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The purpose of these cooperative agreements is to further IHS health program objectives in the AI/AN community with expanded outreach and education efforts for the MSPI and HIV/AIDS programs on a national scale and in the interest of improving Indian health care. This announcement includes two separate awards, each of which will be awarded as noted below. The purpose of the MSPI award is to further the goals of the national MSPI program. The MSPI is a national demonstration project aimed at addressing the dual problems of methamphetamine use and suicide in Indian Country. The MSPI supports an AI/AN community driven focus on the utilization and development of evidence-based and practice-based intervention models that promote a culturally appropriate prevention, treatment, and postvention approach to methamphetamine use and suicide. The six goals of the MSPI are to effectively prevent, reduce, or delay the use and/or spread of methamphetamine use; build on the foundation of prior methamphetamine and suicide prevention and treatment efforts in order to support the IHS, Tribes, and urban Indian health organizations in developing and implementing Tribal and/or culturally appropriate methamphetamine and suicide prevention and early intervention strategies; increasing access to methamphetamine and suicide prevention services; improving services for behavioral health issues associated with methamphetamine use and suicide prevention; promoting the development of new and promising services that are culturally and community relevant; and demonstrating efficacy and impact. The purpose of the HIV/AIDS award is to further the goals of the national HIV/AIDS program. HIV and AIDS are a critical and growing health issue within the AI/AN population. The IHS National HIV/AIDS Program seeks to avoid complacency and to increase awareness of the impact of HIV/AIDS on AI/ANs. All activities are part of the IHS's implementation plan to meet the three goals of the President's National HIV/A

HIV surveillance and prevention program to prevent new HIV infections and achieve viral suppression among persons living with HIV. In particular, the FOA promotes and supports improving health outcomes for persons living with HIV through achieving and sustaining viral suppression, and reducing health-related disparities by using quality, timely, and complete surveillance and program data to guide HIV prevention efforts. These goals are in accordance with the national prevention goals, HIV Care Continuum, and CDC’s High-Impact HIV Prevention (HIP) approach. The integration of these programs allows each jurisdiction to operate in unison and maximize the impact of federal HIV prevention funding. An integrated FOA strengthens implementation of HIP by further allowing health departments to align resources to better match the geographic burden of HIV infections within their jurisdictions and improve data collection and use for public health action. The FOA priorities are to increase individual knowledge of HIV status, prevent new infections among HIV-negative persons, reduce transmission from persons living with HIV, and strengthen interventional surveillance to enhance response capacity and intensive data-to-care activities to support sustained viral suppression. Priority activities include (but are not limited to) HIV testing; linkage to, re-engagement in, and retention in care and support achieving viral suppression; pre-exposure prophylaxis (PrEP) related activities; community-level HIV prevention activities; HIV transmission cluster investigations and outbreak response efforts.

The purpose of this Funding Opportunity Announcement (FOA) is to increase the identification of HIV positive persons through targeted HIV counseling and testing (HCT), assist in spouse and child disclosure of HIV status, and improve linkage and enrollment of all newly identified HIV clients to HIV/AIDS care, treatment and support services. Linkage is defined as the process of identifying new HIV positive clients through a bidirectional relationship among index case testing service outlets and HIV/AIDS care and treatment facilities, enrolling newly diagnosed HIV clients into appropriate chronic care by using referral slip and/or escorting of all newly identified HIV clients to appropriate care, treatment and support services. The care and support services will serve to improve clients ART adherence, and overall quality of life of persons living with HIV (PLHIV) and their families. This in turn will reduce new HIV infections, improve the quality of life for PLHIVs, and mitigate the negative health, psychological, social, and economic impacts of HIV infection in the long term.

The justice system is an important target for HIV prevention and treatment, as an estimated 25% of all people living with HIV will pass through the justice system each year. As well, a high proportion of people with opioid use disorder (OUD) and people who inject drugs (PWID) pass through the justice system each year. OUD and injection drug use elevate HIV risk. Community re-entry from incarceration is a time of heightened risk for substance use relapse, opioid-related mortality, HIV risk behaviors, and discontinuation of HIV treatment. Justice involved people who have HIV, or who are at elevated risk for HIV, should have the opportunity to receive evidence-based HIV services appropriate to their level of risk. These include screening, initiation on Pre-Exposure Prophylaxis (PrEP) or highly active antiretroviral therapy (HAART), and engagement in related substance use disorder treatment services. HIV treatment-as-prevention can help reach the goal of ending the HIV epidemic in the United States. This initiative aligns with the NIH-OAR priority of reducing the incidence of HIV, and with the President's objective to End the HIV Epidemic by 2030.

