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National Cancer Institute (NCI)

The National Cancer Institute (NCI) plans to publish a Funding Opportunity Announcement (FOA) as an RFA (i.e., Request for Applications) for the "Implementation Science for Cancer Control in People Living with HIV (PLWH) in Low- and Middle-Income Countries (LMICs) Initiative (U01).This FOA aims to support implementation science to accelerate the integration of evidence-based cancer control interventions for PLWH into HIV treatment and prevention programs worldwide by leveraging existing infrastructure. The FOA solicits applications in implementation science to address gaps in the delivery of evidence-based cancer control among PLWH in LMICs and generate data in LMICs that can inform effective and equitable implementation of evidence-based cancer control strategies for PLWH worldwide. This Notice of Intent to Publish (NOITP) encourages multi-disciplinary teams of researchers with expertise in HIV or cancer and in implementation science to consider developing responsive applications that address the cancer control needs of PLWH populations in LMIC settings.

This NOITP is being provided to allow potential applicants sufficient time to develop meaningful collaborations and responsive projects.

The RFA is expected to be published in Summer of 2021 with an expected application due date in Fall of 2021.

The RFA will utilize the U01 Research Project Grant activity code. Details of the planned RFA are provided below.

Advances in human immunodeficiency virus (HIV) treatment have led to increased lifespans among PLWH. Despite these successes, the aging population of PLWH continues to experience substantial risk of other comorbidities including cancer. Compared with HIV-uninfected individuals, PLWH are at higher risk for classical AIDS-defining cancer (ADCs), including Kaposi sarcoma and cervical cancer, as well as several non-AIDS defining cancers (NADCs), such as lung and liver. Approximately 90 percent of PLWH live in LMICs where access to effective cancer control measures may be limited. In addition, increased access to antiretroviral therapy (ART) among PLWH has led to an increased cancer burden in this aging population in LMICs, similar to trends in high-income countries (HICs). The cancer risks among PLWH in LMICs is further exacerbated by factors such as modifiable risk factors (tobacco use, poor diet, and physical inactivity), and prevalent oncogenic infections.

Despite the increasing cancer burden among PLWH in LMICs, there is limited research to guide the adoption and integration of evidence-based cancer control strategies and interventions for resource-limited settings. Substantial, multi-sector investments in recent decades have built strong healthcare delivery systems for HIV treatment and prevention worldwide, and this infrastructure has great potential to be leveraged for cancer control. Research in implementation science can inform the development, adaptation, and implementation of effective and scalable approaches to evidence-based cancer control that utilize the robust service delivery capacity of existing HIV treatment and prevention programs in LMICs.

NCI encourages projects using implementation science to accelerate the translation of evidence-based cancer control interventions among PLWH in LMICs. Applications should pursue approaches to identifying, understanding, and developing strategies for overcoming barriers to the adoption, adaptation, integration, scale-up, and sustainability of evidence-based cancer control interventions in PLWH. Interventions are programs, practices, or policies that have been empirically demonstrated to improve health. The projects advanced through this program, while being targeted to PLWH in specific LMIC settings, should additionally provide insights to addressing cancer control in other resource-constrained settings. Examples of research topics supported by this proposal include, but are not limited to, the following topics focused on PLWH in LMICs:

• Studies to design, develop, and test theory-informed strategies to improve uptake and integration of evidence-based cancer control interventions.
• Studies evaluating the comparative effectiveness and cost-effectiveness of different implementation strategies.
• Studies of policies and other contextual factors that influence the success of dissemination and/or implementation efforts.
• Studies that explore strategies to support the integration of telehealth/telemedicine interventions to deliver evidence-based cancer control.
• Studies to understand how and why implementation efforts are successful (or unsuccessful) in HIV-positive populations in LMICs.

The U01 projects supported by this program will have substantial scientific and programmatic involvement from NCI. The research teams are encouraged to use multi-PI structures with significant involvement or leadership from the LMIC investigators and institutions. The implementation science projects proposed must address an appropriate cancer control problem that is significant in the proposed LMIC setting. While the scope of the projects can include adaptation and validation of some interventions, the core of the research activities should focus on their implementation in practice settings. Projects proposed in response to this FOA will likely require multidisciplinary teams with cancer, HIV, and implementation science expertise to succeed. Investigators responding to this FOA should also consider if the research has potential for future integration and scale-up/sustainability in the proposed LMIC setting.

Applications are not being solicited at this time.

Please direct all inquiries to:

Vidya Vedham, Ph.D.

National Cancer Institute (NCI)

240-276-7272

vidya.vedham@nih.gov