The purpose of this FOA is to stimulate research on interventions to reduce HIV/AIDS-associated stigma and its impact on the prevention and treatment of HIV/AIDS and on the quality of life of People Living with HIV/AIDS (PLWH). Specifically, this initiative will support research on a) novel stigma reduction interventions that link to increase in care-seeking behavior and/or decrease in transmission; b) reducing the impact of stigma on adolescent and/or youth health; c) strategies to cope with the complex burden of stigmatization due to HIV and one or more comorbidities/coinfections; d) reducing effects of stigma on and/or by family members or caregivers of PLWH; and e) innovative and improved stigma measurement in the context of implementation of an intervention. The overall goals are to understand how to reduce stigma as a factor in HIV transmission, to eliminate or mitigate the aspects of stigma that limit beneficial health outcomes for the infected and at-risk individuals and communities, and to initiate exploratory studies to determine the feasibility of stigma interventions related to HIV prevention, treatment and/or care in Low and Middle-Income Countries (LMICs).
Section I. Funding Opportunity Description
This Funding Opportunity Announcement (FOA) issued by the Fogarty International Center (FIC) seeks to stimulate new and impactful research towards the development of stigma reduction interventions leading to better outcomes for the prevention and treatment of HIV/AIDS and on the quality of life of People Living with HIV/AIDS (PLWH) in Low and Middle-Income Countries (LMICs). Specifically, this initiative will support research on a) novel stigma reduction interventions that link to increase in care-seeking behavior and/or decrease in transmission; b) reducing the impact of stigma on adolescent and/or youth health; c) strategies to cope with the complex burden of stigmatization due to HIV and one or more co-morbidities/co-infections; d) reducing the effects of stigma on and/or by family members or caregivers of PLWH; and e) innovative and improved stigma measurement in the context of intervention development or implementation. The R21 grant mechanism is intended to encourage exploratory/developmental research by providing support for the early and conceptual stages of project development (https://grants.nih.gov/grants/funding/r21.htm). It is hoped that this preliminary research will lay the foundation for larger intervention studies that can be funded by other organizations or NIH institutes that support stigma research.
The objective of this FOA is to lay the groundwork for, or pilot, stigma-reduction interventions to improve HIV health seeking behavior across the HIV care continuum and improve biological and mental outcomes for PLWH or their caregivers. In the context of an intervention, the areas of focus may include but are not limited to:
-Adapting, developing, validating or implementing stigma reduction interventions in PLWH. Target populations may include adolescents and/or youth, caregivers, and other key populations such as sex workers, people who inject drugs, transgender people, prisoners, and men who have sex with men, among others.
-Adapting, developing, or validating measurement instruments to assess the success of the intervention in reducing stigma and in improving health outcomes.
-Formative research on novel stigma reduction interventions to understand the obstacles to seeking care.
-Formative research to assess the complexities in layered or intersecting stigma that might lead to strategies to address the synergistic burden.
-Studies to assess stigma reduction interventions in specific social groups (for example, unmarried pregnant women); or across multiple groups (for example PLWH and their health care workers) linking to a health outcome such as decrease in transmission.
-Studies to assess the association of structural level stigma reduction interventions with better health outcomes; for example, modifiable structural factors such as health policy and its impact on health outcomes.
Tools for addressing stigma awareness in HIV+ adolescents, young children and orphans and increase their participation in care seeking and prevention strategies.
Applications proposing studies that do not address a stigma reduction intervention strategy linked to measurement of a beneficial health outcome would not be supported under this FOA.
Through this FOA, FIC seeks to initiate exploratory studies to determine feasibility of implementable and ultimately scalable approaches to understand and reduce stigma as a factor in HIV transmission. Applicants should assemble teams with the appropriate range of expertise required to accomplish the aims of the study, which may include a collaborative team with multi-disciplinary expertise.
The proposed collaborative exploratory research is expected to help build the capacity for full research programs by improving the research environment and strengthening LMIC individual and institutional research capabilities in the proposed research areas. The proposed work and follow up research are expected to contribute to the long-term goals of building sustainable capacity for stigma research in LMICs. One or more investigators from an institution in the U.S. and one or more investigators from an institution in an LMIC must collaborate as key personnel on the application. Applicants should explicitly address the needs of collaborating LMIC institutions to develop capacity for carrying out research in this field.
Section III. Eligibility Information
1. Eligible Applicants
Higher Education Institutions
-Public/State Controlled Institutions of Higher Education
-Private Institutions of Higher Education
The following types of Higher Education Institutions are always encouraged to apply for NIH support as Public or Private Institutions of Higher Education:
-Historically Black Colleges and Universities (HBCUs)
-Tribally Controlled Colleges and Universities (TCCUs)
-Alaska Native and Native Hawaiian Serving Institutions
-Asian American Native American Pacific Islander Serving Institutions (AANAPISIs)
Nonprofits Other Than Institutions of Higher Education
-Nonprofits with 501(c)(3) IRS Status (Other than Institutions of Higher Education)
-Nonprofits without 501(c)(3) IRS Status (Other than Institutions of Higher Education)
-Non-domestic (non-U.S.) Entities (Foreign Institutions)
Non-domestic entities are restricted to higher education institutions and other non-profit organizations in LMICs, which are defined by The World Bank as low-, lower-middle-, or upper-middle-income economies - http://data.worldbank.org/about/country-classifications/country-and-lending-groups Hong Kong-based institutions are not eligible as applicant or primary LMIC -partner institutions. If Hong Kong is included, a second institution in mainland China must be involved as the primary collaborating LMIC institution.
At least one institution in the U.S. and at least one institution in an LMIC must be involved as partners in the grant application.
Non-domestic (non-U.S.) Entities (Foreign Institutions) are eligible to apply.
Non-domestic (non-U.S.) components of U.S. Organizations are eligible to apply.
Foreign components, as defined in the NIH Grants Policy Statement, are allowed.