The purpose of this program is to implement comprehensive HIV prevention programs to reduce morbidity, mortality, and related health disparities. In accordance with the National HIV/AIDS Strategy (http://www.whitehouse.gov/sites/default/files/uploads/NHAS.pdf) and CDC's High-Impact HIV Prevention (HIP) approach (http://www.cdc.gov/hiv/strategy/hihp/index.htm), this FOA focuses on HIV in the nation by reducing new infections, increasing access to care, and promoting health equity. These goals will be achieved by enhancing community-based organizations' capacities to increase HIV testing, link HIV-positive persons to HIV medical care, increase referrals to Partner Services (PS), provide prevention and essential support services for HIV-positive persons and high-risk persons with unknown/negative serostatus, and increase program monitoring and accountability. Standard performance measures for HIV prevention programs that are consistent with the focus of the National HIV/AIDS Strategy on improving performance and accountability are included in this FOA.

This NOFO will build on previous PEPFAR support under the HHS/CDC HIV treatment program in Côte d'Ivoire (CI) to ensure continuity of comprehensive HIV/AIDS services to an existing pool of clients receiving HIV/AIDS care, support, and/or treatment. The program will also continue expanding access to HIV/AIDS services while building the capacity of national structures and contributing to sustainable service delivery within the health sector in CI. Specifically, it serves to increase capacity and sustainability of the response toward controlling the HIV/AIDS epidemic by initially providing support for HIV service delivery aligning with PEPFAR geographic and programmatic pivots by local indigenous organizations and ultimately providing technical assistance to the national Ministry of Health and Public Hygiene (MSHP) to sustain and expand comprehensive HIV prevention, care, and antiretroviral therapy (ART) programs. The recipient(s) will combine a facility and community-based strategy to support HIV/AIDS services. At the end of the 5-year project period, the recipient(s) should be able to collect and evaluate program data that demonstrates improved quality of HIV prevention, care, and treatment services in CI and to transition activities to MSHP and/or local organizations to sustain a basic HIV service package.

India is home to the third largest number of people living with HIV/AIDS (PLWH) in the world. There are an estimated 2.09 million people living with HIV. The Government of India (GoI) has undertaken a robust scale up of its antiretroviral treatment (ART) program, starting from eight ART centers in 2004 to over 420 centers now in 2014. Currently, over 750,000 PLWH are on ART out of 1.1 million eligible for treatment. Despite scale up success, several challenges remain for the ART program to achieve the expansion it envisages over the next five years. These include human capacity issues, loss of patients from detection to enrollment in HIV care, and late HIV detection and retention. At every stage, over 200,000 patients are lost from testing to enrollment in care, to retention in care and then to treatment. Although progress has been made in the implementation of the HIV-TB program, there are several gaps that need to be addressed. The linkages between HIV/AIDS and the Revised National Tuberculosis Control Program (RNTCP) are suboptimal, particularly in northern states due to limited capacity and infrastructure. Only 61% (2014) of TB patients were screened for HIV and knew their HIV status in the last one year. Of those identified as HIV positive, 85% were linked to ART. However, the concern is that the referral from HIV testing and care facilities to RNTCP is quite low.

This NOFO is to conduct a national PHIA in Nigeria, on behalf of the Government of Nigeria (GoN), to strengthen monitoring of program impact and outcomes to more comprehensively inform national responses to HIV. A PHIA is a large, nationally representative household survey used to collect data on the uptake of care and treatment services for HIV, provide home-based HIV counseling and testing, and estimate HIV incidence, CD4 T-cell counts, viral load, and HIV drug resistance. The Nigeria Population-based HIV Impact Assessment (NPHIA) will cover a representative sample of all the 36 states and the Federal Capital Territory (FCT) and will provide useful and actionable data that will increase cost efficiency and effectiveness of HIV programs. The data will assess the impact of PEPFAR and other stakeholder investment in ending Nigeria’s HIV epidemic and Nigeria’s progress towards achieving the Joint United Nations Program on HIV/AIDS (UNAIDS)/PEPFAR goal of testing 90 percent of people living with HIV (PLHIV), placing 90 percent of those on treatment, and achieving viral suppression in 90 percent of those on treatment.

