Funding for Enhanced Surveillance of Persons with Early and Late HIV Diagnosis

What to know

  • NOFO Number: PS22-2211
  • Application Due Date: Tuesday, April 26, 2022, 11:59 PM EST
  • Letter of Intent Due Date: April 1, 2022, 11:59 PM EST
  • The purpose of this page is to support applicants for Notice of Funding Opportunity (NOFO) PS22-2211.

Funding overview

This NOFO supports identification and recruitment of adults with recent HIV diagnoses at stage 0 and stage 3. This NOFO aims to improve understanding of barriers and gaps associated with new infection. Additionally, it aims to improve understanding of late diagnosis in the era of multiple testing modalities and prevention options.

These enhanced surveillance activities will identify actionable missed opportunities for early diagnosis and prevention. This will inform and enhance:

  • The allocation of resources.
  • Development and prioritization of interventions.
  • Evidence-based local and national decisions to improve HIV testing and address prevention gaps.

New HIV infections continue to occur in the United States despite the many ways that now exist to fight it. Powerful prevention tools and varied modalities are now available to diagnose, treat, and prevent HIV. Each new HIV infection is considered a failure of HIV prevention.

A substantial proportion of new HIV diagnoses in the U.S. are classified as early (stage 0) or late (stage 3) diagnoses. Early and late diagnoses present opportunities to examine failures of HIV prevention and testing services for those who need them most. Enhanced surveillance of people with early and late diagnoses is needed to identify actionable missed opportunities for early diagnosis and prevention.

This Notice of Funding Opportunity supports enhanced surveillance among persons with early or late HIV diagnoses. It will inform understanding of individual- and systems-level barriers preventing people from realizing the benefits of current prevention and testing interventions. Strategies and activities include identifying, contacting, and recruiting people who received an early or late HIV diagnosis in the past year. They will participate in behavioral interviews conducted by a Centers for Disease Control and Prevention (CDC) contractor.

Recipients also engage local community partners to ensure appropriateness of recruitment approaches and disseminate findings to the community. These strategies and activities will contribute to efforts to improve uptake of HIV prevention and testing services. Ultimately, it will reduce new HIV infections in the United States.

NOFO re-announcement

This funding opportunity is a re-announcement of PS22-2202, which was cancelled. For PS22-2211, up to 10 awards are anticipated. The average award amount will be $200,000 per year (contingent upon the availability of funding).

PS22-2202 applications will not be reviewed or considered in funding decisions for PS22-2211. PS22-2202 applicants who wish to be considered for the current funding opportunity must submit an application by the due date. Applications were due on April 26, 2022.

Important dates

Key dates for this NOFO include:

  • Informational webinar: March 2, 2022
  • Letters of Intent due (optional): April 1, 2022
  • Applications due: April 26, 2022, 11:59 PM EST
  • Award date: August 1, 2022, 11:59 PM EST
  • Project Period: August 1, 2022–July 31, 2026

Eligibility

Eligible applicants include state, local, and territorial health departments or their Bona Fide Agents. Based on the statutory authority for this funding opportunity, only the following entities are eligible to apply:

  • All U.S. state health departments
  • The six local health departments with independent HIV surveillance programs
    • City of Chicago Department of Public Health
    • Houston Department of Health and Human Services
    • Los Angeles County Department of Public Health
    • City of Philadelphia Department of Public Health
    • New York City Department of Health and Mental Hygiene
    • San Francisco Department of Public Health
  • District of Columbia Department of Health
  • Territorial health departments

Eligibility is not dependent on the occurrence of stage 0 diagnoses. However, applicants that meet one or both of the following criteria may be prioritized in funding:

  • At least 40 annual stage 0 diagnoses.
  • At least 8% of all annual diagnoses occurring at stage 0.

Accessing and submitting applications

To access the application package for NOFO PS22-2211: Enhanced Surveillance of Persons with Early and Late HIV Diagnosis:

  1. Go to: grants.gov.
  2. Select: "Search Grants" from the top menu.
  3. In the "Opportunity Number" box, type: CDC-RFA-PS22-2211.

Applications must be submitted by Tuesday, April 26, 2022, at 11:59 PM EST at www.grants.gov.

Recipients

Awards

Up to 10 awards are anticipated. The period of performance is four years. However, the number of awards and length of the performance period are contingent on the availability of funds.

