Opportunity Information: Apply for RFA MH 24 235

The National Institutes of Health (NIH) funding opportunity titled "Biotypes of CNS Complications in People Living with HIV (P01 Clinical Trial Not Allowed)" (Funding Opportunity Number RFA-MH-24-235) supports large, multi-project research programs aimed at understanding why central nervous system (CNS) complications still occur in people living with HIV even when the virus is well controlled with suppressive antiretroviral therapy. The premise behind the announcement is that HIV can enter the CNS very early, as soon as about eight days after infection, and that this early and persistent interaction between HIV, the brain, and the immune system can lead to a wide range of long-term outcomes. These outcomes can include cognitive problems (such as memory or attention changes), neurological issues, and mental health related complications. While the field has accumulated substantial data on HIV-related CNS pathology, the opportunity highlights that clear, targetable cause-and-effect mechanisms remain difficult to pin down, which is one reason effective therapies to slow, stop, or reverse these CNS effects are still lacking.

A central goal of this initiative is to move beyond one-size-fits-all descriptions of HIV-associated CNS complications and instead define "actionable biotypes" based on underlying biological mechanisms. In this context, a biotype can be understood as a biologically grounded subgroup of people who share a similar mechanistic pathway leading to CNS complications, even if their outward symptoms overlap with those of other subgroups. The emphasis on actionable biotypes signals that NIH is looking for research that does more than classify patients; the classification should be tied to mechanistic drivers that can realistically inform prevention strategies, clinical monitoring, or future therapeutic development. The opportunity also underscores heterogeneity: people living with HIV can experience very different CNS trajectories, and teasing apart that diversity is viewed as essential for developing precision approaches that match interventions to the specific biology driving an individual's symptoms.

The award mechanism is a P01 program project grant, which typically supports a coordinated set of interrelated projects organized around a unifying scientific theme. This format is meant to encourage interdisciplinary teams to tackle complex problems from multiple angles, for example by integrating clinical characterization with neuroimaging, immunology, virology, neuropathology, genetics, biomarkers, and computational or systems biology approaches, as long as everything is tied together by a shared framework focused on mechanistic biotypes. The notice explicitly states "Clinical Trial Not Allowed," meaning the supported research should not include prospective assignment of human participants to an intervention to evaluate effects on health-related outcomes. Applicants can still generally propose many types of human-focused clinical research, observational studies, biospecimen analyses, and data-driven subtype discovery, but they must avoid designs that meet the NIH definition of a clinical trial for this specific announcement.

Eligibility is broad and includes many types of institutions and organizations. 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 and Indian housing authorities; nonprofit organizations with or without 501(c)(3) status (as long as they are not institutions of higher education, since higher-ed entities have their own category); for-profit organizations (other than small businesses); and small businesses. The announcement also calls out additional eligible applicants such as Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISI), Hispanic-serving Institutions, Historically Black Colleges and Universities (HBCUs), Tribally Controlled Colleges and Universities (TCCUs), faith-based or community-based organizations, eligible federal agencies, regional organizations, U.S. territories or possessions, and non-U.S. entities (foreign organizations). This wide eligibility reflects an interest in drawing on diverse scientific and community strengths, including institutions serving populations disproportionately affected by HIV and organizations positioned to support meaningful engagement with people living with HIV.

From an administrative standpoint, this is a discretionary grant opportunity issued by NIH in the health and education funding activity categories, with CFDA (Assistance Listing) numbers 93.242, 93.279, and 93.853. The posting lists an original closing date of 2023-12-11 and a creation date of 2023-08-29. The award ceiling and expected number of awards are not specified in the provided source data, which usually means applicants need to consult the full funding announcement and NIH budget guidance for allowable project periods, budget structure, and any institute- or program-specific expectations.

Overall, the opportunity is designed to accelerate progress on HIV-associated CNS complications by supporting integrated research programs that can identify biologically meaningful subgroups and link them to clear mechanisms. The intended payoff is a stronger foundation for precision medicine approaches, where future diagnostics, monitoring tools, or treatments can be tailored to the specific pathways driving CNS complications in different groups of people living with HIV, rather than treating these complications as a single uniform condition.

  • The National Institutes of Health in the education, health sector is offering a public funding opportunity titled "Biotypes of CNS Complications in People Living with HIV (P01 Clinical Trial Not Allowed)" and is now available to receive applicants.
  • Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.242, 93.279, 93.853.
  • This funding opportunity was created on 2023-08-29.
  • Applicants must submit their applications by 2023-12-11. (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.
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Frequently Asked Questions (FAQs)

What is the title and funding opportunity number for this NIH grant?

The opportunity is titled "Biotypes of CNS Complications in People Living with HIV (P01 Clinical Trial Not Allowed)" and the Funding Opportunity Number is RFA-MH-24-235.

What is the main purpose of this funding opportunity?

This NIH opportunity supports large, coordinated research programs designed to understand why central nervous system (CNS) complications can still occur in people living with HIV even when HIV is well controlled on suppressive antiretroviral therapy. A major emphasis is identifying mechanistic, biologically grounded subgroups ("actionable biotypes") that can explain different CNS outcomes and point toward future prevention, monitoring, and treatment strategies.

