Opportunity Information: Apply for HRSA 22 155
The Health Resources and Services Administration (HRSA), within the U.S. Department of Health and Human Services, offered a cooperative agreement funding opportunity focused on increasing the use of long-acting injectable (LAI) antiretroviral (ARV) medications among people with HIV, with a clear emphasis on improving outcomes for communities of color. The grant is tied to national priorities in the National HIV/AIDS Strategy (2022-2025) and broader efforts to end the HIV epidemic by strengthening two core outcomes: viral suppression and retention in care. The underlying premise is that newer FDA-approved LAI ARV options may help address persistent inequities in HIV care by offering an alternative to daily oral regimens, which can be difficult to maintain for many reasons tied to access, stability, stigma, and privacy.
A major driver for the project is the recognition that racial and ethnic minority populations often face layered barriers to consistent HIV treatment, including unequal access to care, health literacy gaps, insurance and coverage challenges, and HIV-related stigma. LAI ARVs may reduce some day-to-day burdens associated with pills and could also help some patients better protect their privacy, since fewer medication-taking moments can mean fewer opportunities for unwanted disclosure. At the same time, HRSA notes that real-world uptake has been limited in parts of the Ryan White HIV/AIDS Program (RWHAP) because LAI ARVs introduce practical complications, such as medication distribution logistics, on-site administration requirements, and billing and reimbursement complexity. This opportunity is designed to confront those operational barriers directly by building workable, replicable clinical protocols and implementation supports.
The central goal of the program is to develop, implement, test, and refine standardized protocols that make LAI ARV use successful and sustainable in routine HIV clinical practice, especially for patients who have historically struggled to start, adhere to, or remain on oral therapy. Rather than funding multiple unrelated projects, HRSA structured this as a coordinated model: it planned to fund one recipient organization to act as the Coordination and Evaluation Provider (CEP). The CEP is expected to have strong infrastructure and capacity, including qualified staff, training capabilities, clinical systems support, robust data collection and reporting processes, and expertise in protocol development and implementation evaluation. In practical terms, the CEP would function as the hub that helps shape protocols, supports participating sites, monitors progress, and generates evidence about what works and what needs adjustment.
The CEP would then solicit and issue subawards to as many as 10 demonstration sites (subrecipients). These sites would implement the co-developed LAI ARV protocols in direct patient care settings and collect standardized data to support evaluation. HRSA indicated a priority for demonstration sites located in Ending the HIV Epidemic (EHE) jurisdictions, aligning the work with areas where targeted HIV intervention is a national focus. Through this hub-and-spoke approach, HRSA anticipated that successful protocols could be scaled and replicated more widely across HIV care systems, helping more clinics overcome operational hurdles and enabling more patients to access LAI ARVs consistently.
In terms of logistics and award structure, this was a discretionary cooperative agreement (meaning substantial federal involvement is typical compared with a standard grant). The opportunity number was HRSA-22-155, listed under CFDA 93.899. HRSA expected to make one award, with an award ceiling of $1,500,000. Eligible applicants were broad and included various levels of government (state, county, city/township, special districts), public and private institutions of higher education, federally recognized tribal governments and other tribal organizations, and nonprofit organizations with 501(c)(3) status (with additional eligibility details referenced in the full notice). The opportunity was originally posted April 21, 2022, with an original closing date of June 21, 2022.
Overall, the grant opportunity is best understood as an implementation and equity-focused effort: it is less about proving whether LAI ARVs work medically (they are already FDA-approved) and more about building the real-world clinical, administrative, and financing pathways that allow these medications to be delivered reliably and fairly. The intended outcome is that, by improving clinic readiness and reducing system-level friction, more people with HIV, particularly people of color and others disproportionately affected by barriers to care, can achieve viral suppression and stay engaged in treatment over time.Apply for HRSA 22 155
- The Department of Health and Human Services, Health Resources and Services Administration in the health sector is offering a public funding opportunity titled "Increasing Uptake of Long-Acting Injectable Antiretrovirals Among People with HIV" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.899.
- This funding opportunity was created on Apr 21, 2022.
- Applicants must submit their applications by Jun 21, 2022. (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 $1,500,000.00 in funding.
- The number of recipients for this funding is limited to 1 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), 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, Private institutions of higher education, Others (see text field entitled Additional Information on Eligibility for clarification).
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Frequently Asked Questions (FAQs)
What is this HRSA funding opportunity about?
This cooperative agreement focuses on increasing the use of long-acting injectable (LAI) antiretroviral (ARV) medications among people with HIV, with a clear emphasis on improving outcomes for communities of color. The work centers on making LAI ARVs practical and sustainable in routine clinical care by developing and testing standardized implementation protocols.
Which federal agency is offering this opportunity?
The opportunity is offered by the Health Resources and Services Administration (HRSA), within the U.S. Department of Health and Human Services.
