Increasing Uptake of Long-Acting Injectable Antiretrovirals Among People with HIV

This notice announces the opportunity to apply for funding under the Increasing Uptake of Long-Acting Injectable Antiretrovirals Among People with HIV cooperative agreement Increasing viral suppression and client retention in care are critical components of meeting the goals of the National HIV/AIDS Strategy (2022-2025) and ending the HIV epidemic. In order to reach these goals, it is imperative for HIV care communities to address health care inequities. With the advent of FDA-approved long-acting injectable (LAI) antiretroviral (ARV) medication formulations, initiatives that promote, facilitate, and evaluate the uptake and ongoing utilization of LAI ARV medication may improve clinical outcomes for people with HIV, especially for minority populations who continue to face disparate health care inequities and stigma. This project is designed to develop protocols, implement them and modify as needed, to increase uptake of LAI ARV medications among people of color with HIV, since LAI ARV medications may offer benefits in addressing health inequities and achieving viral suppression.
 In addition to alleviating challenges associated with oral medications, ongoing utilization of LAI ARV medications in lieu of oral regimens may potentially reduce HIV-related stigma and enhance protection of health privacy. While there are some unique clinical and social benefits to this injectable drug formulation, some aspects of its distribution, administration requirements, and billing have already hindered uptake and utilization within the Ryan White HIV/AIDS Program (RWHAP). As minority populations have historically experienced significant disparities in accessing care and treatment, including the health literacy and access to health care coverage options necessary to engage in care, developing interventions to increase the uptake of LAI ARV medication formulations will help to proactively address and potentially reduce or prevent disparities minority communities may face in accessing this breakthrough therapy.
 The main objective of this program is to develop and implement protocols for successful use of LAI ARV medication within clinical practice. This program will fund 1 organization to serve as the Coordination and Evaluation Provider (CEP). The CEP must have the capacity and infrastructure (e.g., staffing/personnel, trainings, clinical systems, data collection and reporting, protocol and implementation evaluation) to support development, implementation, and refinement of LAI ARV medication administration protocols with the goal of replicating and expanding successful protocols. The recipient will solicit and subaward up to 10 demonstration sites (subrecipients) to implement these co-developed protocols and collect data from direct patient care, with priority given to entities located within EHE jurisdictions. HRSA anticipates that through evaluation and scale-up of LAI ARV medication administration protocols, patients with historic difficulty accessing or continuing oral HIV therapy can be bridged to this treatment modality, thus improving viral suppression and retention in care, especially among racial and ethnic minorities.