders NicVAX high-antibody responders Controls

NIDA HIV/AIDS PAs, PAS/PARs & RFAs NIDA HIV/AIDS PAs, PAS/PARs & RFAs PA AIDS-Science Track Award for Research Transition (R03) PA Drug Abuse Aspects of HIV/AIDS (R01) PA Drug Abuse Aspects of HIV/AIDS (R03) PA Health Disparities in HIV/AIDS: Focus on African Americans (R01) PA Health Disparities in HIV/AIDS: Focus on African Americans (R01) PA Health Disparities in HIV/AIDS: Focus on African Americans (R21) PA Health Disparities in HIV/AIDS: Focus on African Americans (R03) PA Drug Abuse Aspects of HIV/AIDS and Other Infections (R21) PA Drug Abuse Aspects of HIV/AIDS and Other Infections (R03) PA AIDS-Science Track Award for Research Transition (R03) PA Drug Abuse Aspects of HIV/AIDS (R01) PA Drug Abuse Aspects of HIV/AIDS (R03) PA Health Disparities in HIV/AIDS: Focus on African Americans (R01) PA Health Disparities in HIV/AIDS: Focus on African Americans (R01) PA Health Disparities in HIV/AIDS: Focus on African Americans (R21) PA Health Disparities in HIV/AIDS: Focus on African Americans (R03) PA Drug Abuse Aspects of HIV/AIDS and Other Infections (R21) PA Drug Abuse Aspects of HIV/AIDS and Other Infections (R03) PAS Drug Abuse, Risky Decision Making and HIV/AIDS (R01) PAS Drug Abuse, Risky Decision Making and HIV/AIDS (R21) PAS Drug Abuse, Risky Decision Making and HIV/AIDS (R03) PAS Non-Injection Drug Abuse and HIV/AIDS (R01) PAS Non-Injection Drug Abuse and HIV/AIDS (R03) PAS Non-Injection Drug Abuse and HIV/AIDS (R21) PAS Non-Injection Drug Abuse and HIV/AIDS (R01) PAS Drug Abuse, Risky Decision Making and HIV/AIDS (R01) PAS Drug Abuse, Risky Decision Making and HIV/AIDS (R21) PAS Drug Abuse, Risky Decision Making and HIV/AIDS (R03) PAS Non-Injection Drug Abuse and HIV/AIDS (R01) PAS Non-Injection Drug Abuse and HIV/AIDS (R03) PAS Non-Injection Drug Abuse and HIV/AIDS (R21) PAS Non-Injection Drug Abuse and HIV/AIDS (R01) RFA-DA Mechanisms of Drug Abuse Interactions with HIV Neuropathogenesis (R01) RFA-DA Mechanisms of Drug Abuse Interactions with HIV Neuropathogenesis (R21) RFA-DA HIV and Drug Abuse Interventions Among Pregnant Women in Drug Abuse Treatment (R01, R03 and R21) RFA-DA Mechanisms of Drug Abuse Interactions with HIV Neuropathogenesis (R01) RFA-DA Mechanisms of Drug Abuse Interactions with HIV Neuropathogenesis (R21) RFA-DA HIV and Drug Abuse Interventions Among Pregnant Women in Drug Abuse Treatment (R01, R03 and R21) PAs PAS/PARs RFAs

Testing & Counseling Testing & Counseling HIV/AIDS Priority Areas Criminal Justice Criminal Justice Health Disparities Health Disparities Vulnerability Progression Vulnerability Progression CTN, CJDATS, NIAID, CDC, ATN, WIHS, MACS Proteomics NeuroAIDS Models Cognit imp HIV/HCV Proteomics NeuroAIDS Models Cognit imp HIV/HCV Non-IDU Epigenetics International Non-IDU Epigenetics International Drug interactions Pharmacokinetics, Pharmacogenomics Drug interactions Pharmacokinetics, Pharmacogenomics Adherence Neurobiology Risk Genetics Drug abuse & HIV Tx as HIV prevent. E health Adherence Neurobiology Risk Genetics Drug abuse & HIV Tx as HIV prevent. E health Children Women Children Women Access Stigma, Microbicides Women, Youth Stigma, Microbicides Women, Youth co-infections Psych-comorb co-infections Psych-comorb Infection rates Medications Re-entry Services Medications Re-entry Services Testing Re-entry Drug Tx Testing Re-entry Drug Tx Modeling International Modeling International Link to Tx Youth/Women Link to Tx Youth/Women Early detection Collaboration Non-IDU Prevention Treatment Epidemiology Consequences