EXPIRED
March 3, 2021
PA-20-183 - Research Project Grant (Parent R01 Clinical Trial Required)
National Institute on Minority Health and Health Disparities (NIMHD)
National Institute on Drug Abuse (NIDA)
National Institute of Mental Health (NIMH)
Background
The objective of the Ending the HIV Epidemic: A Plan for America is to reduce new HIV infections in the United States by 75 percent in five years and by 90 percent by 2030 (https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/overview). This will be accomplished by implementing proven strategies to prevent new HIV infections--including use of pre-exposure prophylaxis (PrEP) by high risk HIV negative individuals and achieving an undetectable viral load through antiretroviral therapy (ART) among people living with HIV (PLWH)--in geographic hotspots with disproportionate numbers of new HIV infections. PLWH who are virally suppressed cannot transmit HIV, but according to the CDC, PLWH engaged in HIV care but not virally suppressed account for 20% of new HIV transmissions.
To meet the Plan for America objectives, the target level for viral suppression among PLWH is 95%. According to the CDC, about two-thirds (63%) of PLWH currently demonstrate 12-month viral suppression, with significant disparities evident. Among PLWH in HIV care, racial/ethnic minorities, less educated and lower SES individuals, and adolescents and young adults are less likely to be prescribed ART, achieve viral suppression on ART, and maintain sustained viral suppression than their more advantaged or older counterparts. Lack of suppression, coupled with unprotected sexual contact or injection drug use, contributes to an elevated risk of HIV transmission within these groups. Better strategies are needed to promote ART initiation and adherence in PLWH from health disparity populations engaged in HIV care and to reduce HIV risk behaviors during periods of non-suppression. Although a variety of interventions exist to improve adherence to ART and other medications, many focus on health education and text message reminders and do not address social determinants associated with poorer ART adherence and viral suppression. Such factors include poverty, unemployment, limited health literacy, limited English proficiency, housing instability, food insecurity, criminal justice involvement, lack of social support, intimate partner violence, community violence, stigma and discrimination, and lack of access to culturally competent HIV care or pharmacy services. As a result, many adherence interventions are less effective with PLWH from health disparity populations or show initial effects that dissipate over time. In addition, many existing ART adherence interventions do not address HIV risk behaviors during periods of non-suppression. Therefore, multi-domain, multi-level interventions that address social determinants of health are needed to help PLWH from health disparity populations initiate and sustain ART adherence and reduce HIV risk behaviors.
Research Objectives
The purpose of this NOSI is to encourage research projects that test interventions to promote ART initiation, ART adherence, and suppressed viral load for PLWH engaged in HIV care in one or more geographic hotspots (see https://files.hiv.gov/s3fs-public/Ending-the-HIV-Epidemic-Counties-and-Territories.pdf for a list of hotspots). The population focus for this initiative is expected to be primarily Black and Latino men who have sex with men (MSM) and transgender women, as these populations have elevated rates of new HIV infection as well as risk of HIV transmission. Other health disparity populations with low levels of viral suppression within the proposed hotspots may also be included as appropriate, including non-Hispanic white MSM, cisgender African American or Latina women, or rural residents who inject drugs.
Interventions are expected to have the following features:
Areas of special interest include but are not limited to the following:
NIDA is interested in the following areas of research involving people who use drugs (PWUD) including key populations e.g., Black/African American gay, bisexual, and men who have sex with men (MSM), Hispanics/Latinos MSM, Transgender Women, Female Sex Workers (FSW), High Risk Heterosexuals of racial ethnic minority groups (HRH) where drug use is a common contributing HIV risk:
Areas of special interest to NIDA include but are not limited to the following:
Applications Not Responsive to the NOSI:
Application and Submission Information
Submit applications for this initiative using one of the following funding opportunity announcements (FOAs) or any reissues of these announcement through the expiration date of this notice.
All instructions in the SF424 (R&R) Application Guide and the funding opportunity announcement used for submission must be followed, with the following additions:
Applications nonresponsive to terms of this NOSI will not be considered for the NOSI initiative.
Scientific/Research Contact(s)
Jennifer Alvidrez, PhD
National Institute on Minority Health and Health Disparities (NIMHD)
Telephone: 301-594-9567
Email: jennifer.alvidrez@nih.gov
Richard A Jenkins
National Institute on Drug Abuse (NIDA)
Phone: 301-443-6504
E-mail: jenkinsri@nida.nih.gov
Susannah Allison, Ph.D.
National Institute of Mental Health (NIMH)
Telephone: 240-627-3861
Email: allisonsu@mail.nih.gov
Peer Review Contact(s)
Examine your eRA Commons account for review assignment and contact information (information appears two weeks after the submission due date).
Financial/Grants Management Contact(s)
Priscilla Grant, JD
National Institute on Minority Health and Health Disparities (NIMHD)
Telephone: 301-594-8412
Email: pg38h@nih.gov
Pamela G Fleming
National Institute on Drug Abuse (NIDA)
Phone: 301-480-1159
E-mail: pfleming@nida.nih.gov