Opportunity Information: Apply for RFA MH 24 161

The National Institutes of Health (NIH) funding opportunity "Improving Choice, Use, and Equitable Implementation of Biomedical HIV Prevention for Women (R21 Clinical Trial Optional)" (RFA-MH-24-161) supports exploratory and early-stage research aimed at improving how women can access, choose, start, and continue using the HIV prevention vaginal ring in real-world settings. The emphasis is on closing practical knowledge gaps that affect whether the ring is actually taken up and used consistently outside tightly controlled research environments, where everyday barriers like access, stigma, partner dynamics, clinic workflows, cost, transportation, and competing life priorities can shape prevention decisions.

A central focus of this opportunity is understanding what drives or limits uptake (starting to use the ring), adherence (using it as intended), and persistence (staying on it over time). The call highlights research that examines barriers and facilitators at multiple levels, including individual factors (such as perceptions of risk, side effects, comfort with insertion, or concerns about privacy), interpersonal factors (such as partner influence, relationship power, family expectations, or peer norms), and structural factors (such as clinic availability, supply chains, health insurance coverage, legal or policy constraints, discrimination, and broader socioeconomic conditions). Importantly, NIH signals that it is especially interested in evidence generated in routine care and community contexts, rather than only within clinical trials or open-label extension studies, since real-world delivery is where prevention products often succeed or fail.

The opportunity also encourages development and testing of behavioral and support interventions designed to improve consistent use and long-term continuation. This can include counseling approaches, peer or community support models, digital reminders or telehealth-based follow-up, partner or couples-oriented strategies when appropriate, stigma-reduction interventions, and tailored communication that supports informed choice among prevention methods. The goal is not only to improve outcomes like adherence and continuation, but also to strengthen the fit between the product and the realities of womens lives, including differences across age groups, relationship situations, geographic settings, and cultural contexts.

Another major pillar is implementation science, meaning studies that look at how to deliver the vaginal ring effectively, equitably, and at scale. NIH is looking for research that identifies implementation barriers and facilitators in health systems and communities, and that tests strategies to optimize delivery. This can involve evaluating service delivery models (for example, integration into family planning, maternal health, or primary care services), provider training and workflow redesign, task-shifting, community-based distribution, pharmacy-based models, differentiated service delivery, and approaches to improve demand creation and retention. Equity is a clear theme throughout, with the intent to improve access and distribution so that populations facing higher HIV vulnerability or greater structural barriers are not left behind.

This is an R21 mechanism, which generally supports early-stage, high-impact exploratory research, and it is listed as "clinical trial optional," meaning applicants may propose clinical trials if appropriate, but they are not required. The funding opportunity is categorized as a discretionary grant in the health and social services area, and it is associated with CFDA numbers 93.242, 93.310, and 93.865. The original closing date listed is 2023-09-27, indicating it was a time-bound solicitation.

Eligibility is broad and includes many types of domestic organizations such as state, county, city, township, and special district governments; public housing authorities; independent school districts; public and private institutions of higher education; federally recognized tribal governments; tribal organizations; nonprofits with or without 501(c)(3) status; for-profit organizations (other than small businesses) and small businesses. The announcement also explicitly calls out additional eligible applicant types that reflect a commitment to diverse institutional participation and community engagement, including 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 faith-based or community-based organizations, eligible federal agencies, U.S. territories or possessions, regional organizations, and non-U.S. (foreign) entities.

Overall, the grant is designed to move beyond demonstrating that the vaginal ring can work under ideal conditions and instead build the practical, behavioral, and implementation evidence needed to make this prevention option easier to access, acceptable to use, and sustainably delivered in the settings where women actually seek care and make HIV prevention decisions.

  • The National Institutes of Health in the health, income security and social services sector is offering a public funding opportunity titled "Improving Choice, Use, and Equitable Implementation of Biomedical HIV Prevention for Women (R21 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, 93.310, 93.865.
  • This funding opportunity was created on 2023-08-25.
  • Applicants must submit their applications by 2023-09-27. (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.
Apply for RFA MH 24 161

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