The five-year grant will focus on an innovative, multidisciplinary approach to treating HIV patients with active methamphetamine use disorder.

To address a critical gap in care, UC San Diego has received a $12.3 million, five-year grant from the National Institutes of Health’s National Institute on Drug Abuse to launch the Brain-Focused Research on Antiretrovirals and Methamphetamine (Brain-FRAMe) program.

Brain-FRAMe is a multidisciplinary initiative focused on treating people with HIV who also have an active methamphetamine use disorder.

This set of patients presents an important public health challenge, as methamphetamine use not only significantly increases the risk of HIV infection, by lowering risk aversion and changing immune mechanisms, but also complicates the management of the virus once contracted.

For those living with HIV, continued methamphetamine use often leads to severe medical, neurological and mental health disorders that alter immune responses and impairing cognition, mood and impulsivity.

As a result, many patients have difficulty adhering to traditional oral antiretroviral therapy (ART), hindering their abilities to achieve durable viral suppression.

This particular group of patients have typically been excluded from research, historically difficult to maintain in care. 

The new grant will help the Brain-FRAMe program address this population in new, creative ways, investigating the combined efficacy of long-acting injectable ART and medication for addiction treatment with long-acting injectable naltrexone oral bupropion, instead of the usually administered oral daily pills.

Researchers expect this combination to improve viral suppression and reduce methamphetamine use, restoring brain health in this highly vulnerable population.

The Brain-FRAMe team’s approach will integrate implementation science, pharmacology, virology, immunology and neuroscience, studying the same participants over a 52-week period with four teams: clinical implementation; neurobehavioral phenotyping; biophenotyping and pharmacology; and basic science mechanisms.

Data from these teams will be synthesized by a dedicated data integration and analysis group.

By addressing the biological mechanisms of brain health alongside clinical treatment, the Brain-FRAMe program could create a blueprint for treatment for people living with HIV and methamphetamine addiction, ultimately reducing new infections and advancing public health outcomes in the San Diego community and beyond.