Promoting Reductions in Intersectional StigMa (PRISM) to Improve the HIV Prevention Continuum (R34 Clinical Trial Required) | RFA MH 19 410

Opportunity Information: Apply for RFA MH 19 410

The Promoting Reductions in Intersectional StigMa (PRISM) to Improve the HIV Prevention Continuum (R34 Clinical Trial Required) funding opportunity (RFA-MH-19-410) is a National Institutes of Health (NIH) discretionary research grant aimed at strengthening HIV prevention by directly addressing intersectional stigma. The core idea is that many people at heightened risk for HIV face not just one form of stigma, but multiple overlapping stigmas tied to identities or experiences such as race and ethnicity, sexual orientation, gender identity, substance use, involvement with the justice system, sex work, poverty, or immigration status. This “stacking” of stigmas can create powerful barriers that reduce the likelihood someone will seek HIV testing, start prevention services, or stay connected to ongoing prevention tools like PrEP and related support services. PRISM is designed to move beyond general stigma concepts and fund research that measures these combined stigma experiences more accurately and tests ways to reduce their real-world impact on the HIV prevention continuum.

The FOA supports two broad kinds of projects. The first category focuses on improving measurement and understanding: applicants can propose studies that advance how intersectional stigma is defined and measured, and that examine the mechanisms and pathways through which it blocks HIV testing and linkage to prevention. In practice, this could include developing or refining quantitative scales, validating instruments across different populations or settings, and building models that show how stigma operates at multiple levels (individual, interpersonal, community, healthcare system, and policy). It also includes investigating how stigma translates into avoidance of clinics, mistrust of providers, fear of disclosure, concerns about confidentiality, reduced self-efficacy, or diminished access to culturally safe services, all of which can disrupt timely HIV testing and entry into prevention.

The second category emphasizes solutions: applicants may develop and test interventions intended to reduce intersectional stigma and, as a result, increase uptake of HIV testing and successful linkage to ongoing prevention. Because this is an R34 mechanism and explicitly indicates “Clinical Trial Required,” the expectation is that funded projects will include intervention development, adaptation, and pilot testing with a clinical trial component. An R34 is commonly used to support early-stage or preparatory clinical trial work, such as feasibility testing, acceptability, refinement of intervention components, pilot randomization procedures, and generation of effect-size estimates to justify a later, larger trial. Interventions could be directed at individuals (for example, counseling, peer navigation, or mHealth supports), healthcare settings (provider training, stigma-reducing clinic workflows, confidentiality improvements), or community and structural levels (partnership models, community-led engagement strategies), as long as they are designed to reduce intersectional stigma and demonstrate measurable improvements in HIV testing and linkage to prevention services.

The population focus is “key populations at substantial risk for HIV infection,” meaning the opportunity is oriented toward groups disproportionately impacted by HIV and by layered stigma. The FOA is anchored in the HIV prevention continuum, so competitive applications would typically connect stigma reduction to concrete prevention outcomes, including HIV testing behavior, linkage to prevention services after testing, and ongoing engagement with prevention strategies. The emphasis on mechanisms and pathways signals that NIH is looking not only for whether an intervention “works,” but also for evidence explaining how stigma is being reduced and how those changes translate into improved prevention behaviors and service uptake.

From an eligibility standpoint, PRISM is broadly open to many organization types. Eligible applicants include state, county, city or township governments; 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 (including those other than federally recognized governments); public housing authorities and Indian housing authorities; nonprofits with or without 501(c)(3) status (excluding institutions of higher education in those nonprofit categories); for-profit organizations other than small businesses; and small businesses. The FOA also highlights additional eligible applicants such as Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISI), Hispanic-serving Institutions, Historically Black Colleges and Universities (HBCUs), Tribally Controlled Colleges and Universities (TCCUs), faith-based or community-based organizations, eligible federal agencies, regional organizations, U.S. territories or possessions, and even non-U.S. entities (foreign organizations). This breadth reflects the reality that stigma and HIV prevention gaps are often best addressed through community-engaged, culturally grounded research partnerships, including organizations embedded in the communities most affected.

Administratively, the opportunity is a grant under the NIH umbrella in the health funding activity category, associated with CFDA number 93.242. The original posting information lists a creation date of November 23, 2018 and an original closing date of January 23, 2019, with an award ceiling listed at $225,000. While that closing date indicates this specific announcement cycle has passed, the summary still captures the intent and structure of the PRISM initiative: to produce better tools for measuring intersectional stigma, to clarify how it disrupts HIV prevention behaviors and service linkage, and to pilot-test stigma-reduction interventions that can realistically improve HIV testing and connection to ongoing prevention among populations most burdened by HIV risk and social marginalization.

• The National Institutes of Health in the health sector is offering a public funding opportunity titled "Promoting Reductions in Intersectional StigMa (PRISM) to Improve the HIV Prevention Continuum (R34 Clinical Trial Required)" 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 2018-11-23.
• Applicants must submit their applications by 2019-01-23. (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 $225,000.00 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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