Interventions for Stigma Reduction to Improve HIV/AIDS Prevention, Treatment and Care in Low- and Middle- Income Countries (R01 - Clinical Trial Optional) | PAR 23 190

Frequently Asked Questions (FAQs) - NIH PAR-23-190 (R01): HIV/AIDS-Associated Stigma Reduction in LMICs

1) What is PAR-23-190 funding?

PAR-23-190 is a National Institutes of Health (NIH) funding opportunity that supports research projects to develop, refine, and/or pilot test interventions aimed at reducing HIV/AIDS-associated stigma in low- and middle-income countries (LMICs).

2) What is the main goal of this opportunity?

The central goal is practical and outcomes-focused: reduce HIV-related stigma in ways that measurably improve HIV prevention, treatment, and care outcomes, and ultimately improve quality of life for people living with HIV/AIDS (PLWH).

3) What grant mechanism is used?

This opportunity uses the NIH R01 research project grant mechanism.

4) Are clinical trials required?

No. Clinical trials are allowed but not required. The opportunity is described as "clinical trial optional," which means you may propose a clinical trial if it fits your aims, but you can also propose other study types such as measurement development, implementation research, and intervention pilot testing.

5) What kinds of projects does NIH want to fund under this announcement?

Projects may include developing stigma reduction interventions, refining existing approaches, and/or pilot testing interventions in LMIC contexts. NIH also emphasizes innovation in stigma measurement as a foundation for designing and evaluating better interventions.

6) What outcomes should stigma reduction interventions be connected to?

NIH encourages proposals that show clear pathways from stigma reduction to concrete HIV outcomes such as:

• Increased care-seeking
• Improved treatment uptake and adherence
• Better engagement and retention in care
• Reduced HIV transmission risk

7) Why is HIV-related stigma treated as a health systems and health behavior issue in this program?

The program frames stigma not only as a social problem, but also as a barrier that directly affects health behavior and health system performance. Stigma can shape whether people seek testing, enter care, stay in care, adhere to treatment, and access prevention services, and it can also be embedded in policies, provider behavior, or service delivery practices.

8) Does the opportunity emphasize real-world feasibility in LMIC settings?

Yes. NIH signals interest in interventions that can be realistically deployed in LMIC contexts, including community settings and health care systems where stigma may be embedded in everyday practice.

9) What role does measurement play in PAR-23-190?

A major emphasis is improving how HIV-associated stigma is measured so interventions can be better targeted and evaluated. The opportunity calls for innovation in measurement, including tools that capture how HIV stigma intersects with other stigmas related to multiple morbidities or social identities.

10) What is meant by "intersectional" or "compounded" stigma in this opportunity?

The opportunity encourages research on layered stigma experiences where HIV stigma stacks with stigma related to other conditions or identities. Examples mentioned include stigma linked to mental health conditions, substance use, tuberculosis, viral hepatitis, sexual orientation, gender identity, sex work, and other coinfections or comorbidities.

11) What kinds of measurement advances fit this call?

Based on the description, measurement-focused projects could involve developing or adapting robust stigma tools that work across contexts and populations and that capture layered experiences of stigma (for example, HIV stigma plus stigma related to tuberculosis or substance use). Strong measurement is positioned as a foundation for stronger interventions.

12) Which populations are highlighted as priorities?

NIH highlights several populations and life stages where stigma has distinct dynamics and consequences, including:

• Adolescents and youth
• Family members and caregivers of PLWH (spillover effects)
• Aging PLWH

13) Why are adolescents and youth specifically emphasized?

The announcement points to youth-specific stigma dynamics affecting willingness to test, disclose, seek contraception or HIV prevention services, initiate antiretroviral therapy, adhere to treatment, and remain engaged in care. Confidentiality concerns and social pressures can be especially intense during adolescence and young adulthood.

14) What are "spillover effects" of stigma on families and caregivers?

The opportunity recognizes that stigma can extend beyond the individual living with HIV and affect family members and caregivers. These spillover effects may influence household relationships, caregiving roles, social support, economic stability, and overall wellbeing.

15) How does the opportunity address the needs of aging people living with HIV?

NIH identifies stigma-related challenges for aging PLWH as a priority area. This reflects that people living with HIV are living longer and may face age-related conditions alongside HIV, and stigma can affect long-term wellbeing and care engagement over time.

16) What types of stigma reduction interventions are encouraged?

NIH is interested in novel interventions that do more than raise awareness and that have a credible connection to measurable HIV outcomes. The opportunity describes a range of possible delivery channels, including clinics, peer networks, schools, workplaces, digital platforms, and community organizations, as long as the interventions can be evaluated and linked to changes in prevention or care outcomes.

17) Does NIH require interventions to be linked to measurable changes?

Yes. The program emphasizes interventions that can plausibly shift behavior, service uptake, or health system functioning, and that can be evaluated in ways that connect stigma reduction to outcomes such as improved testing, earlier treatment initiation, better adherence, reduced drop-off from care, or reduced risky exposures.

18) Are projects limited to community settings, or can health care system interventions be proposed?

Both are consistent with the opportunity as described. NIH references community settings and health care systems, including cases where stigma may be embedded in policies, provider behavior, or service delivery practices.

19) Who is eligible to apply?

Eligibility is broad. Eligible applicants include:

• Federal, state, county, and local governments
• Public and private institutions of higher education
• Independent school districts
• Special district governments
• Public housing authorities
• Nonprofit organizations with or without 501(c)(3) status
• For-profit organizations (other than small businesses) and small businesses
• Tribal governments and tribal organizations (including federally recognized tribes and other tribal entities)

20) Are community-based and faith-based organizations eligible?

Yes. The announcement explicitly calls out faith-based and community-based organizations as eligible applicants.

21) Are minority-serving institutions specifically included?

Yes. The opportunity explicitly mentions additional eligible applicants 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).

22) Can non-U.S. organizations apply?

Yes. The opportunity allows non-domestic (non-U.S.) entities (foreign organizations), regional organizations, and U.S. territories or possessions. This aligns with the focus on LMICs and supports leadership and implementation capacity in the countries and regions most affected.

23) What is the award ceiling listed for this opportunity?

The listed award ceiling is $400,000.

24) What is the original closing date?

The original closing date listed is 2025-12-22.

25) How is this opportunity categorized administratively?

It is categorized as a discretionary grant and uses an R01 funding instrument type.

26) Which CFDA numbers are associated with this opportunity?

The opportunity is associated with multiple CFDA numbers: 93.121, 93.242, 93.279, 93.393, 93.396, 93.847, and 93.989.

27) Why are multiple CFDA numbers listed?

Based on the description provided, the multiple CFDA numbers reflect participation across NIH institutes and programs that touch HIV, comorbidities, and related behavioral and social science areas.

28) Is this funding limited to HIV stigma only, or can projects address stigma related to comorbidities too?

The focus is HIV/AIDS-associated stigma, but the opportunity explicitly encourages work that addresses intersectional and compounded stigma, including stigma tied to coinfections, comorbidities, and social identities that shape HIV outcomes.

29) What is the overall "fit" NIH is looking for?

The announcement is designed for applicants who can propose rigorous, context-sensitive stigma research that leads directly to better interventions and measurable improvements in HIV prevention and the care continuum in LMIC settings.