This initiative will support research projects that examine innovative approaches and strategies to prevent, test and treat HIV among health disparity populations or subgroups within primary care settings located in geographic areas with a high rate of new infections in the United States.
This initiative will support intervention research that tests innovative approaches and strategies to prevent, test and treat HIV among health disparity populations or subpopulations within primary care settings located in geographic areas with a high rate of new infections. (Geographic hot spots can be found through the link https://files.hiv.gov/s3fs-public/Ending-the-HIV-Epidemic-Counties-and-Territories.pdf .)
Primary care refers to the day-to-day healthcare given by a health care clinician that includes comprehensive and longitudinal care. Characteristically, this clinician acts as the first contact and principal point of continuing care for most medical problems for patients and coordinates other specialist care that the patient may need. Primary care clinicians offer a usual source of care, early detection and treatment of disease, chronic disease management, and preventive care. A primary care setting refers to the environment in which primary care is provided. Primary care settings may include general internal medicine, family medicine, general pediatricians, adolescent medicine, and general nurse practitioners. Most primary care practices are affiliated with specific health care systems, but settings also include stand-alone practices, community clinics, school-based health centers, college/university health centers, federally qualified health centers and similar venues where primary care is delivered. In some settings, general gynecologists provide primary care to women.
Research designs are expected to evaluate comprehensive strategies that address a range of prevention, care, and treatment barriers across one or more phases of the HIV treatment cascade (diagnosis, linkage to care, initiation of PrEP, adequate ART to achieve viral suppression, as applicable), engagement in care, retention in care and achievement of viral suppression. Projects that test multi-level interventions that evaluate multi-level approaches at the patient, clinician, peer/family, setting, and community level to address social determinants of health are strongly encouraged (see NIMHD research framework https://www.nimhd.nih.gov/about/overview/research-framework.html for examples of determinants at different levels of influence). Interventions focused solely on the individual level (e.g., patient education, individual lifestyle interventions) are not a priority for this RFA.
Study designs may involve intervention effectiveness, comparative effectiveness, success of intervention implementation strategies, or optimization of multi-component interventions. It is strongly encouraged that leadership and/or clinicians and other personnel within the primary care setting(s) be involved as research partners.
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