This NOFO will support implementation and acceleration of comprehensive HIV prevention, care, and treatment programs for HIV/AIDS epidemic control in Fort Portal Region of Uganda. This will entail implementation of comprehensive HIV/AIDS services in line with the new WHO guidelines,including targeted HIV testing services (HTS) to find more people living with HIV (PLHIV), especially men and key and priority populations (KP/PP) through HIV care and treatment; TB/HIV prevention, diagnosis, and treatment;elimination of Mother-to-Child Transmission (eMTCT); Voluntary Medical Male Circumcision (VMMC); services for orphans and vulnerable children (OVC); and associated laboratory and strategic information (SI) services through a health systems strengthening approach. Additionally, the recipient will work closely with the Ministry of Health (MOH) to strengthen the technical capacity of regional structures and District Health Teams (DHTs) for an effective public health decentralized HIV/AIDS response. Expected outcomes include improved access,coverage, and quality of HIV services ensuring 90% of PLHIV know their status;90% of people diagnosed with HIV infection receive antiretroviral therapy (ART); and 90% of those on treatment are virally suppressed.

PEPFAR South Sudan collaborates closely with the Republic of South Sudan (RSS) Ministry of Health (MOH) and other key partners to implement the HIV/AIDS National Strategic Plan (NSP) and has developed a five year PEPFAR strategy for the RSS. By targeting geographic areas with high HIV prevalence, PEPFAR will assist the RSS to reach the HIV programmatic goal/tipping point of 16,000 net new HIV patients on treatment and an annual reduction of new HIV infections to below 13,000 by 2017. A primary objective to reach this goal requires improved availability and quality of HIV services for families and other high-impact populations using a public health approach. Under this funding opportunity announcement (FOA), PEPFAR South Sudan prioritizes working in collaboration with the MOH to implement the following approaches: 1) expand HIV testing and counseling (HTC) through high-yield testing approaches, 2) improve access to ART services for pregnant and breastfeeding mothers, their partners, and children, 3) strengthen pediatric HIV testing, care and treatment within a family centered approach, and 4) advance the development of a sustainable infrastructure for South Sudan's workforce. This FOA solicits a combination of capacity building and mentorship for the RSS MOH at the national, state and local levels as well as through direct service delivery to complement the MOH, Global Fund and other partner efforts to scale-up HIV prevention, care and treatment programs in South Sudan.

The purpose of this NOFO is to provide funding and technical assistance for PEPFAR countries to establish HIV recent infection surveillance to detect recent infections, monitor trends in the HIV epidemic, identify hot spots associated with recent HIV transmission, and inform programmatic interventions to reach epidemic control. Point-of-care tests for recent infection distinguish between recent (HIV seroconversion in the last 6 months, on average) and non-recent HIV infection and provide results within minutes. These data may be linked to HIV case-based surveillance for ongoing epidemic monitoring and used by programs to provide enhanced counselling for immediate ART initiation, prioritize index testing, and intervene to prevent HIV transmission. This NOFO will require a multi-disciplinary team with expertise in surveillance, laboratory, prevention, HIV testing services, health informatics, data management, data analytics, and supply chain to support the planning, implementation, and impact evaluation of this PEPFAR priority activity.

This notice solicits applications for a new three-year Special Projects of National Significance (SPNS) initiative entitled Capacity Building in the Ryan White HIV/AIDS Program to Support Innovative Program Model Replication. This Notice of Funding Opportunity (NOFO) responds to recent changes in the HIV epidemic and the need to find effective solutions that improve health outcomes along the HIV care continuum for people living with HIV (PLWH). During recent years, a number of innovative interventions have demonstrated effective responses that contribute to ending the HIV epidemic. Ryan White providers who have developed these evidence-informed interventions have produced replication manuals and other tools to assist organizations and jurisdictions interested in adapting and/or replicating such interventions. This NOFO seeks to build the capacity of Ryan White HIV/AIDS Program (RWHAP) recipients and subrecipients to replicate effective models of care., with a particular focus on RWHAP jurisdictions identified as disproportionately affected by HIV By building capacity and encouraging the implementation or replication of effective models of care, the RWHAP intends that these jurisdictions will bring recent innovations to scale, thus improving systems of care, reducing health disparities, improving outcomes along the HIV care continuum, and ultimately contributing towards meeting the goals and objectives of the National HIV/AIDS Strategy.

