Functional Wellness in HIV: Maximizing the Treatment Cascade (R21 Clinical Trial Optional) | PA 18 154

Opportunity Information: Apply for PA 18 154

Functional Wellness in HIV: Maximizing the Treatment Cascade (R21 Clinical Trial Optional) is a National Institutes of Health (NIH) discretionary grant opportunity administered by the National Institute of Nursing Research (NINR). Its central purpose is to spur the early-stage development of HIV-focused interventions that strengthen how health care is delivered across the full continuum of care for people living with HIV. In practical terms, the opportunity is aimed at improving performance along the HIV treatment cascade, meaning the linked steps that move a person from diagnosis to consistent engagement in care, receipt of effective treatment, and sustained viral suppression. By emphasizing "functional wellness," the program signals interest in interventions that do more than improve laboratory outcomes alone and instead enhance a person’s ability to maintain health and daily functioning while navigating long-term HIV care.

The mechanism is an NIH R21, which is commonly used to support exploratory or developmental research. That typically means applicants are expected to propose innovative, pilot-scale work that can establish feasibility, generate preliminary evidence, or refine an intervention and its delivery approach prior to a larger confirmatory trial. The listing explicitly notes "Clinical Trial Optional," indicating that projects may include a clinical trial component but are not required to. This flexibility makes it suitable for teams that want to test intervention concepts in real-world settings, compare delivery strategies, or conduct smaller trials, as well as teams doing formative work such as intervention design, usability testing, implementation planning, or preliminary effectiveness assessments.

The program is situated within the broad NIH health and education funding activity category (CFDA 93.361). The intervention focus is on "opportunities to improve the delivery of healthcare across the continuum of care," which points to systems, practice, and patient-centered innovations that can reduce drop-off at any point in the cascade. Examples of the kinds of problems this solicitation is meant to address include delayed linkage to care after diagnosis, inconsistent retention in care due to structural or psychosocial barriers, medication adherence challenges, gaps in coordination among providers and services, and inequities that lead to poorer outcomes in specific communities. Because NINR is leading the opportunity, nursing science and interdisciplinary care delivery approaches are especially relevant, including interventions that can be embedded in clinical workflows, community settings, or hybrid models of care.

Eligibility is broad and intentionally inclusive, reflecting an interest in reaching diverse populations and encouraging partnerships across sectors. Eligible applicants include state, county, city/township, and special district governments; independent school districts; public and state-controlled institutions of higher education; private institutions of higher education; federally recognized Native American tribal governments; tribal organizations other than federally recognized governments; public housing authorities/Indian housing authorities; nonprofits with and without 501(c)(3) status; for-profit organizations other than small businesses; small businesses; and other entities. The announcement also highlights additional eligible applicant categories such as Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISIs), Hispanic-serving Institutions, Historically Black Colleges and Universities (HBCUs), Tribally Controlled Colleges and Universities (TCCUs), faith-based or community-based organizations, eligible federal agencies, U.S. territories or possessions, regional organizations, and non-U.S. entities (foreign organizations). This range suggests NINR is open to proposals led by academic institutions, health systems, community organizations, tribal and territorial partners, and international groups, particularly when they can demonstrate meaningful access to affected communities and the capacity to test or refine scalable care delivery interventions.

From a funding standpoint, the award ceiling listed is $200,000, which aligns with the smaller, developmental nature of R21 projects. The funding instrument type is a grant, and the opportunity category is discretionary. The original closing date provided in the source is May 7, 2018, and the record shows a creation date of November 3, 2017, indicating this specific posting was part of an earlier NIH solicitation cycle. Even so, the content is useful as a guide to NINR’s priorities around HIV care delivery research and intervention development, especially projects designed to improve continuity, engagement, and outcomes across the treatment cascade.

Overall, the opportunity is best understood as support for practical, testable intervention ideas that can measurably improve how people living with HIV move through and remain engaged in effective care. Strong applications would typically connect an identified breakdown in the treatment cascade to a clearly defined intervention and delivery strategy, describe how the approach improves functional wellness and care experiences, and present an evaluation plan appropriate for an exploratory R21 scope, with attention to populations and settings where improvements can reduce disparities and increase sustained viral suppression.

• The National Institutes of Health in the education, health sector is offering a public funding opportunity titled "Functional Wellness in HIV: Maximizing the Treatment Cascade (R21 Clinical Trial Optional)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.361.
• This funding opportunity was created on 2017-11-03.
• Applicants must submit their applications by 2018-05-07. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Each selected applicant is eligible to receive up to $200,000.00 in funding.
• 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.

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