Increasing Immediate Engagement and Retention in HIV Treatment with Substance Users (R01- Clinical Trials Required) | RFA DA 23 002

Opportunity Information: Apply for RFA DA 23 002

The NIH funding opportunity "Increasing Immediate Engagement and Retention in HIV Treatment with Substance Users" (RFA-DA-23-002) is an R01 grant program focused on improving how quickly people living with HIV (PLWH) who also have substance use disorders (SUD) get connected to HIV treatment and how well they stay engaged in both HIV and SUD care over time. The core problem the announcement is trying to solve is that even when clinics offer same-day or otherwise rapid antiretroviral therapy (ART/ARV) starts, many patients still experience delays or drop off from care because of real-world barriers such as competing needs (housing, food, safety, mental health), administrative enrollment delays for support programs (ADAP, Ryan White, Medicaid), and service systems that are hard to navigate. The opportunity highlights that these challenges can be especially severe in resource-limited settings, where staffing, transportation options, and service capacity may be constrained.

A central point in the announcement is that standard engagement approaches, including Strengths-Based Case Management and Patient Navigation, often do not show strong effectiveness for people with SUD. The NIH is signaling that individuals with both HIV and substance use issues frequently face more complex clinical and social situations than many traditional linkage-to-care models were designed to handle. This population may need coordinated engagement with multiple services at once (HIV primary care, addiction treatment, behavioral health, case management, social supports), and the pathway from diagnosis to sustained viral suppression can break down at several points. The grant therefore emphasizes intervention strategies that do more than initiate ART quickly; it prioritizes approaches that also help people remain continuously in care and achieve durable viral suppression, aligning with national "Ending the HIV Epidemic" goals.

The research emphasis is on developing and testing evidence-based interventions that operate at the systemic, organizational, and/or provider levels. In practical terms, that means the NIH is looking for projects that change how care is delivered, how organizations coordinate services, how providers engage patients, or how systems remove structural bottlenecks that slow treatment initiation and undermine retention. The desired impact is twofold: reduce the time between HIV diagnosis and treatment start, and strengthen longer-term retention in both HIV care and SUD care. Because this is labeled "Clinical Trials Required," applicants are expected to include a clinical trial component to rigorously test the intervention, rather than only conducting observational work or formative assessments.

Eligibility is broad and includes many types of U.S.-based organizations and governments. Eligible applicants include state, county, city, township, and special district governments; federally recognized tribal governments and other tribal organizations; public housing authorities; independent school districts; public and private institutions of higher education; nonprofits with or without 501(c)(3) status; for-profit organizations (other than small businesses) and small businesses; and other entities. The announcement also explicitly calls out additional eligible applicant types such as Alaska Native and Native Hawaiian Serving Institutions, AANAPISISs, Hispanic-serving institutions, Historically Black Colleges and Universities (HBCUs), Tribally Controlled Colleges and Universities (TCCUs), faith-based or community-based organizations, regional organizations, eligible federal agencies, and U.S. territories or possessions. At the same time, it draws clear boundaries around foreign participation: non-domestic (non-U.S.) entities and non-U.S. institutions are not eligible to apply, and non-domestic components of U.S. organizations are not eligible to apply. However, "foreign components" are allowed as defined by the NIH Grants Policy Statement, meaning parts of the research may involve international elements under NIH rules even though the applicant organization itself must be domestic.

Administratively, the opportunity is a discretionary grant under the NIH, within the health and education activity category, and is associated with CFDA number 93.279. The funding instrument is an R01, which generally supports substantial research projects. The opportunity record lists an original closing date of 2022-08-11 and a creation date of 2022-04-06. The award ceiling and expected number of awards are not specified in the provided source data, suggesting applicants would need to consult the full funding announcement or NIH budget guidance for limits and expectations. Overall, the opportunity is aimed at generating strong, trial-based evidence for interventions that can speed up treatment starts and prevent care disengagement among PLWH who use substances, particularly by fixing system and service delivery problems that conventional navigation and case management models have not adequately addressed.

• The National Institutes of Health in the education, health sector is offering a public funding opportunity titled "Increasing Immediate Engagement and Retention in HIV Treatment with Substance Users (R01- Clinical Trials Required)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.279.
• This funding opportunity was created on 2022-04-06.
• Applicants must submit their applications by 2022-08-11. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For-profit organizations other than small businesses, Small businesses, Others.

Apply for RFA DA 23 002

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