The average award amount is $200,000 per year (contingent upon the availability of funding). This is an estimated average, not a maximum amount. Amounts vary based on the anticipated annual number new stage 0 or stage 3 HIV diagnosis in the jurisdiction. The occurrence of stage 3 diagnoses will not influence funding decisions.

Recruiting eligibile participants

Identification of eligible persons

Recipients will identify stage 0 and stage 3 diagnoses according to the CDC and Council for State and Territorial Epidemiologists surveillance case definitions. Recipients may use the Enhanced HIV/AIDS Reporting System (eHARS) stage 0 calculated variable. This project defines stage 0 diagnoses as those in both Category A and Category B.

Data from medical charts will not be collected as part of this NOFO. Additionally, neither CDC nor the contractor will have access to personally identifying information (PII).

Participant recruitment

Award recipients will identify, recruit, and schedule/reschedule all eligible participants for the quantitative survey. Additionally, they will conduct a small subset of participants for qualitative in-depth interviews. CDC will provide both instruments for the quantitative survey and the qualitative interviews to recipients before implementation. However, all data collection activities will be conducted by a third-party contractor.

Recipients will generate a list of all eligible adults who received an HIV diagnosis at stage 0 or stage 3. These diagnoses will come from their jurisdiction in the past 12 months. Recipients will be required to attempt to locate, contact, and recruit all persons on the eligible case list. Since this activity constitutes a census and not a sample, there is no target sample size for recipients. The number of eligible persons will vary by jurisdiction based on the number of new HIV diagnoses.

Participant surveys

Only phone-based and web-based interviews will be conducted under this NOFO. Because the CDC contractor conducting the interviews cannot have access to participants' PII, in-person interviews cannot be conducted.

In Year 1, recipients are expected to work with community partners to discuss and refine recruitment approaches. This process could include consideration of strategies to recruit persons experiencing homelessness or other populations with special circumstances. For example, recipients may suggest strategies like providing cell phone minutes or burner phones to facilitate participation in the phone-based survey. If such strategies are proposed in the application, they should be reflected in the budget submitted by the applicant.

All eligible persons identified in the case list will be recruited for the quantitative survey. Only a small subset will be recruited for the qualitative in-depth interview. Participating in the qualitative interview will not preclude participants from participating in the quantitative survey.

The CDC contractor will provide a scheduling system, portal, or link that recipients will use to:

  • Schedule a telephone interview.
  • Access the web-based survey.

Recipients will use the contractor-provided system to ensure the participant has completed their scheduled interview or web-based survey. Recipients should attempt to recontact the participant to reschedule if the scheduled interview is missed or needs to be rescheduled.

Participant incentives

The CDC contractor will be responsible for participant incentives. Applicants should not include incentives in their proposed budgets.

At this time, CDC anticipates $50 incentives for the quantitative survey and $50 for the qualitative in-depth interview.

The contractor will not receive any identifying information from recipients. The contractor will provide a system where recipients will schedule participant interviews or provide a link to access the web-based survey. The contractor will provide recipients with a unique identifier for each participant. Recipients will securely maintain the link between PII and this unique identifier.

Frequently asked questions

What expenses are allowed and disallowed? Is there a budget limit?
Please refer to the NOFO for general budget guidance. The estimated average award amount is $200,000 per year (contingent on the availability of funds and the number of awards). Applicants should aim for this average amount in their proposed budgets. Applicants should budget based on their anticipated level of effort to recruit all targeted persons in their jurisdiction. Personnel costs should be comparable to a typical surveillance project. Because surveys and interviews are conducted by CDC contractors, personnel expenses related to these interviews are not necessary to estimate.

Approximately what proportion of the estimated average award of $200,000 will need to be allocated to personnel costs?
Recipients should budget for the expected level of effort needed to carry out the required strategies and activities of the NOFO. Please refer to the below budget elements as an example.

Personnel:

  • Principal Investigator (5%)
  • Project Coordinator/Recruiter (50-100%)
  • Data analyst (during year 4 of NOFO only) (10%)

In-state Travel:

  • Sufficient mileage/public transportation costs for recruiter (if applicable)

Supplies:

  • Office supplies
  • Laptop or tablet
  • Encryption software
  • SAS or other software to extract data from local case surveillance and to analyze data

Other:

  • Telephone
  • Printing
  • Staff identification
  • Advisory group incentives (if applicable)
  • Cell phone minutes (if applicable, e.g., to recruit persons without reliable access to phone or internet)

How does this project comply with state laws that prevent health departments from sharing personally identifying information (PII) of people with diagnosed HIV?
Recipients of this funding opportunity will not share any participant PII or contact information with the third-party contractor conducting the survey. Survey participants will be given a unique ID and a phone number or unique web link. Participants will use this to initiate contact with the survey interviewer or access the web-based survey, respectively. Recipients, not the contractor, are responsible for monitoring survey completion and attempting to reschedule participants who do not complete their survey.

