This Notice calls for research on understanding and addressing the impact of stigma or other social determinants of health as they relate to HIV prevention and treatment for socially disadvantaged populations.

Stigma and other social determinants of health, that is, those social conditions and economic circumstances that influence health, are known barriers to HIV prevention and HIV treatment. For example, stigma related to HIV or other intersecting forces of discrimination or disadvantage (intersectional stigma or intersectional discrimination), socio-economic factors such as homelessness, lack of employment and having no high school education are all associated with increased risk of HIV in cities or regions with high HIV/AIDS prevalence. Remaining in school is associated with delayed sexual debut and potentially reduces risk of HIV acquisition among young girls in Sub-Saharan Africa. The mechanisms through which stigma and other social determinants exert their effect may include but are not limited to the following multi-level factors: social/interpersonal (e.g., social capital, social cohesion, culture), and systems/community (e.g., unemployment, legislation, access to health care, institutionalized racism, policies).

Many studies are cross-sectional and focus on one type of stigma or a limited set of social determinants and by doing so, miss an opportunity to understand the mechanisms by which stigma or other social determinants are interrelated and interact to impact HIV prevention and HIV treatment outcomes. There is a specific interest in understanding mutable mechanisms by which stigma or other social determinants exert their effects, at multiple levels that could be targeted for intervention. The field would also benefit from a greater understanding of protective factors and resilience, particularly why some individuals, despite facing intersectional stigma or discrimination and living in highly disadvantaged environments, are able to maintain their health. Research that characterizes the social and structural conditions (e.g., culture, community organization) which facilitate resilience is particularly encouraged. Filling these research gaps is fundamental to the development of effective structural and/or multi-level interventions to prevent HIV and improve HIV care outcomes.

This Notice solicits theoretically-driven research grant applications which will: 1) advance measurements of intersectional stigma (or discrimination) or other social determinants of health to examine the mechanisms and pathways by which they are a barrier to HIV prevention and HIV treatment; or 2) develop and test interventions to address their impact to improve HIV prevention and HIV treatment outcomes.

Applicants are strongly encouraged to utilize community-informed participatory research approaches to meaningfully engage communities most impacted by social determinants in HIV to help frame research questions and approach and to synthesize findings in order to inform effective policy and programming. Research teams are encouraged to include experts across disciplines, sectors, conditions and communities. The strategic integration of mixed methodologies is also strongly encouraged. Finally, non-intervention research applications should clearly indicate how this is the first step in a planned program of research that would inform future interventions to reduce the impact of social determinants of health on HIV prevention and treatment outcomes.

Areas of Research Interest

Research to understand and address stigma or other social determinants of health in HIV, including, but not limited to:

• Studies to develop new or utilize existing methods to better characterize and measure mechanisms and pathways that are posited to underlie intersectional stigma or other social determinants or drive HIV related outcomes over the life course.
• Studies to develop assessments to capture underlying mechanisms of a social determinant or set of determinants with priority given to those that include multiple social determinants and that can be used repeatedly and are sensitive enough to meaningfully capture change over time.
• Studies that incorporate biological-behavioral-social-environmental interactions as they relate to stigma or social determinants and HIV-associated risk, vulnerability or disease progression.
• Studies to identify extra-individual level factors (e.g., interpersonal such as social networks; community such as social norms or resources; and societal such as discrimination, polices or laws) associated with HIV vulnerabilities or resiliencies (positive outcomes) over time.
• Studies that use mathematical modeling to connect subnational and national level data on social determinants to better estimate their relative contribution on HIV outcomes.
• Studies that combine data sets and use data analytic techniques that account for change over time (e.g. time-series) and examine the mediating pathways between multiple social determinant factors and HIV related outcomes.
• Studies to develop or apply analytic techniques to understand the relative contribution of multiple social determinants to a specific set of HIV related outcomes in the same population.
• Studies to develop and test interventions designed to address the mechanisms and pathways that underlie stigma or other social determinants and drive HIV-related outcomes over the life course, along with examination of potential mechanisms of change.

It is strongly recommended that applicants review the NIMH Division of AIDS Research current Funding Opportunity Announcements (available on our website at https://www.nimh.nih.gov/about/organization/dar/aids-related-funding-opportunity-announcements-foas.shtml), and consult with a Program Officer before application submission.

The NIMH has published updated policies and guidance for investigators regarding human research protection and clinical research data and safety monitoring (NOT-MH-15-025). The application’s Protection of Human Subjects section and data and safety monitoring plans should reflect the policies and guidance in this notice. Plans for the protection of research subjects and data and safety monitoring will be reviewed by the NIMH for consistency with NIMH and NIH policies and federal regulations.

Application and Submission Information

This notice applies to due dates on or after May 7, 2020 and subsequent receipt dates through September 8, 2022.

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.

