PROJECT SUMMARY / ABSTRACT Modern antiretroviral treatments alter the progression of disease, enabling the majority of HIV+ individuals to live near-normal life spans. Yet, ~ 20% of patients in the US fail to achieve long-term virologic suppression, and even for those who do, there remains the threat of multiple comorbid complications. The critical questions that arise are how will clinicians maximize treatment success, assess the sociobehavioral barriers to linkage and persistent engagement in care, understand the causes of treatment and non-treatment related complications of HIV disease, and develop interventions that maximize health and well-being of HIV infected persons over many decades of life. To address these questions, investigators need access to clinical outcomes information that is tightly linked to biologic specimens and socio-biologic and genetic data to enable translational research. The CFAR Network of Integrated Clinical Systems (CNICS) project is an established resource that has contributed substantially to the contemporary HIV research agenda. Established in 2002 and funded as an R24 research platform in 2006, CNICS is a clinic-based research network that reflects the outcomes of clinical decisions and management options used in the care of HIV infected individuals at 8 CFAR sites: UAB, U Washington, UCSF, UCSD, Case Western Reserve, Fenway Health (Brown / Harvard), U North Carolina, and Johns Hopkins. What makes CNICS unique is the way in which CNICS augments the comprehensive EHR data with a combination of other resources for research that include patient-reported and patient-centered socio-behavioral data; adjudication of key clinical events; strategic biological specimen collection; and genetic characterization of the cohort. The mission of CNICS is to provide access to the specimen and data repository to any investigator who submits an approved concept proposal. In this fashion, CNICS is a 'peer-reviewed open access' research platform available to investigators worldwide. The specific aims for this competitive renewal of CNICS leverages the robust CNICS foundation to accomplish the following: 1: Collect high quality data from a representative sample of patients; 2: Enable investigators to perform research by providing data and specimens to a diverse array of scientists worldwide; and 3: Mentor early to mid-career investigators engaged in HIV-focused research in CNICS.