What are the community engagement requirements of the NOFO?
Recipients are required to engage with community partners and/or community advisory boards (CAB) throughout the project. In Year 1, before data collection, recipients work alongside their community partners to identify locally appropriate recruitment strategies for targeted persons. Additionally, in Year 1, recipients and their community partners have an opportunity to review the quantitative survey instrument to provide feedback.

In Year 4, each recipient receives their final local dataset. They will work with their respective community partners identify the best way(s) to share data findings to better reach community stakeholders. This will also help inform HIV program planning in their respective jurisdictions. Examples of dissemination activities include community fact sheets, webinars, and data-to-action workshops with community stakeholders. The goal of the data dissemination activities is to work alongside community partners to translate data findings into actionable next steps.

Are letters of support required for this NOFO?
Letters of support are not required. However, they are encouraged if the applicant proposes to collaborate with other organizations to conduct the required strategies and activities. No standard template is provided for letters of support. Letters of support should be addressed to the Grants Management Specialist listed in the NOFO and submitted with the NOFO application.

What data will be shared with the recipients, and how will it be shared?
CDC or their contractor will securely share with each recipient their own line-listed dataset from the quantitative survey after data collection. Data from the qualitative in-depth interviews will also be shared with recipients.

Will recipients need to obtain IRB approval for this project as research or non-research?
CDC anticipates that this project will be determined to be surveillance, not research. However, CDC project determination has not yet taken place. Furthermore, the CDC determination does not preclude any required local processes for project determination or approval. The NOFO requires recipients to obtain local regulatory approvals as necessary (including IRB approval, authority to conduct surveillance, etc.).

Will a template for the Evaluation and Performance Measurement Plan be provided, or should applicants develop their own?
No, a template will not be provided, and it is suggested that applicants create their own. Applicants can refer to the NOFO for illustrative examples of performance measures. Applicants may include these measures or develop their own measures. CDC will work with funded recipients during the first six months of the award to refine and finalize the evaluation plan.

Contacts

For programmatic technical assistance, email MPitasi@cdc.gov.

For financial, awards management, or budget assistance, contact:

Edna Green, Grants Management Specialist
Department of Health and Human Services
Office of Grants Services
District of Chamblee2939 Flowers Rd MS TV-2
Atlanta, GA 30341
Email: EGreen@cdc.gov

Additional resources

Attachments

  • Attachment A: Indication of complete HIV laboratory reporting
  • Attachment B: Enumeration of stage 0 diagnoses

Note: The Notice of Funding Opportunity application package must be downloaded from www.grants.gov.

Applications for this funding opportunity must include Attachment A and Attachment B containing the information described below. There are no standardized forms or templates provided for these attachments.

Attachment A

Attachment A should clearly indicate whether the jurisdiction currently has complete reporting of HIV laboratory information. This refers to laws or regulations for reporting CD4 levels and viral load results to the state/local health department. This requires:

  • A minimum of 95% of HIV-related test results reported by laboratories to the state or local health department.
  • At least 95% of all CD4 and viral load test results reported by the jurisdiction to CDC.

For more information about reporting of CD4 and viral load results, refer to Monitoring selected national HIV prevention and care objectives by using HIV surveillance data — United States and 6 dependent areas, 2019. Attachment A should be submitted as a PDF no longer than 2 pages entitled "Attachment A Lab Reporting."

Attachment B

Attachment B should include both:

  1. The annual number of new stage 0 diagnoses in the jurisdiction.
  2. The annual percentage of all new diagnoses that occur at stage 0 in the jurisdiction using the most recent available data.

Applicants can provide local eHARS data or refer to the most recent CDC HIV surveillance report. Attachment B should be submitted as a PDF no longer than 2 pages entitled "Attachment B Enumeration."

Important resources

Informational webinar

Slides from an informational webinar on the NOFO (which occurred on March 2, 2022) are available for reference.

Slides [PDF – 831 KB]

Technical Assistance Mailbox

Potential applicants can send questions about the NOFO and application process to MPitasi@cdc.gov. In addition to their questions, applicants should provide their health department name, phone number and an e-mail address for a response.

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Content Source:
National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention