PROJECT SUMMARY FOR CLINICAL CORE The UCSF Bay Area CFAR has a long history of supporting and accelerating clinically impactful HIV research, which ultimately requires direct investigation of those living with HIV and at-risk human populations. The SCOPE cohort was a major innovation and direct consequence of CFAR investment that has had a profound impact on basic and translational HIV research conducted not just at UCSF, but around the world. Since 2017, the Clinical & Population Sciences Core (now restructured into the CFAR Clinical Core) contributed to 216 peer-reviewed publications, provided mentoring and training to 57 early-stage investigators (ESIs), and supported a total of 361 NIH-funded projects (supporting 338 unique core users). The revamped Clinical Core of the UCSF Bay Area CFAR now contains three components: the SCOPE Cohort, a new Participant Referral Service designed to increase the diversity of participants in the SCOPE cohort and other CFAR investigator- initiated studies; and the Specimen Processing and Banking Sub-Core or AIDS Specimen Bank. Over the past 40 years, the AIDS Specimen Bank (ASB) has provided the unique expertise and infrastructure to support the processing and storage of biospecimens in the areas of host-viral interactions, microbiome, HIV transmission, treatment, prevention, and pathogenesis of HIV. Over this past project period, the ASB processed more than 94,000 specimens and distributed 12,100 specimens, contributing to multiple projects. In the next funding cycle, we will continue to leverage and amplify the impact of the existing SCOPE cohort to expand multidisciplinary human subject research and increase its integration with the CFAR Network of Integrated Clinical Systems (CNICS). We will also initiate a novel program called the Participant Referral Service to recruit additional participants – including those from communities disproportionately impacted by HIV but underrepresented in participating in research – from the diverse Ward 86 HIV clinic at San Francisco General Hospital. Ward 86 patients are racially/ethnically diverse (45% white, 17% African American, 27% Latinx, 6.3% Asian, 12% multi-racial), socioeconomically challenged, and have high rates of marginal housing (33%). Therefore, recruiting Ward 86 patients into CFAR studies will serve our cross-cutting priority of health equity. Moreover, we will move the ASB, supported by the CFAR, into the Clinical Core given its critical function in storing and curating specimens in the SCOPE cohort. By providing access to a well-characterized cohort for human subjects data and specimens (SCOPE), as well as platforms from which to diversity participants in human subjects research supported by the CFAR, the Clinical Core will help launch the careers of early stage investigators (ESIs), especially those from groups underrepresented in HIV research. The Clinical Core is well integrated with the other CFAR Cores, especially the Basic and Translational Core, a...