Transgender Status-Neutral Community-to-Clinic Models to End the HIV Epidemic | CDC RFA PS22 2209

Opportunity Information: Apply for CDC RFA PS22 2209

The CDC funding opportunity "Transgender Status-Neutral Community-to-Clinic Models to End the HIV Epidemic" (CDC RFA PS22-2209) is a discretionary cooperative agreement designed to reduce HIV infections and improve HIV outcomes among transgender people, with a particular focus on transgender women (TGW), who experience a disproportionately high HIV burden in the United States. The opportunity is grounded in surveillance data showing substantial numbers of new HIV diagnoses among TGW and transgender men (TGM), a concentration of diagnoses among young adults ages 20-29, and stark racial and ethnic disparities in HIV positivity, especially among Black/African American and Hispanic/Latina TGW compared with White TGW. It also highlights that, despite high awareness of pre-exposure prophylaxis (PrEP), actual PrEP use remains low, and viral suppression among TGW living with diagnosed HIV lags behind what is needed to end the epidemic.

A central theme of the announcement is that biomedical tools alone are not enough if people cannot reliably access respectful, competent care. The CDC description ties HIV risk and poorer HIV outcomes to common structural and social barriers faced by many transgender people, including poverty, homelessness, exchange sex, exposure to violence and abuse, suicidal ideation, and higher rates of substance use. On top of those challenges, the opportunity recognizes a practical service-delivery gap: some clinical settings are not culturally responsive to transgender patients, which can discourage continued engagement in care, while some transgender-focused providers may have less experience delivering comprehensive HIV prevention and treatment. At the same time, community-based organizations (CBOs) that are trusted by transgender communities may be excellent at outreach and engagement but may not offer the full range of clinical services needed for PrEP, nPEP, rapid antiretroviral therapy (ART) initiation, STI and hepatitis testing, and other ongoing health care.

The proposed approach is a "status-neutral" model, meaning services are organized so that a person can enter care regardless of HIV status and be seamlessly connected to the right next steps. In practice, this means HIV testing is paired with immediate pathways to prevention or treatment: people who test HIV-negative should be evaluated for PrEP eligibility and non-occupational post-exposure prophylaxis (nPEP) needs, and then offered and prescribed PrEP or nPEP when indicated; people who test HIV-positive should be linked quickly to care, including rapid initiation of ART. The opportunity emphasizes that transgender-focused clinical touchpoints, especially visits for gender-affirming care such as feminizing or masculinizing hormone therapy, create real-world opportunities to integrate HIV education, risk assessment, testing, prevention prescribing, and treatment linkage without requiring patients to navigate separate, disconnected systems.

The demonstration project described in the notice calls for transgender clinics and transgender-serving CBOs to work together to build holistic community-to-clinic models that provide comprehensive, co-located or tightly coordinated services. The envisioned service package goes beyond HIV and includes gender-affirming care (including hormone therapy and other procedures as appropriate), routine STI and hepatitis testing, preventive health services, and chronic disease care, alongside reliable access to mental health services, substance use disorder treatment, and social support services. A key expectation is that these services be delivered with trans-specific cultural awareness so transgender people feel welcomed, respected, and listened to, which the CDC frames as essential to retention in prevention and care.

From an implementation standpoint, this funding is structured as a cooperative agreement, signaling that awardees should expect substantial engagement with the CDC rather than a hands-off grant. The CDC also intends for recipients to participate in a national learning collaborative where funded partners share lessons learned, refine best practices, and spread effective strategies for clinic-CBO partnerships. The program is positioned as a small demonstration effort (the notice lists four expected awards) meant to develop and test replicable models for improving transgender health outcomes through integrated, affirming, status-neutral pathways that can accelerate progress toward ending the HIV epidemic.

Key administrative details included in the source information are that the awarding agency is the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (NCHHSTP), the assistance listing is under CFDA 93.944, eligibility is listed as unrestricted (open broadly, subject to any additional eligibility clarifications in the full notice), and the original funding notice was created December 22, 2021 with an original closing date of February 25, 2022. The award ceiling is listed as 0 in the provided fields, which typically indicates applicants should rely on the full funding announcement for specific budget guidance rather than interpreting that field as the true cap.

• The Department of Health and Human Services, Centers for Disease Control - NCHHSTP in the health sector is offering a public funding opportunity titled "Transgender Status-Neutral Community-to-Clinic Models to End the HIV Epidemic" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.944.
• This funding opportunity was created on Dec 22, 2021.
• Applicants must submit their applications by Feb 25, 2022. (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 4 candidate(s).
• Eligible applicants include: Unrestricted (i.e., open to any type of entity above), subject to any clarification in text field entitled Additional Information on Eligibility.

Apply for CDC RFA PS22 2209

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