Using Syndemics to Understand HLBS Disease Emergence and Progression in People with HIV (PWH)(R01 Clinical Trial Not Allowed) | RFA HL 21 018

Opportunity Information: Apply for RFA HL 21 018

Using Syndemics to Understand HLBS Disease Emergence and Progression in People with HIV (PWH) (R01 Clinical Trial Not Allowed) is a National Institutes of Health (NIH) funding opportunity that supports research focused on why and how multiple health conditions related to heart, lung, blood, and sleep (HLBS) tend to cluster together among people with HIV, and how those conditions may interact in ways that worsen outcomes. The central idea behind the announcement is the syndemics framework, which looks at overlapping epidemics that reinforce each other, especially when shaped by broader social and structural pressures. Rather than treating each disease in isolation, the opportunity encourages applicants to examine how combinations of HLBS comorbidities and multimorbidities emerge and progress together in real-world populations of people living with HIV.

A key emphasis of the announcement is identifying the upstream and interacting drivers that make these disease clusters more likely or more severe. Applicants are expected to focus on population-level patterns and mechanisms tied to social, economic, environmental, behavioral, structural, and psychological factors. In practice, that means studying things like access to care, housing instability, stigma and discrimination, poverty, neighborhood conditions, chronic stress, mental health, substance use, occupational exposures, food access, and other contextual forces that can shape risk and resilience. The goal is to clarify how these forces do not just add risk independently, but can produce synergistic effects where the combined burden is greater than the sum of its parts, ultimately accelerating HLBS disease emergence or worsening progression in people with HIV.

The announcement is positioned to generate evidence that can move clinical care toward more integrated and holistic management of people with HIV who also face HLBS comorbidities. Beyond explaining patterns, the FOA highlights a practical endpoint: identifying strategies that could improve coordinated care approaches and producing data that helps evaluate whether such approaches are feasible and cost-effective. In other words, the research should ideally point toward actionable models of care or system-level strategies that acknowledge multimorbidity and the real-life conditions that drive it, and that can be assessed for implementation potential and economic value.

This opportunity uses the R01 research project grant mechanism and is explicitly marked as Clinical Trial Not Allowed, signaling that the proposed work should not be designed as a clinical trial. It falls under NIH’s health research mission and is associated with multiple CFDA numbers (93.233, 93.837, 93.838, 93.839, 93.840), reflecting the cross-cutting nature of the topic across heart, lung, blood, sleep, and related research areas. The funding opportunity number is RFA HL 21 018. The listing indicates an award ceiling of $485,000 and an expectation of approximately 6 awards.

Eligibility is broad and includes many types of U.S.-based organizations and governments, such as state, county, city, township, and special district governments; independent school districts; public and state-controlled institutions of higher education; private institutions of higher education; nonprofits with or without 501(c)(3) status; for-profit organizations (other than small businesses); and small businesses. It also includes Native American tribal governments that are federally recognized, as well as tribal organizations that are not federally recognized tribal governments, plus public housing authorities and Indian housing authorities. The opportunity specifically calls out additional eligible applicants 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, regional organizations, eligible federal agencies, and U.S. territories or possessions.

Foreign institutions (non-U.S. entities) are not eligible to apply as the applicant organization. However, the announcement allows non-domestic components of U.S. organizations, and it permits foreign components as defined in the NIH Grants Policy Statement. This structure supports U.S.-led projects that may still incorporate international expertise, data, or collaborations when justified and compliant with NIH policy.

The opportunity was created on 2020-09-24, with an original closing date listed as 2021-12-14. Overall, it is aimed at deepening understanding of intertwined HLBS conditions in people with HIV through a syndemics lens and translating that understanding into practical, integrated care strategies that can be evaluated for real-world feasibility and economic impact.

• The National Institutes of Health in the health sector is offering a public funding opportunity titled "Using Syndemics to Understand HLBS Disease Emergence and Progression in People with HIV (PWH)(R01 Clinical Trial Not Allowed)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.233, 93.837, 93.838, 93.839, 93.840.
• This funding opportunity was created on 2020-09-24.
• Applicants must submit their applications by 2021-12-14. (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 $485,000.00 in funding.
• The number of recipients for this funding is limited to 6 candidate(s).
• 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 HL 21 018

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