PA-20-144, Innovations in HIV Prevention, Testing, Adherence and Retention to Optimize HIV Prevention and Care Continuum Outcomes (R01 Clinical Trial Optional)

PA-20-145, Innovations in HIV Prevention, Testing, Adherence and Retention to Optimize HIV Prevention and Care Continuum Outcomes (R21 Clinical Trial Optional)

PA-20-141, Formative and Pilot Intervention Research for Prevention and Treatment of HIV/AIDS (R34 Clinical Trial Optional)

PA-19-126, Mentored Research Scientist Development Award (Parent K01 - Independent Clinical Trial Not Allowed)

PA-19-127, Mentored Research Scientist Development Award (Parent K01 - Independent Clinical Trial Required)

PA-19-116, Mentored Clinical Scientist Research Career Development Award (Parent K08 Independent Clinical Trial Required)

PA-19-117, Mentored Clinical Scientist Research Career Development Award (Parent K08 Independent Clinical Trial Not Allowed)

PA-19-118, Mentored Patient-Oriented Research Career Development Award (Parent K23 Independent Clinical Trial Required)

PA-19-119, Mentored Patient-Oriented Research Career Development Award (Parent K23 Independent Clinical Trial Not Allowed)

PA-19-052, NIH Small Research Grant Program (Parent R03 Clinical Trial Not Allowed)

PA-19-129, NIH Pathway to Independence Award (Parent K99/R00 Independent Clinical Trial Required)

PA-19-130, NIH Pathway to Independence Award (Parent K99/R00 - Independent Clinical Trial Not Allowed)

PA-19-121, Midcareer Investigator Award in Patient-Oriented Research (Parent K24 Independent Clinical Trial Required)

PA-19-122, Midcareer Investigator Award in Patient-Oriented Research (Parent K24 Independent Clinical Trial Not Allowed)

PA-19-272, PHS 2019-02 Omnibus Solicitation of the NIH, CDC, and FDA for Small Business Innovation Research Grant Applications (Parent SBIR [R43/R44] Clinical Trial Not Allowed)

PA-19-273, PHS 2019-02 Omnibus Solicitation of the NIH, CDC, and FDA for Small Business Innovation Research Grant Applications (Parent SBIR [R43/R44] Clinical Trial Required)

PA-19-270, PHS 2019-02 Omnibus Solicitation of the NIH for Small Business Technology Transfer Grant Applications (Parent STTR [R41/R42] Clinical Trial Not Allowed

PA-19-271, PHS 2019-02 Omnibus Solicitation of the NIH for Small Business Technology Transfer Grant Applications (Parent STTR [R41/R42] Clinical Trial Required

PAR-19-051, Emerging Global Leader Award (K43 Independent Clinical Trial Required)

PAR-19-098, Emerging Global Leader Award (K43 Independent Clinical Trial Not Allowed)

PAR-17-485, NIMH Research Education Mentoring Program for HIV/AIDS Researchers (R25)

PAR-18-714, Academic Research Enhancement Award for Undergraduate-Focused Institutions (R15 - Clinical Trial Not Allowed)

PAR-19-133, Academic Research Enhancement Award for Undergraduate-Focused Institutions (R15 Clinical Trial Required)

PAR-19-134, Research Enhancement Award Program (REAP) for Health Professional Schools and Graduate Schools (R15 Clinical Trial Not Allowed)

PAR-19-135, Research Enhancement Award Program (REAP) for Health Professional Schools and Graduate Schools (R15 Clinical Trial Required)

PAR-19-283, Fogarty HIV Research Training Program for Low-and Middle-Income Country Institutions (D43 Clinical Trial Optional)

PA-19-192, Ruth L. Kirschstein National Research Service Award (NRSA) Individual Fellowship for Students at Institutions Without NIH-Funded Institutional Predoctoral Dual-Degree Training Programs (Parent F30)

PA-19-195, Ruth L. Kirschstein National Research Service Award (NRSA) Individual Predoctoral Fellowship (Parent F31)

PA-19-196, Ruth L. Kirschstein National Research Service Award (NRSA) Individual Predoctoral Fellowship to Promote Diversity in Health-Related Research (Parent F31 -Diversity)

PA-19-188, Ruth L. Kirschstein National Research Service Award (NRSA) Individual Postdoctoral Fellowship (Parent F32)

PA-18-403, Ruth L. Kirschstein National Research Service Award (NRSA) Institutional Research Training Grant (Parent T32)

All instructions in the SF424 (R&R) Application Guide and the funding opportunity announcement used for submission must be followed, with the following additions:

• For funding consideration, applicants must include NOT-MH-20-020 (without quotation marks) in the Agency Routing Identifier field (box 4B) of the SF424 R&R form. Applications without this information in box 4B will not be considered for this initiative.

Applications nonresponsive to terms of this NOSI will be not be considered for the NOSI initiative.

Please direct all inquiries to the contacts in Section VII of the listed funding opportunity announcements with the following additions/substitutions:

Scientific/Research Contact(s)

Gregory Greenwood, PhD, MPH
National Institute of Mental Health (NIMH)
Telephone: 240-669-5532
Email: [email protected]

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)
Rita Sisco
National Institute of Mental Health (NIMH)
Telephone: 301-443-2805
Email: [email protected]