This Funding Opportunity Announcement (FOA) is intended to appeal to a broad audience of alcohol and HIV/AIDS researchers, including alcohol researchers with no prior experience in HIV/AIDS research but with a keen appreciation for the relationship between problem drinking and HIV/AIDS and a strong interest in acquiring such experience; HIV/AIDS researchers with no prior alcohol research experience who realize the importance of more intensive alcohol interventions to improving clinical outcomes among HIV-infected individuals; and those with prior research experience in the area of co-occurring HIV/AIDS and alcohol and other substance abuse. The primary objective for this announcement is to support small research projects : 1) to characterize the relative importance of reducing alcohol misuse in the prevention of acquisition and transmission of HIV in order to identify and apply appropriate alcohol and HIV interventions as public health measures; 2) to more fully understand and prevent the progression of HIV disease in the presence of continued alcohol exposure; and 3) to develop operational research frameworks for addressing the occurrence and persistence of infections in high-risk populations (e.g. minority women, young gay men, etc.), and translate findings into effective, culturally appropriate preventive and treatment interventions for these targeted populations.

This Funding Opportunity Announcement (FOA) is intended to appeal to a broad audience of alcohol and HIV/AIDS researchers, including alcohol researchers with no prior experience in HIV/AIDS research but with a keen appreciation for the relationship between problem drinking and HIV/AIDS and a strong interest in acquiring such experience; HIV/AIDS researchers with no prior alcohol research experience who realize the importance of more intensive alcohol interventions to improving clinical outcomes among HIV-infected individuals; and those with prior research experience in the area of co-occurring HIV/AIDS and alcohol and other substance abuse. The primary objectives for this announcement are to increase innovative developmental research: 1) to characterize the relative importance of reducing alcohol misuse in the prevention of acquisition and transmission of HIV in order to identify and apply appropriate alcohol and HIV interventions as public health measures; 2) to more fully understand and prevent the progression of HIV disease in the presence of continued alcohol exposure; and 3) to develop operational research frameworks for addressing the occurrence and persistence of infections in high-risk populations (e.g. minority women, young gay men, etc.), and translate findings into effective, culturally appropriate preventive and treatment interventions for these targeted populations. Given the breadth of research objectives included in this announcement, potential applicants are encouraged to carefully review all sections of the announcement for research opportunities.

This Funding Opportunity Announcement (FOA) is intended to appeal to a broad audience of alcohol and HIV/AIDS researchers, including alcohol researchers with no prior experience in HIV/AIDS research but with a keen appreciation for the relationship between problem drinking and HIV/AIDS and a strong interest in acquiring such experience; HIV/AIDS researchers with no prior alcohol research experience who realize the importance of more intensive alcohol interventions to improving clinical outcomes among HIV-infected individuals; and those with prior research experience in the area of co-occurring HIV/AIDS and alcohol and other substance abuse. The primary objectives for this announcement are to increase research: 1) to characterize the relative importance of reducing alcohol misuse in the prevention of acquisition and transmission of HIV in order to identify and apply appropriate alcohol and HIV interventions as public health measures; 2) to more fully understand and prevent the progression of HIV disease in the presence of continued alcohol exposure; and 3) to develop operational research frameworks for addressing the occurrence and persistence of infections in high-risk populations (e.g. minority women, young gay men, etc.), and translate findings into effective, culturally appropriate preventive and treatment interventions for these targeted populations. Given the breadth of research objectives included in this announcement, potential applicants are encouraged to carefully review all sections of the announcement for research opportunities.

Mozambique is at a critical junction of controlling its HIV/AIDS epidemic in order to meet The Joint United Nations Programme on HIV/AIDS (UNAIDS) goal of 90-90-90 by 2020 and 95-95-95 by 2030. Reaching these goals not only requires robust clinical interventions, but simultaneously requires addressing social, cultural, and legal barriers that inhibit equal access to health services for all people living with and affected by HIV. This requires not only the training of those at a local level who interact with people living with HIV/AIDS (PLHIV) or other vulnerable populations but also building the capacity of civil society organizations that can assist with improving uptake of HIV services as well as improving retention and linkages. This NOFO will increase the availability, accessibility, acceptability, and quality of HIV services provided in health facilities or community level by implementing innovative activities that reduce stigma and discrimination, increase retention and linkages of HIV and TB services, improve health facilities’ redress mechanisms, optimize care for HIV and TB patients, and improve patient rights and access to quality services for PLHIV.

