ATN’s primary mission is to conduct both independent and collaborative research that explores promising behavioral, microbicidal, prophylactic, therapeutic, and vaccine modalities in HIV-infected and at-risk adolescents, ages 12 years through 24 years. ATN activities encompass the full spectrum of research needs for youth, from primary prevention—including HIV preventive vaccine, microbicide, and pre-exposure prophylaxis trials—for HIV at-risk youth in the community, to secondary and tertiary prevention with clinical management of HIV infection among youth along the entire HIV care continuum. Secondary and tertiary prevention research investigates novel treatment strategies and regimens, drug adherence, risk reduction interventions, and linkage and engagement to care strategies that can lead to optimal antiretroviral therapy initiation and virologic suppression outcomes.
ATN is the only domestic, multicenter research network devoted to the health and well-being of HIV-infected and at-risk adolescents and young adults. The network was started by the Maternal and Pediatric Infectious Disease Branch (MPIDB) in 2001 through a cooperative agreement mechanism. Other NIH institutes, including the National Institute on Drug Abuse, National Institute of Mental Health, and National Institute on Minority Health and Health Disparities, co-fund ATN. The first, second, and third funding cycles ended in February 2006, 2011, and 2016, respectively; ATN was re-competed in 2016 and was funded for a fourth 5-year period. It has extensive experience in recruiting and retaining understudied youth populations in the United States. From 2003 to 2013, the network had more than 26,000 enrollments among 88 ATN studies, with enrollment and retention rates among completed studies more than 90%. Among 32 studies with completed analyses, there have been 134 manuscripts published with 18 more in review, and 112 abstracts presented, with 8 more in review. Additionally, ATN has successfully forged collaborations with the Centers for Disease Control and Prevention (CDC); Health Resources and Services Adminsitration (HRSA); AIDS Clinical Trial Group; HIV Vaccine Trials Network; International Maternal, Pediatric, Adolescent AIDS Clinical Trials (IMPAACT) Network; and Microbicide Trials Network, as evidenced by 12 co-endorsed collaborating protocols.
In 2016, ATN was re-structured to increase collaborations across three adolescent-focused HIV/AIDS clinical trials network hubs and a coordinating center. The new structure is designed to create transparent mechanism for network hub leaders to solicit and support ideas from the research community and allow for external researchers, as well as other networks, to tap into the networks' clinical trial infrastructure and capacity. It also is intened to support coordinated efforts with community partners. Since the new cycle began, there have been approximately 2,800 enrollments across 21 ongoing ATN studies with excellent retention rates. There have been 26 manuscripts published or in press and 38 abstracts presented. Several collaborations are currently being pursued, including with CDC, HRSA, HIV Prevention Trials Network, and IMPAACT.
The principal investigators and their hubs are as follows:
- CARES U19 : Mary Jane Rotheram-Borus, Ph.D., University of California, Los Angeles
- iTech U19 : Lisa Hightow-Weidman, M.D., University of North Carolina, Chapel Hill; Patrick Sullivan, M.D., Emory University, Atlanta
- Scale it Up U19 : Sylvie Naar-King, Ph.D., Florida State University, Tallahassee; Jeffrey Parsons, Ph.D., Hunter College, New York City
Lisa LaVange, Ph.D., and Michael Hudgens, Ph.D., serve as co-principal investigators for the U24 coordinating center at the University of North Carolina, Chapel Hill. The center will provide infrastructure, logistical, and organizational support for the ATN executive committee and will facilitate emerging studies and collaborative activities across the ATN U19 hubs and with external networks and investigators.
The leadership group hubs working with the coordinating center will have overall responsibility for developing, implementing, and adapting ATN's clinical research agenda to address:
- Primary prevention interventions
- Biomedical prevention interventions
- Novel approaches to identifying undiagnosed infection
- Behavioral and social interventions (e.g., multilevel, combination prevention, mental health, substance use studies)
- HIV Continuum of Care
- Interventions and programs, both independent and collaborative, to improve outcomes
- Community- and structural-level interventions to improve outcomes
- Strategies to address evolving healthcare financing challenges
- Evaluation of long-acting antiretroviral therapy for treatment
- Risk reduction interventions
- Interventions to promote care engagement and adherence to antiretroviral medications
- Integrated treatment approaches (psychological, medical, and ancillary services studies)
- In January 2015, MPIDB convened an expert panel to review the work and structure of the ATN (PDF 849 KB).
- ATN Website (maintained by the ATN Data Coordination Center at the University of North Carolina)
- NICHD Contacts: Bill G. Kapogiannis and Sonia Lee
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