Tobacco Use and HIV in Low and Middle Income Countries (R21 Clinical Trial Optional) | PAR 18 022

Opportunity Information: Apply for PAR 18 022

The National Institutes of Health funding opportunity titled "Tobacco Use and HIV in Low and Middle Income Countries (R21 Clinical Trial Optional)" (Funding Opportunity Number PAR-18-022) supports exploratory and developmental research that looks specifically at the intersection of tobacco use and HIV infection in low- and middle-income countries (LMICs). The core intent is to generate early-stage evidence, pilot data, and practical approaches that can later be scaled or tested in larger studies, with a strong emphasis on real-world conditions where resources, staffing, and infrastructure may be limited.

A central priority of this FOA is the development and evaluation of tobacco cessation interventions that are tailored for people living with HIV. The announcement encourages projects that recognize the clinical and social realities of HIV-positive populations in LMICs, including complex care pathways, stigma, mental health and substance use concerns, and barriers to consistent access to treatment. It also explicitly highlights the importance of addressing co-morbidities that commonly overlap with HIV in these settings, particularly tuberculosis (TB). In practice, that means the FOA is looking for intervention ideas that fit within HIV and TB care environments, reflect local culture and health systems, and can be delivered feasibly in low-resource clinics and communities.

Because this is an R21 mechanism, the scope is meant for exploratory or proof-of-concept work rather than large definitive trials. The "Clinical Trial Optional" designation signals that applicants may propose a clinical trial if it is appropriate for the research questions (for example, piloting an intervention, testing feasibility, acceptability, adherence, short-term cessation outcomes, or implementation approaches), but a clinical trial is not required. The FOA also makes clear that funds may support not just the intervention itself, but the practical steps needed to run a solid early-stage project, including research planning, intervention delivery, and follow-up activities that help determine whether the approach is workable and worth expanding.

The opportunity is categorized as a discretionary grant program under education and health-related activities and is associated with CFDA numbers 93.279 and 93.393. The listed award ceiling is $200,000, reflecting a relatively contained budget consistent with the R21 goal of supporting early, high-potential ideas. The original closing date shown for the opportunity is January 7, 2020, and the record indicates it was created on November 28, 2017, which is useful context for anyone trying to track the historical announcement or locate related NIH documentation and any successor opportunities.

Eligibility is broad and includes many types of U.S.-based and non-U.S. organizations. Eligible applicants include state, county, city, township, and special district governments; independent school districts; public and state-controlled institutions of higher education; private institutions of higher education; federally recognized tribal governments; tribal organizations that are not federally recognized; public housing authorities and Indian housing authorities; nonprofits with and without 501(c)(3) status (outside of higher education); for-profit organizations (other than small businesses); small businesses; and other entities. The FOA also calls out additional eligible applicants such as Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISISs), Hispanic-serving Institutions, Historically Black Colleges and Universities (HBCUs), Tribally Controlled Colleges and Universities (TCCUs), faith-based or community-based organizations, eligible federal agencies, U.S. territories or possessions, regional organizations, and non-domestic (non-U.S.) entities, including foreign organizations. This wide eligibility aligns with the LMIC focus and the expectation that effective tobacco cessation work in HIV settings often requires partnerships among universities, clinics, community organizations, and local or regional health bodies.

Overall, the FOA is aimed at sparking practical, context-sensitive tobacco cessation research embedded within HIV care in LMICs, with particular interest in interventions that can be delivered and sustained in low-resource environments and that account for overlapping conditions like TB. It supports the kind of early-stage testing and refinement that can move promising cessation strategies from concept to credible evidence, setting the stage for larger-scale studies and broader public health impact.

• The National Institutes of Health in the education, health sector is offering a public funding opportunity titled "Tobacco Use and HIV in Low and Middle Income Countries (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): 93.279, 93.393.
• This funding opportunity was created on 2017-11-28.
• Applicants must submit their applications by 2020-01-07. (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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