Implementation Science to Optimize HIV Prevention and Treatment

The NIH Office of AIDS Research (OAR) within the NIH Office of the Director partners with NIH Institutes, Centers, and Offices to coordinate the NIH HIV Research Program and ensure the science is aligned with priorities outlined in the NIH Strategic Plan for HIV and HIV-Related Research. OAR aims to bridge the research-to-practice gap by promoting and supporting implementation science that uncovers how best to integrate evidence-based interventions for HIV prevention and treatment and associated conditions into real-world settings.

This office does not award grants. Applications must be relevant to the objectives of at least one of the participating NIH Institutes and Centers listed in this topic.

NCI is interested in applications to investigate how to implement improved prevention, earlier diagnosis, optimal treatment, and survivorship of malignancies in people with HIV. People with HIV have increased risk of certain tumors and are acquiring more tumors that occur in older individuals as the population of people with HIV ages. These tumors are often diagnosed at a later stage in people with HIV, and treatment outcomes are often worse than in the general population. In addition, NCI is interested in applications that seek to understand how best to integrate multi-component interventions to optimize the health of people with HIV and cancer. Research is needed on how best to integrate cancer control interventions into HIV healthcare settings; implement care coordination between HIV and oncology teams; implement interventions to improve treatment adherence and symptom management among HIV-positive cancer survivors; address the complex social needs of patients with HIV and cancer.

NIA is interested in research that considers the intersection of HIV, aging-related health conditions, and unique challenges faced by affected communities, to inform delivery of evidence-based interventions to promote healthy aging and improve the quality of life of older adults living with or at risk for HIV.

Research to identify, develop, and test strategies to overcome barriers to adoption, adaptation, integration, sustainability, and scale-up of evidence-based interventions, practices, tools, treatments, and guidelines for HIV prevention, treatment, and care unique to older adults is a priority. This includes research that examines the integration or coordination of healthcare for HIV-related and age-related conditions and to understand mechanisms of action underlying proven interventions, and other strategies along with the cumulative science of behavior change to inform implementation efforts.

Implementing alcohol-focused combined behavioral and pharmacological interventions: Between 30 - 40% of people with HIV are diagnosed with Alcohol Use Disorders. Reducing alcohol use can effectively facilitate ending the HIV epidemic when combined alcohol-focused interventions are integrated with other mental health and substance use interventions. Alcohol impacts depression, anxiety, pain, trauma and use of other substances such as tobacco and interacts with medications in aging populations. A combined approach may greatly improve the effectiveness of Interventions which can be framed within both behavioral (e.g. non-adherence and poor viral control) and/or biological research (e.g., inflammation and Immunological response to stress). This research directly addresses the goals of this announcement to develop new strategies across different environmental (e.g., homelessness) and geographic contexts (e.g., density of alcohol outlets). 

Applicants to NIAID should identify partnerships with relevant implementers with a stated commitment to evaluate and incorporate changes which are proven to be both successful and cost-effective. Specific interest areas include (but are not limited to): 

• Multidisciplinary implementation research efforts informed by epidemiology, data science, modeling, and related fields; integrated approaches to deliver screening, prevention, treatment and care services for HIV and common co-infections, including interventions to address sexually transmitted (e.g. doxycycline post-exposure prophylaxis) and opportunistic infections.
• Research that leverages information and communication technologies, including artificial intelligence, digital technology, telehealth, electronic health records, and data exchange.
• Studies designed to assess or prepare for the implementation of FDA-approved "next generation" HIV interventions, such as long-acting injectable antiretroviral therapy.

NIAMS aims to support the implementation of research findings into real-world settings. Clinical research areas include, but are not limited to, rheumatology, orthopedics, dermatology, bone diseases, muscle diseases, as well as sports and rehabilitation medicine. In the context of HIV prevention, treatment, and care, there is heightened risk of NIAMS-related co-occurring conditions. NIAMS encourages innovative research applications focused on HIV-related social, economic and health consequences that also seek to develop and test strategies that foster broad implementation, uptake, and sustainability of evidence-based approaches used to prevent and/or manage arthritis, musculoskeletal, and skin diseases and disorders. In addition to promoting the use of context-specific strategies and dynamic multi-level approaches, NIAMS strongly emphasizes the importance of studies where end-users are engaged throughout the research process to ensure sustainable implementation. 

NICHD supports research to develop, test, and/or implement strategies that expand engagement and re-engagement in HIV prevention, testing, treatment, care, and response services with a focus on pediatric/adolescent and maternal populations that are disproportionately impacted by HIV and/or that are largely unreached by current programs.

