Modified Clinical Science Core Project Summary/Abstract Section The Midwest D-CFAR Clinical Science Core (CSC) is committed to addressing the persistent clinical challenges posed by HIV and its related conditions. Despite significant progress in combating clinical AIDS through antiretroviral therapy, HIV-related conditions – especially syndemic factors like mental health issues, and drug use – continue to impact the epidemic in Missouri. Additionally, as the HIV-positive population ages, comorbid clinical conditions such as cardiovascular disease, metabolic disorders, mental health, and impaired cognitive function contribute significantly to healthy life-years lost. To tackle these complex issues, the CSC aims to support creative and interdisciplinary investigator-initiated clinical scientific projects. The Washington University and Saint Louis University collaborative environment is conducive to this effort, boasting a rising class of energetic clinical researchers seeking NIH funding and a rich environment for HIV clinical research with substantial annual funding. However, the existing infrastructure has not been fully leveraged for investigator-initiated research. To address these gaps, the CSC plans to use infrastructural funding from a D-CFAR to foster synergies, increase the number of investigator-initiated trials, and expand clinical research into HIV-related comorbid conditions. Their specific objectives are: Aim 1. Provide streamlined training, consultation, and support for foundational clinical research practices, including study coordination, protocol development, ethical and regulatory approval, and access to clinical trial unit facilities. By leveraging their expertise in clinical trials and participant enrollment, the CSC seeks to support a growing cadre of innovative and interdisciplinary clinical research projects. Aim 2. Offer key resources and support throughout the research process, from idea generation to pilot funding applications, with a focus on accelerating interdisciplinary research addressing HIV comorbidities and co-occurring conditions. Through events like Transdisciplinary HIV Studios and coordination of pilot data collection, the CSC aims to facilitate cross-disciplinary scientific dialogue and maximize the utilization of existing clinical research infrastructure. Aim 3. Provide specialized resources in analytical, biostatistical, data management, and geospatial analysis for clinical research in HIV. To address the unique analytical needs of HIV-related research, the CSC will offer a one-stop shop for consulting services and specialized training sessions for junior investigators. The CSC will bring together new collaborators and novel ways of thinking about issues relevant to addressing the ongoing epidemic, improving care for long-term consequences of living with HIV, and identifying and evaluating strategies to address HIV treatment, prevention, and cure.