Cameroon is one of the 30 countries with the highest burden of TB/HIV co-infection worldwide. Only 54% of TB cases were notified in 2016 and 5.5% were children. TB treatment coverage was 55% and treatment success 84%.Despite implementation of TB and HIV strategic plans, TB case finding, diagnosis, and management remain suboptimal. TB/HIV co-infection remains high, Isoniazid Preventive Therapy (IPT) implementation is limited, and antiretroviral therapy (ART) services are not fully integrated in TB clinics. Human resource capacity is limited, and there are continued challenges with stock management.Cameroon adheres to the Sustainable Development Goals and the WHO Strategy to END TB. This NOFO will support development of models to improve screening, case identification, prevention, diagnosis, and treatment of TB among people living with HIV (PLHIV). It will also strengthen HIV testing, ART initiation, clinical monitoring, and care for TB clients, and strengthen health systems by building monitoring and evaluation (M&E) and infection control (IC) capacity. These interventions will strengthen TB/HIV services and improve capacity for an effective TB/HIV response in Cameroon.

The goal of this funding opportunity announcement (FOA) is to translate and adapt the most successful global, evidence-based HIV-related service provision strategies to marginalized populations in the United States (U.S.) with a substantial risk of HIV-infection and AIDS. The ultimate goal, is to produce improvements in HIV-related health outcomes in these key populations through strategies that successfully and durably reach them with timely HIV testing, prevention and treatment technologies that lead to the achievement of the UNAIDS 90-90-90 benchmarks: by 2020, 90 percent of all people living with HIV will know their HIV status, 90 percent of all people with diagnosed HIV infection will receive sustained antiretroviral therapy and 90 percent of all people receiving antiretroviral therapy will have viral suppression.

HIV+ alcohol users remain at high risk for medication non-adherence and rapid disease progression, medication toxicities, organ failure, and poor viremic control, leading to increased risk of transmission and premature death. Recent advances in technology and biomedical science (e.g., new pharmacological agents, alcohol and inflammation biomarkers, internet and mobile technology) open new opportunities for strengthening the quality of HIV/alcohol-related implementation research through utilization of novel technology and biomarkers. This initiative seeks to advance knowledge on implementation and comparative effectiveness of alcohol-focused interventions among HIV+ individuals. Multiple factors need to be investigated, including potentially important patient and provider characteristics, and the organizational, financial, and structural factors that facilitate or inhibit the delivery of evidence-based services for HIV+ individuals with a range of severity of alcohol use problems. The overall goal is to inform clinical decision-making to implement effective interventions that will improve prevention, care, and outcomes across the continuum of HIV and alcohol problem severity and patterns of alcohol use. This solicitation is divided into two major topics. An application may choose to address one or both. These topics include: 1) comparative effectiveness research focused on understanding factors related to early detection, patient engagement and retention in appropriate alcohol and HIV care, and achieving and maintaining optimal treatment responses in diverse settings, and 2) modeling and testing alternative implementation approaches to improve uptake and scaling-up of effective interventions and reduce HIV disease transmission and progression.

HIV+ alcohol users remain an underserved group at high risk for medication non-adherence and rapid disease progression, medication toxicities, organ failure, and poor viremic control leading to increased risk of transmission and premature death. It has been estimated that the effective implementation of alcohol interventions for HIV+ individuals may reduce the rates of new infections by nearly 20% and extend life by up to 15 years in some at-risk and patient populations respectively. This new initiative seeks to advance knowledge of the effective implementation and comparative effectiveness of alcohol-focused interventions among HIV+ individuals. Multiple factors need to be investigated, including potentially important patient and provider characteristics, and the organizational, financial, and structural factors that facilitate or inhibit the delivery of evidence-based services for HIV+ individuals with a range of alcohol use disorders. The overall goal is to inform clinical decision-making that will enhance treatment outcomes and reduce harms associated with interventions for HIV+ individuals with alcohol use disorders. This solicitation is divided into two parts, one or both of which an applicant may choose to address. These parts include: 1) comparative effectiveness research focused on understanding factors related to patient engagement in appropriate alcohol and HIV care and retention in treatment; and 2) modeling and testing alternative approaches to the implementation of effective interventions to reduce HIV disease transmission and progression. This announcement addresses the need to further develop patient- centered approaches for making informed health care decisions and to improve research on health care delivery and outcomes.