A System-Level Syndemic Approach to Improve HIV Care and Treatment for People from Racial and Ethnic Minority Groups – Demonstration Systems | HRSA 24 107

Opportunity Information: Apply for HRSA 24 107

This Health Resources and Services Administration (HRSA) funding opportunity (HRSA-24-107) supports the creation of up to five multi-year "demonstration systems" that will test a system-level, syndemic approach to improving HIV care and treatment outcomes for people with HIV from racial and ethnic minority groups. The awards are structured as cooperative agreements, meaning HRSA is expected to have substantial involvement beyond simply issuing funds, and recipients will be expected to work closely with the agency while designing, implementing, and evaluating their models. The project period is up to four years, and the program sits within HRSA's health funding portfolio (CFDA 93.899).

The central goal is to improve linkage to care and long-term retention for people who are most likely to fall out of HIV care, particularly within racial and ethnic minority communities. The target population includes individuals newly diagnosed within the past 12 months, as well as people previously diagnosed who are currently out of care or at elevated risk of being lost to care. Examples of high-risk situations include missing HIV medical appointments, not being virally suppressed, or experiencing major transitions that can disrupt care, such as leaving incarceration. In practice, the program is aimed at people who face overlapping clinical and social challenges that interact to worsen health outcomes and make consistent HIV treatment harder to maintain.

The approach HRSA is asking applicants to demonstrate is explicitly "syndemic," meaning it recognizes that HIV outcomes are strongly affected by co-occurring and mutually reinforcing issues rather than HIV alone. Demonstration systems are expected to build comprehensive, integrated care models that combine three major elements. First, they must strengthen engagement and retention in primary HIV care, with a focus on keeping people connected over time so they can start and stay on antiretroviral therapy and achieve viral suppression. Second, the model must incorporate care and treatment for co-occurring and interacting conditions, specifically including mental health conditions and/or substance use conditions, which are common drivers of missed visits, treatment interruptions, and poor outcomes. Third, the program requires active work on key social determinants of health that directly shape a person's ability to stay in care, including intimate partner violence (IPV), food insecurity, unstable housing, and other related barriers. The emphasis is not just on referrals, but on building integrated systems that can identify these needs, coordinate services, and reduce the real-world obstacles that derail care.

A major feature of the opportunity is the expectation that awardees will not only implement services but also participate in evaluation of the syndemic system model. As demonstration sites, recipients are meant to generate practical evidence about what works at the system level for improving HIV care outcomes for racial and ethnic minority groups, especially for those who are out of care or most likely to be lost to care. This implies attention to implementation, coordination across providers and sectors, and measurable outcomes related to linkage, retention, and viral suppression, alongside improvements in behavioral health and social needs that influence HIV outcomes.

Eligibility is limited to entities that are eligible for funding under Parts A through D of the Ryan White HIV/AIDS Program. This includes public entities and non-profit private entities, and specifically includes Tribes and Tribal organizations. The opportunity is limited to domestic applicants, with "domestic" defined broadly to include the 50 states, the District of Columbia, Puerto Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S. Virgin Islands, and several freely associated states and republics (the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau). The application closing date listed is July 24, 2024, and HRSA anticipates making five awards.

• The Health Resources and Services Administration in the health sector is offering a public funding opportunity titled "A System-Level Syndemic Approach to Improve HIV Care and Treatment for People from Racial and Ethnic Minority Groups – Demonstration Systems" 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 2024-06-24.
• Applicants must submit their applications by 2024-07-24. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• The number of recipients for this funding is limited to 5 candidate(s).
• Eligible applicants include: Others.

Apply for HRSA 24 107

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