Five HIV Research Funding Opportunities from CDC
CDC’s Division of HIV Prevention recently released five notices of funding opportunity (NOFO) for research activities on several key issues in HIV prevention.
- Long-Acting Antiretroviral Therapy Preferences among Black Women
- Rapid ART Initiation in the Emergency Department
- Long-Acting Injectables in Non-Clinic Settings
- Medical Mistrust Among Hispanic/Latino MSM
- Telehealth to Support Retention and Adherence to ART
The funding opportunities are aligned with National HIV/AIDS Strategy (NHAS) priorities and support the implementation of the Ending the HIV Epidemic in the U.S. (EHE) initiative. Details on each opportunity with deadlines and links for more information are provided below.
Long-Acting Antiretroviral Therapy Preferences among Black Women
Exploring Preferences for Long-Acting Antiretroviral Therapies (LA-ART) in a Community-Based Sample of Priority Populations Living with HIV Who are Disproportionately Affected will support formative research on acceptance and perceived barriers and facilitators of using current and future LA-ART among cis-gender Black women with HIV (CgBWH). Creating equitable access to HIV treatment and care for people with HIV includes successful uptake of new and emerging treatments, such as LA-ART, which offer advantages such as convenience and reduced stigma compared to daily oral treatment. Inequities in HIV include the disproportionate rate of HIV among CgBWH. CgBWH account for nearly 60% of new HIV infections in U.S. women, despite making up less than 15% of the female population. Due to a host of social determinants of health (SDOH) like racism, poverty, stigma, unequal access to health care, and housing and educational inequities, CgBWH bear the highest burden of HIV infection among U.S. women. Given this disproportionate rate of infection and related SDOH, the focus population of this NOFO is CgBWH. This NOFO supports the EHE initiative “Treat” pillar. Specifically, the EHE plan lists CgBWH as a priority population to focus on for prevention, care, and treatment interventions and resources for the greatest impact in reaching the NHAS goals.
Rapid ART Initiation in the Emergency Department
Expanding Rapid Initiation of Antiretroviral Therapy (ART) in Non-traditional Settings: Emergency Department will support implementation research on the rapid or immediate initiation of ART for persons newly diagnosed with HIV or for people with HIV returning to care in emergency department (ED) settings. Immediate initiation of ART is recommended for anyone newly diagnosed with HIV, regardless of CD4 count. The rapid ART model, defined as immediate diagnosis, linkage to care, and ART initiation on the same day as a new HIV diagnosis or return to care, should offer an accelerated entry into HIV medical care. Rapid ART confers a higher rate of engagement in care, reduces the time to viral suppression, and improves morbidity and mortality in people with HIV. The ED offers a unique setting to immediately engage with patients who are not accessing HIV care services. The implementation research supported by this funding will deploy rapid ART models in ED settings and evaluate acceptability, perceived barriers and facilitators, feasibility, sustainability, and HIV care continuum outcomes. Applied research resulting from this funding is expected to decrease HIV infections and quickly achieve viral suppression among people with HIV. This research is aligned with the NHAS and the EHE initiative's “Treat” pillar.
Long-Acting Injectables in Non-Clinic Settings
Long-Acting Injectables (LAI) for the Treatment of HIV in Non-Clinic Community-Based Settings will support research on LAI-ART by implementing LAI-ART administration in non-clinic settings. LAI-ART offers many potential advantages over daily oral treatment such as improved convenience, adherence, and treatment satisfaction. Barriers and challenges exist with implementation of LAI-ART into current healthcare practice, both in logistics and in equity. Some of these barriers may be overcome by using non-clinic sites, such as community pharmacies, to administer LAI-ART. A multi-site effectiveness-implementation research study, designed to compare receiving LAI-ART in non-clinic community settings with the oral standard-of-care HIV clinical treatment, should offer a unique source of information for improving acceptability, availability, and uptake of LAI-ART. Implementation outcomes of interest include acceptability, perceived barriers and facilitators, feasibility, and sustainability. Health outcomes of interest include missed visits, on-time receipt of injections, and the HIV care continuum, including retention in care and viral load suppression. Applied qualitative and quantitative research resulting from this funding is expected to strengthen adherence to ART and is aligned with the NHAS and the EHE initiative's “Treat” pillar.
Medical Mistrust Among Hispanic/Latino MSM
Identifying and Addressing Historical and Structural Drivers of Medical Mistrust (MM) among Hispanic/Latino Gay, Bisexual and Other Men Who Have Sex with Men (HLMSM) for HIV Prevention targets EHE initiative jurisdictions with large Hispanic/Latino populations (30% or more based on 2020 US Census data) and will support research that captures variations in medical mistrust drivers among different Hispanic/Latino subgroups (e.g., Central Americans, Mexicans, Puerto Ricans, US-born, non-US-born, 1st generation, 2nd generation). The root causes for MM in Hispanic/Latino populations in the United States are understudied. MM is a social determinant of health associated with HIV disparities within HLMSM (e.g., low PrEP willingness and adherence) that prevents and delays access and engagement in HIV prevention and care services (such as PrEP, ART). The little research on MM among HLMSM has neither utilized a heterogeneous H/L population with different ethnic groups (e.g., Cuban, Mexican, Puerto Rican), nor addressed the historical roots and relevance of MM to healthcare access. Grounded in community-based participatory research (CBPR) principles, the objectives of this 2-phase NOFO are to: 1) identify MM drivers in HLMSM and existing interventions that build trust in health services via formative research (Phase 1); and (2) evaluate implementation of targeted multilevel interventions that build trust in health services (Phase 2).
Telehealth to Support Retention and Adherence to ART
Enhancing Telehealth Strategies to Support Retention and Adherence to Antiretroviral Therapy will support research on evidence of effectiveness of TeleART by implementing a hybrid effectiveness-implementation research study. Telehealth services such as TeleART are becoming more widely implemented; however, to date, there is a dearth of evidence of effectiveness of TeleART for ART adherence and retention in HIV care in the U.S. The study research supported by this NOFO should:
- evaluate the effectiveness of an enhanced telehealth program for maintenance of HIV medication adherence among clinically stable people with HIV (PWH); identify potential implementation facilitators and challenges by evaluating the delivery of these strategies; and
- evaluate the cost and cost-effectiveness of providing telehealth to patients on ART, and evaluate program enhancements that include, but may not be limited to, biospecimen sample self-collection and the use of specialized staff such as community health workers and patient navigators.
This enhanced telehealth program should focus on groups disproportionately affected by HIV and other persons for whom social determinants of health (e.g., stigma, discrimination, poverty, and low socioeconomic status) limit their engagement in HIV care and treatment. Specifically, African American cis-gender women, and/or Black or Hispanic/Latino gay, bisexual and other men who have sex with men, and/or transgender women, are groups of interest. The research supported by this NOFO should align with the NHAS and the EHE initiative's “Treat” pillar.