Promoting Reductions in Intersectional StigMa (PRISM) to Improve the HIV Prevention Continuum (R21 Clinical Trial Optional) | RFA MH 19 411

Opportunity Information: Apply for RFA MH 19 411

The Promoting Reductions in Intersectional StigMa (PRISM) to Improve the HIV Prevention Continuum funding opportunity (RFA-MH-19-411) is a National Institutes of Health (NIH) research grant announcement focused on how intersectional stigma affects HIV prevention and what can be done to reduce its impact. Intersectional stigma refers to the combined, overlapping effects of multiple stigmatized identities or experiences (for example, stigma related to race or ethnicity, sexual orientation, gender identity, substance use, sex work, incarceration history, immigration status, poverty, or mental illness). The central idea behind PRISM is that stigma is not just a background social issue; it can directly block people from accessing HIV testing and from successfully linking to and staying engaged in ongoing HIV prevention services, such as PrEP, other biomedical prevention options, and prevention-related clinical or community care.

The FOA invites applications that fit into one of two broad research tracks. The first track emphasizes measurement and mechanisms: projects that improve how intersectional stigma is defined and measured and that carefully examine the pathways through which stigma becomes a barrier to HIV testing and linkage to prevention. This includes work that clarifies how different forms of stigma interact, how stigma operates at different levels (individual, interpersonal, community, structural), and how those processes translate into delayed testing, avoidance of care settings, lack of trust in providers or institutions, disrupted continuity of prevention services, and reduced uptake of prevention tools. The second track is intervention-focused: projects that develop, refine, and test strategies to reduce intersectional stigma itself and, as a result, increase HIV testing and improve linkage to and engagement in prevention among populations at substantial risk for HIV infection. In practice, this could include interventions delivered in clinics, community organizations, digital platforms, or mixed settings, and may involve provider training, peer navigation, community-led stigma reduction approaches, structural changes in service delivery, or multi-level strategies that address both social norms and practical barriers created by discriminatory policies or practices.

This particular announcement is the R21 version of the PRISM initiative, meaning it is designed for exploratory, early-stage, or high-risk/high-reward research. The FOA explicitly notes that projects without extensive preliminary data, or projects that leverage existing datasets in innovative ways, may be especially appropriate for the R21 mechanism. In contrast, the companion announcements include an R01 version (RFA-MH-19-412), which generally fits projects with stronger preliminary evidence and/or more robust longitudinal analyses, and an R34 version (RFA-MH-19-410), which is typically used to develop and pilot test interventions in preparation for larger-scale efficacy or effectiveness trials. The PRISM R21 is labeled “Clinical Trial Optional,” which means applicants may propose clinical trial work if it makes sense for the aims, but they are not required to do so.

From an administrative and eligibility standpoint, PRISM is a discretionary grant program in the health category, associated with CFDA numbers 93.242 and 93.307, and administered under NIH. The award ceiling listed is $200,000, and the original closing date for the posted opportunity was January 23, 2019, with a creation date of November 23, 2018. A wide range of applicant organizations are eligible, including state, county, and local 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 that are not federally recognized governments; public and Indian housing authorities; nonprofit organizations (both with and without 501(c)(3) status); for-profit organizations (other than small businesses); small businesses; and other categories. The FOA also highlights 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, eligible federal agencies, non-U.S. entities (foreign organizations), regional organizations, and U.S. territories or possessions. In short, NIH is signaling strong interest in broad participation, including organizations that are closely connected to communities most affected by HIV risk and stigma.

Overall, PRISM is aimed at strengthening the HIV prevention continuum by treating intersectional stigma as a measurable, actionable driver of prevention gaps. Whether the project is centered on better tools to quantify and understand stigma’s real-world effects or on designing and testing stigma-reduction approaches that improve testing and prevention linkage, the goal is the same: generate evidence that can help close persistent disparities in HIV prevention access and outcomes for key populations who face layered and compounding forms of stigma.

• 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 (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, 93.307.
• 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 $200,000.00 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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