Reducing Stigma to Improve HIV/AIDS Prevention, Treatment and Care in Low and Middle- Income Countries (R21 Clinical Trial Optional) | PAR 18 732

Opportunity Information: Apply for PAR 18 732

Reducing Stigma to Improve HIV/AIDS Prevention, Treatment and Care in Low and Middle-Income Countries (R21 Clinical Trial Optional) is a National Institutes of Health (NIH) discretionary grant opportunity (Funding Opportunity Number PAR 18-732) designed to spark early-stage, exploratory research focused on HIV/AIDS-related stigma in low- and middle-income countries (LMICs). The central idea behind the program is that stigma is not just a social problem running alongside HIV, but a direct driver of delayed testing, avoidance of care, poor treatment adherence, and reduced quality of life for people living with HIV/AIDS (PLWH). By funding R21 studies, NIH is aiming to help researchers pilot and refine practical interventions, build feasibility evidence, and generate the kind of preliminary data needed to move promising stigma-reduction strategies toward larger-scale implementation and testing. Because it is labeled “Clinical Trial Optional,” applicants may propose either clinical trial-style intervention studies or non-trial research, depending on what best fits the question and setting.

The FOA prioritizes research that develops and evaluates interventions intended to reduce HIV-associated stigma and the downstream harms stigma causes in prevention, treatment, and care. It highlights several specific emphasis areas. One is the creation of novel stigma-reduction interventions that can be directly linked to measurable public health outcomes, such as increased care-seeking behavior (for example, earlier HIV testing, improved linkage to care, better retention) and/or decreased HIV transmission risk. Another focus is on adolescents and youth, recognizing that stigma can be especially damaging during these developmental stages and can intersect with school environments, peer networks, disclosure fears, and barriers to accessing youth-friendly health services. The FOA also explicitly calls for strategies that address “layered” or compounded stigma, where HIV stigma is intertwined with stigma related to comorbidities or coinfections (such as tuberculosis, hepatitis, sexually transmitted infections, mental health conditions, or substance use). In addition, it encourages work aimed at the family and caregiving context, including interventions that reduce stigma experienced by family members or caregivers of PLWH, and interventions that reduce stigmatizing attitudes or behaviors coming from family systems themselves. Finally, a major methodological priority is improving how stigma is measured, particularly in the context of implementing an intervention. This includes developing more innovative tools, more sensitive measures that can detect change over time, and measurement approaches that are feasible in real-world LMIC implementation settings.

Across these research areas, the larger goals are to better understand how stigma contributes to HIV transmission dynamics, to eliminate or reduce stigma-related barriers that limit positive health outcomes for people living with or at risk for HIV, and to support exploratory studies that test whether stigma interventions are workable, acceptable, and scalable in LMIC contexts. In practical terms, NIH is signaling interest in research that does more than document stigma; it wants applicants to test approaches that can be deployed through clinics, communities, schools, peer networks, and health systems, and that can plausibly move the needle on prevention and care outcomes. The FOA also implicitly recognizes that stigma operates at multiple levels (individual, interpersonal, community, and structural), so competitive proposals often align interventions and measurements with the level(s) where change is targeted.

On eligibility, the opportunity is broad and intentionally inclusive. Eligible applicants include many types of U.S. governmental entities (state, county, city/township, special district governments), public housing authorities/Indian housing authorities, independent school districts, and public or state-controlled institutions of higher education. It also includes federally recognized Native American tribal governments, tribal organizations that are not federally recognized, nonprofits (both 501(c)(3) and non-501(c)(3)), private institutions of higher education, for-profit organizations (other than small businesses), small businesses, and other organizational types. The FOA also calls out additional eligible applicant categories such as Historically Black Colleges and Universities (HBCUs), Hispanic-serving Institutions, Tribally Controlled Colleges and Universities (TCCUs), Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISIs), faith-based or community-based organizations, and eligible federal agencies. Importantly for work in LMICs, non-domestic (non-U.S.) entities (foreign organizations) and regional organizations are eligible as well, along with U.S. territories or possessions. This structure supports partnerships led by organizations within LMICs and encourages research that is grounded in local realities rather than being purely externally designed.

From the funding details provided, the grant mechanism is an R21, which is typically used for exploratory and developmental research. The award ceiling listed is $125,000, and the original closing date shown is August 1, 2018, with a creation date of March 29, 2018. The opportunity is associated with multiple CFDA numbers (93.242, 93.393, 93.394, 93.395, 93.396, 93.399, 93.865, 93.989), reflecting NIH’s involvement across several program areas. Overall, this FOA is best understood as a targeted call for practical, testable ideas that reduce HIV-related stigma in LMIC settings, strengthen the evidence base for what works, and improve the tools used to measure stigma so that future implementation and scale-up efforts can be tracked reliably and tied to meaningful prevention and treatment outcomes.

• The National Institutes of Health in the education, health, income security and social services sector is offering a public funding opportunity titled "Reducing Stigma to Improve HIV/AIDS Prevention, Treatment and Care in Low and Middle- Income Countries (R21 Clinical Trial Optional)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.242, 93.393, 93.394, 93.395, 93.396, 93.399, 93.865, 93.989.
• This funding opportunity was created on 2018-03-29.
• Applicants must submit their applications by 2018-08-01. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Each selected applicant is eligible to receive up to $125,000.00 in funding.
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For-profit organizations other than small businesses, Small businesses, Others.

Apply for PAR 18 732

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