What kinds of CNS complications is the opportunity focused on?

The opportunity focuses on a range of HIV-associated CNS complications and long-term outcomes, including cognitive problems (for example, changes in memory or attention), neurological issues, and mental health related complications. The goal is to explain why these outcomes vary across people living with HIV and to connect them to underlying biological mechanisms.

Why does NIH emphasize early HIV entry into the CNS?

The premise described in the opportunity is that HIV can enter the CNS very early, as soon as about eight days after infection. NIH highlights that early and persistent interactions between HIV, the brain, and the immune system may contribute to long-term CNS outcomes, even when systemic viral control is achieved with antiretroviral therapy.

What does NIH mean by "biotypes" in this announcement?

In this context, a biotype is a biologically grounded subgroup of people who share a similar mechanistic pathway leading to CNS complications. People in different biotypes might have overlapping symptoms, but the underlying biology driving those symptoms is expected to differ. The intent is to move beyond broad, one-size-fits-all labels and instead identify mechanism-based subgroups.

What does "actionable biotypes" mean?

"Actionable" signals that the biotype definitions should be tied to mechanistic drivers that can realistically inform next steps, such as prevention approaches, clinical monitoring strategies, or future therapeutic development. In other words, NIH is looking for biotype frameworks that do more than categorize; they should connect directly to targetable cause-and-effect pathways.

Why is heterogeneity across people living with HIV a key theme here?

The opportunity underscores that people living with HIV can experience very different CNS trajectories. NIH is emphasizing that understanding and separating this diversity is essential to developing precision approaches that match interventions and monitoring to the specific biology driving an individual's CNS complications.

What award mechanism is being used?

The award mechanism is a P01 program project grant. This mechanism typically supports a coordinated set of interrelated projects organized around a unifying scientific theme, encouraging interdisciplinary teams to tackle a complex problem through multiple integrated research components.

What types of research approaches does this P01 encourage?

The opportunity is intended to support interdisciplinary, multi-angle research programs. The description gives examples of potential areas that can be integrated under a shared mechanistic biotype framework, including clinical characterization, neuroimaging, immunology, virology, neuropathology, genetics, biomarker work, and computational or systems biology approaches.

Are clinical trials allowed under this funding opportunity?

No. The announcement explicitly states "Clinical Trial Not Allowed." This means applicants must avoid proposing research that includes prospective assignment of human participants to an intervention to evaluate effects on health-related outcomes (i.e., studies that meet the NIH definition of a clinical trial for this opportunity).

What kinds of human-focused research may still be appropriate if clinical trials are not allowed?

Based on the information provided, the opportunity suggests that many types of human-focused clinical research may still be proposed as long as they do not meet the NIH clinical trial definition for this announcement. Examples mentioned or implied include observational studies, biospecimen analyses, and data-driven subtype/biotype discovery efforts.

Who is eligible to apply for this NIH opportunity?

Eligibility is broad. 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 and Indian housing authorities; nonprofit organizations with or without 501(c)(3) status (when not categorized as institutions of higher education); for-profit organizations (other than small businesses); and small businesses.

Are community-based or faith-based organizations eligible?

Yes. The opportunity explicitly lists faith-based or community-based organizations among eligible applicant types.

Are minority-serving institutions specifically mentioned as eligible?

Yes. The announcement calls out several categories, including Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISI), Hispanic-serving Institutions, Historically Black Colleges and Universities (HBCUs), Tribally Controlled Colleges and Universities (TCCUs), and other organizations positioned to contribute to work relevant to populations disproportionately affected by HIV.

Can non-U.S. (foreign) organizations apply?

Yes. Non-U.S. entities (foreign organizations) are included in the eligibility list provided.

Are U.S. territories or possessions eligible?

Yes. The opportunity lists U.S. territories or possessions as eligible applicants.

Are federal agencies eligible to apply?

Yes. The opportunity includes eligible federal agencies among the additional eligible applicants mentioned.

What are the CFDA (Assistance Listing) numbers associated with this opportunity?

The CFDA (Assistance Listing) numbers provided are 93.242, 93.279, and 93.853.

Which funding activity categories does this grant fall under?

The opportunity is described as a discretionary grant opportunity issued by NIH in the health and education funding activity categories.

What are the key dates listed for this opportunity?

The provided information lists a creation date of 2023-08-29 and an original closing date of 2023-12-11.

Is the award ceiling specified? Is the expected number of awards specified?

No. In the provided source information, the award ceiling and the expected number of awards are not specified.

What is the problem NIH is trying to solve with this initiative?

The opportunity highlights that, despite substantial accumulated data on HIV-related CNS pathology, clear, targetable cause-and-effect mechanisms remain difficult to pin down. This lack of well-defined mechanisms is described as one reason effective therapies to slow, stop, or reverse HIV-associated CNS effects are still lacking. The initiative aims to close that gap by defining mechanistic, actionable biotypes.

What is the intended long-term payoff of this research program?

The intended payoff is a stronger foundation for precision medicine approaches in HIV-associated CNS complications. NIH is aiming to enable future diagnostics, monitoring tools, and treatments to be tailored to the specific pathways driving CNS complications in different groups of people living with HIV, rather than treating these complications as a single uniform condition.

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