The Confluence of Cancer Stigma and HIV Stigma in HIV-positive Individuals Diagnosed with Cancer (R21 Clinical Trial Optional) | RFA CA 25 012

Opportunity Information: Apply for RFA CA 25 012

The National Cancer Institute (NCI), part of the National Institutes of Health, is offering an R21 pilot/exploratory research grant opportunity titled "The Confluence of Cancer Stigma and HIV Stigma in HIV-positive Individuals Diagnosed with Cancer (R21 Clinical Trial Optional)" (Funding Opportunity Number: RFA-CA-25-012; CFDA: 93.393). The purpose of this funding opportunity is to support early-stage, exploratory studies that build a clearer, evidence-based understanding of how cancer-related stigma and HIV-related stigma overlap and interact in people with HIV (PWH) who are also diagnosed with cancer, and how that combined stigma shapes real cancer outcomes. The R21 mechanism is typically used to develop foundational data, test feasibility, and generate insights that can lead to larger, more definitive studies later. Clinical trials are optional under this announcement, meaning applicants may propose intervention research that meets the definition of a clinical trial, but they are not required to do so.

This NOFO is centered on the idea that stigma is not a single, isolated barrier. For a person living with HIV who is diagnosed with cancer, stigma can become layered and mutually reinforcing, affecting decisions about disclosure, engagement with care, mental health, social support, and the ability to navigate complex cancer treatment. NCI is looking for projects that (1) expand what is known about the combined or converging experience of HIV stigma and cancer stigma, (2) assess how these intersecting stigmas influence cancer outcomes among PWH with cancer, and (3) identify and intervene on modifiable mechanisms through stigma reduction strategies. In practical terms, this can include studying how stigma affects screening and diagnosis timing, treatment initiation and adherence, continuity of oncology and HIV care, patient-provider communication, trust in healthcare systems, symptom management, quality of life, survivorship planning, and potentially clinical endpoints linked to cancer progression or mortality, depending on the study design.

A key emphasis is on interventions and approaches that operate at multiple levels, not just the individual level. The announcement explicitly references leveraging stigma reduction interventions "at multiple levels" to target changeable mechanisms that contribute to poorer cancer outcomes. That multi-level framing typically includes individual factors (knowledge, coping, internalized stigma), interpersonal dynamics (family, partners, peer networks, disclosure support), clinical and organizational settings (provider attitudes, clinic workflows, confidentiality protections, integrated HIV-oncology care models), and broader community or structural influences (social norms, discrimination, access barriers, policy environment). The intent is to move beyond describing stigma as a problem and toward testing or refining practical strategies that measurably reduce stigma and its downstream harm in cancer care for PWH.

NCI also signals a strong interest in research that is relevant across domestic and international contexts, with a particular focus on regions where the combined burden of HIV and cancer is higher. This opens the door to studies based in the United States as well as work in other countries or cross-national collaborations, especially in settings where HIV-associated malignancies or cancer incidence among PWH is a significant public health issue. Projects may be designed to reflect local context, health system realities, cultural considerations, and varying forms of stigma, while still contributing to generalizable understanding about how these stigmas converge and how to interrupt their effects.

The eligible applicant pool is broad and includes many types of organizations that could reasonably support pilot research, community-engaged work, or intervention development and testing. Eligible applicants include state, county, and local governments; special district governments; independent school districts; public and state-controlled institutions of higher education; private institutions of higher education; federally recognized Native American tribal governments; tribal organizations that are not federally recognized; public housing authorities/Indian housing authorities; nonprofits with and without 501(c)(3) status; for-profit organizations (other than small businesses); small businesses; and other entities. The NOFO also highlights additional eligible applicants such as Historically Black Colleges and Universities (HBCUs), Hispanic-serving Institutions, Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISIs), Tribally Controlled Colleges and Universities (TCCUs), faith-based or community-based organizations, eligible federal agencies, regional organizations, non-U.S. entities (foreign organizations), and U.S. territories or possessions. This broad eligibility is consistent with the topic area, where meaningful progress often depends on partnerships among academic researchers, oncology and HIV clinics, public health programs, and trusted community organizations.

Administratively, this is a discretionary grant funding opportunity with an original closing date of 2024-12-10, and it was created on 2024-08-15. While the provided source details do not list an award ceiling or expected number of awards, the R21 mechanism generally supports time-limited, exploratory projects intended to answer focused questions, establish feasibility, produce pilot data, and position teams for larger-scale grants. Overall, the opportunity is aimed at generating actionable knowledge and early intervention evidence on how intersecting HIV and cancer stigmas harm outcomes for PWH with cancer, and how targeted, multi-level stigma reduction approaches can improve engagement in care and cancer-related health outcomes in high-burden settings.

• The National Institutes of Health in the education, health sector is offering a public funding opportunity titled "The Confluence of Cancer Stigma and HIV Stigma in HIV-positive Individuals Diagnosed with Cancer (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): 93.393.
• This funding opportunity was created on 2024-08-15.
• Applicants must submit their applications by 2024-12-10. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• 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.

Apply for RFA CA 25 012

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