What national strategies or priorities does this program support?
The program is tied to national priorities in the National HIV/AIDS Strategy (2022-2025) and aligns with broader efforts to end the HIV epidemic by strengthening viral suppression and retention in care.
What are the main outcomes this program is trying to improve?
The two core outcomes emphasized are viral suppression and retention in care for people with HIV.
Why is there a specific emphasis on communities of color?
HRSA highlights persistent inequities in HIV care that disproportionately affect racial and ethnic minority populations, including layered barriers such as unequal access to care, health literacy gaps, insurance and coverage challenges, and HIV-related stigma. The program is designed to improve real-world delivery so that benefits reach communities most impacted by these barriers.
Are LAI ARVs being funded to prove they work medically?
No. The medications are already FDA-approved. This opportunity is primarily focused on implementation: building the clinical, administrative, and financing pathways needed to deliver LAI ARVs reliably and fairly in real-world HIV care settings.
What is the rationale for using long-acting injectable ARVs?
LAI ARVs may help address challenges some patients face with daily oral regimens, which can be difficult to maintain due to access issues, instability, stigma, privacy concerns, and other real-life barriers. Fewer medication-taking moments may also reduce opportunities for unwanted disclosure for some patients.
If LAI ARVs are FDA-approved, why has uptake been limited in some Ryan White HIV/AIDS Program settings?
HRSA notes that real-world uptake has been limited in parts of the Ryan White HIV/AIDS Program (RWHAP) because LAI ARVs can create operational complications, including medication distribution logistics, on-site administration requirements, and billing and reimbursement complexity.
What is the primary goal of the program?
The central goal is to develop, implement, test, and refine standardized protocols that support successful and sustainable LAI ARV use in routine HIV clinical practice, especially for patients who have historically struggled to start, adhere to, or remain on oral therapy.
How is HRSA structuring the project (single award vs. multiple awards)?
HRSA planned a coordinated model and expected to make one award to a single recipient organization. That organization would serve as the Coordination and Evaluation Provider (CEP) and would manage subawards to demonstration sites.
What is a Coordination and Evaluation Provider (CEP)?
The CEP is the hub organization responsible for coordinating the overall initiative. It is expected to help shape and support protocol development, provide implementation support to participating sites, monitor progress, and generate evidence about what works and what needs adjustment.
What capacities or infrastructure is the CEP expected to have?
HRSA indicated the CEP should have strong infrastructure and capacity, including qualified staff, training capabilities, clinical systems support, robust data collection and reporting processes, and expertise in protocol development and implementation evaluation.
Will the CEP work alone, or will it fund other sites?
The CEP is expected to solicit and issue subawards to demonstration sites (subrecipients). Those sites would implement the co-developed LAI ARV protocols in direct patient care settings and collect standardized data to support evaluation.
How many demonstration sites could be funded?
HRSA indicated the CEP could issue subawards to as many as 10 demonstration sites.
Where are demonstration sites preferred to be located?
HRSA indicated a priority for demonstration sites located in Ending the HIV Epidemic (EHE) jurisdictions, aligning the project with areas where targeted HIV intervention is a national focus.
What type of funding mechanism is this?
This is a discretionary cooperative agreement, which generally means substantial federal involvement is typical compared with a standard grant.
What is the opportunity number and CFDA listing?
The opportunity number is HRSA-22-155, and it is listed under CFDA 93.899.
How many awards did HRSA expect to make?
HRSA expected to make one award.
What is the maximum (ceiling) amount for the award?
The award ceiling was $1,500,000.
Who is eligible to apply?
Eligible applicants included various levels of government (state, county, city/township, special districts), public and private institutions of higher education, federally recognized tribal governments and other tribal organizations, and nonprofit organizations with 501(c)(3) status (with additional eligibility details referenced in the full notice).
When was the opportunity posted and when was it originally due?
The opportunity was originally posted on April 21, 2022, with an original closing date of June 21, 2022.
What are the main operational issues this program is intended to address?
Based on HRSA's description, the program is intended to confront operational barriers such as medication distribution logistics, requirements for on-site administration, and billing and reimbursement complexity that can make LAI ARV delivery difficult in routine practice.
What is meant by a "hub-and-spoke" approach in this program?
The CEP acts as the hub by coordinating and evaluating the work and supporting protocol development, while the demonstration sites serve as the spokes by implementing the protocols in patient care settings and submitting standardized data for evaluation.
What is the expected longer-term impact if the project is successful?
HRSA anticipates that successful, workable protocols could be scaled and replicated more widely across HIV care systems. The intended result is improved clinic readiness, less system-level friction, and more consistent access to LAI ARVs so that more people with HIV, particularly people of color and others disproportionately affected by barriers to care, can achieve viral suppression and remain engaged in treatment over time.
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