Expanding Differentiated Care Approaches for Adolescents Living with HIV (R34 Clinical Trial Optional) | RFA MH 22 106

Opportunity Information: Apply for RFA MH 22 106

The NIH funding opportunity "Expanding Differentiated Care Approaches for Adolescents Living with HIV (R34 Clinical Trial Optional)" (RFA-MH-22-106; CFDA 93.242) focuses on improving HIV care for adolescents, a group that consistently experiences some of the weakest outcomes across the HIV care continuum worldwide. The central problem the announcement highlights is that adolescents living with HIV often face distinct barriers to staying engaged in care, adhering to antiretroviral therapy (ART), and achieving viral suppression, and many existing HIV service models were not designed around adolescent needs. As a result, the opportunity is aimed at supporting the development and early testing of service delivery approaches that are more responsive to adolescents and more efficient for health systems.

At the core of the announcement is the concept of differentiated care, also called differentiated service delivery. In this context, differentiated care means client-centered HIV services that are simplified and adapted across the continuum of care. Rather than expecting all patients to navigate the same clinic schedules, visit frequency, staffing structures, and refill procedures, differentiated models adjust the "how, when, where, and by whom" services are delivered to better match a client population's needs. The opportunity emphasizes a dual objective: making services fit adolescents better while also reducing unnecessary burdens on clinics and health systems, such as avoidable facility visits, inefficient use of specialized staff time, or service delivery steps that do not add clinical value for certain groups.

A key motivation for the program is that, while differentiated care has gained traction and has an emerging evidence base, much of the published experience has been concentrated in a relatively narrow slice of HIV care, especially ART delivery for stable adults in high-prevalence settings in sub-Saharan Africa. The announcement points to recent literature, including a Journal of the International AIDS Society supplement on differentiated care, suggesting that the field has developed promising approaches for people living with HIV broadly. However, it also makes the case that adolescents are still frequently overlooked: programs may adopt differentiated models, but they often fail to intentionally design and evaluate those models around the unique clinical, developmental, and social realities of adolescents living with HIV. This grant opportunity is meant to help close that gap by stimulating adolescent-focused differentiated care approaches and generating practical evidence on how to implement them.

The mechanism is an R34, which is commonly used to support early-stage, preparatory, or pilot work that can position a research team to pursue a larger-scale effectiveness trial or broader implementation study later. The "Clinical Trial Optional" label indicates that applicants may propose a study that includes a clinical trial component, but they are not required to do so; proposals can be structured to fit the most appropriate design for developing, refining, and assessing the differentiated care approach being tested. Overall, the spirit of the opportunity is to catalyze models that can realistically be adopted in real-world settings and that measurably improve adolescent engagement and outcomes without increasing strain on already stretched services.

The eligible applicant pool is broad, reflecting NIH's intent to attract partners across government, academia, and community or service-delivery organizations. Eligible applicants include state, county, city, 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; Native American tribal organizations that are not federally recognized; public housing authorities/Indian housing authorities; nonprofits (both 501(c)(3) and non-501(c)(3)); for-profit organizations (other than small businesses); and small businesses. The announcement also explicitly calls out additional eligible groups such as Historically Black Colleges and Universities (HBCUs), Hispanic-serving institutions, Tribally Controlled Colleges and Universities (TCCUs), Alaska Native and Native Hawaiian Serving Institutions, and Asian American Native American Pacific Islander Serving Institutions (AANAPISIs), as well as eligible federal agencies, faith-based or community-based organizations, non-U.S. entities (foreign organizations), regional organizations, and U.S. territories or possessions. This wide eligibility reflects a recognition that adolescent HIV care is often delivered through complex local ecosystems, and meaningful differentiated care solutions may require collaboration among clinics, community organizations, schools, and public health agencies.

Administratively, the opportunity is listed as a discretionary grant in the health funding activity category, sponsored by the National Institutes of Health. The notice was created on 2021-10-20 with an original closing date of 2022-01-06. The provided source text does not specify an award ceiling or expected number of awards, so applicants would typically look to the full funding announcement for budget guidance, project period limits, and review criteria.

In practical terms, the opportunity is about pushing differentiated service delivery beyond its adult-focused evidence base and into adolescent-centered models that can be tested, refined, and prepared for scale. The aim is not only to improve clinical outcomes for adolescents living with HIV, but also to make HIV services less burdensome, more accessible, and more aligned with how adolescents can realistically stay in care over time.

• The National Institutes of Health in the health sector is offering a public funding opportunity titled "Expanding Differentiated Care Approaches for Adolescents Living with HIV (R34 Clinical Trial Optional)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.242.
• This funding opportunity was created on 2021-10-20.
• Applicants must submit their applications by 2022-01-06. (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.

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