NIDA seeks applications to inform, develop or test implementation science approaches to scale-up & sustain evidence-based HIV intervention among people who use drugs, incorporating care & prevention continua. A range of settings can be considered (e.g. community, clinic, drug treatment, harm reduction, criminal-legal), and all levels of intervention (community, client/patient, provider, system). The full range of licit & illicit drugs that may affect HIV risk, prevention &/or care are relevant. Studies should consider contextual influences, risk and protective factors and the range of key populations. Novel research methods & designs are encouraged, along with the full range of modalities. Studies that include emerging technology, e.g., eHealth, data science, & computation approaches are welcome. Community partnerships, incorporating lived experience are encouraged. A syndemic perspective should be considered including co-occurring chronic, infectious disease, & psychiatric disorders.

NIDCR seeks applications to test the integration of services, values, and/or care delivery through cross-sector partnerships in communities to address factors impacting access and adherence to evidence-based HIV and oral disease interventions. Applications must demonstrate existing and/or planned community engagement/partnerships with populations at risk for poorer HIV outcomes or new HIV infections, use of place-based real-world data and infrastructure/tools (e.g. AIDS Research community engagement cores/advisory groups, relevant community-based surveillance, electronic health records, geofencing technologies), and how the tested population-based interventions would be disseminated sustainably to end the HIV epidemic and oral disease burden in the community. The proposed intervention should be guided by a theory-driven conceptual framework, and the use of whole person perspectives and the principles of community engagement are highly encouraged.

NIDDK supports biomedical research on diabetes and other endocrine and metabolic diseases; digestive and liver diseases, nutritional disorders, and obesity; and kidney, urologic, and hematologic diseases, to improve people’s health and quality of life. NIDDK encourages applications to advance the goals of ending the HIV epidemic through implementation research in geographic areas in the U.S. with high HIV incidence and comorbidities, co-infections, and complications relevant to the NIDDK mission. Applications that propose interventional and observational studies that address both ending HIV and co-morbidities in NIDDK mission areas are encouraged. Applications must include a primary endpoint related to an NIDDK mission disease or condition. 

In addition to these general interests, a key priority for NIMH is the science of scale-up, defined as studies on the expansion of effective strategies from a smaller to a larger scale. For example, studies could aim to scale-up an innovative strategy from a single or several delivery settings to all analogous settings in a county, city, or other larger catchment area (e.g., state-wide). Such strategies include, but are not limited to, learning systems such as Learning Collaboratives, Communities of Practice, or training models such as train-the-trainer or user-friendly toolkits. Scale-up strategies often employ quality improvement methods and integrate robust data feedback systems that facilitate adaptation and refinement of the intervention delivery over time. Partnerships are encouraged with federal, regional, state, and local agencies conducting large-scale HIV service delivery.

NINR leverages a person-centered holistic nursing perspective to support rigorous solution-oriented research conducted by scientists from any discipline. NINR leads discoveries of innovative systems and models of care, breakthroughs in disease prevention and health promotion, and advances in population and community health. NINR supports research that addresses health differences, intervenes on the conditions in which people live, uses multilevel approaches to prevent disease and promote health, engages communities, and implements clinical and organizational solutions to maximize positive health outcomes. NINR is particularly interested in applications for research in implementation science that meaningfully engages communities and are multi-sectoral in scope to advance HIV prevention or improve health outcomes among persons living with HIV. Research addressing the specific challenges faced by communities in U.S. rural settings is of interest.

The ODP is interested in providing co-funding support for innovative prevention research that employs rigorous study design, measurement, and analysis methods. For this topic, ODP is particularly interested in HIV prevention implementation trials, especially multi-site or cluster randomized clinical trials. 

The ODP does not award grants; therefore, applications must be relevant to the objectives of at least one of the participating NIH Institutes and Centers (IC). Please reach out to the relevant IC Contact listed for questions regarding IC research priorities.

ORIP’s infrastructure programs empower HIV/AIDS implementation science in all areas of research. Infrastructure and technology play critical roles in enabling emerging field of research and facilitating paradigm shift, allowing researchers to conduct HIV research that leads to innovations in implementation science and long-term HIV cure. 

The S10 program supports commercially available instruments for human studies. Examples include radiology imagers, microscopes and ultrasound scanners for point-of-care; high-performance computational systems for clinical and laboratory informatics, data management systems for patient reported outcomes; genetic and analytical instruments. 

The S15 program supports equipment critical to carrying out implementation research. Examples of the intended equipment include mobile labs to bring tests to patients in remote communities, robots and other tools for laboratory automation, pathology and other lab equipment, and freezers for cryopreservation, etc. 

The Office of Research on Women's Health (ORWH) is interested in research focusing on: 

• Community-led implementation projects to improve testing, prevention, and treatment for women across the life course.
• Comorbidity and multi-morbidity, especially among older populations of women with HIV.
• Development and scale-up of female-specific HIV prevention modalities and dual-purpose prevention technologies.
• Improving public health practices and health care delivery tailored to the needs of women.

This office does not award grants. Applications must be relevant to the objectives of at least one of the participating NIH Institutes and Centers listed in this topic.