DHHS/NIH: Implementing the HIV Service Cascade for Justice-Involved Populations in United States

Deadline: 30 April 2020

The U.S. Department of Health and Human Services (DHHS), the National Institutes of Health (NIH), the National Institute on Drug Abuse (NIDA) is seeking applications for “Implementing the HIV Service Cascade for Justice-Involved Populations (U01 Clinical Trial Required).

A quarter of all people infected with HIV pass through the justice system each year, making it an important system for HIV prevention and treatment. Community re-entry from incarceration is a time of heightened risk for opioid relapse, mortality, HIV risk behaviors, and discontinuation of HIV treatment. Given these elevated levels of risk, justice-involved people who inject drugs (PWID) should be prioritized for screening and linkage to the full continuum of HIV prevention and treatment services, including Pre-exposure prophylaxis (PrEP) and highly active antiretroviral therapy (HAART).

The justice system is an important target for HIV prevention and treatment, as an estimated 25% of all people living with HIV will pass through the justice system each year. As well, a high proportion of people with opioid use disorder (OUD) and people who inject drugs (PWID) pass through the justice system each year. OUD and injection drug use elevate HIV risk.

For the purposes of this FOA, justice setting is broadly defined and is inclusive of prisons, jails, drug courts and other problem-solving courts (e.g., Driving While Impaired (DWI), family courts, veterans courts), policing and police diversion programs, transitions to secure settings from communities, transitions from secure settings to communities (i.e., re-entry), probation and parole, child welfare (particularly when there is concurrent involvement in other parts of the justice system), and juvenile justice. A key area of interest is in testing models to link justice-involved individuals with community-based HIV and OUD prevention and treatment services, recognizing the specific needs, structural challenges, and unique risks for this population. It is not the intent of this RFA to implement treatment services solely within correctional facilities.

Special Considerations

Applications with the following specifics will be considered non-responsive and will not be reviewed:

Applications that do not emphasize prevention and treatment of both HIV and illicit opioid use or opioid misuse for individuals involved in justice settings. Both HIV and opioid-relevant outcomes must be included.
Applications that do not compare the two basic treatment models outlined above (services delivered in existing settings vs. services that are brought to patients (e.g., mobile vans)
Research sites in communities outside the US and its territories
Applications involving fewer than four communities
Applications proposing work in communities that do not meet criteria for HIV outbreak risk
Applications that do not include letters of support from each of the proposed justice settings and community service settings
Applications that do not include one or more senior-level collaborators from both justice and community-based settings
Applications not providing a PD/PI committing a minimum of two person-months annually over the life of the grant award

Award Project Period

The scope of the proposed project should determine the project period. The maximum project period is 5 years.

Eligibility Criteria

Nonprofits having a 501(c)(3) status with the IRS, other than institutions of higher education
Native American tribal governments (Federally recognized)
Private institutions of higher education
Public housing authorities/Indian housing authorities
City or township governments
Independent school districts
Small businesses
Public and State controlled institutions of higher education
Nonprofits that do not have a 501(c)(3) status with the IRS, other than institutions of higher education
Special district governments
State governments
Native American tribal organizations (other than Federally recognized tribal governments)
County governments
For profit organizations other than small businesses