Technical Assistance for Accelerating the Coverage and Quality of Effective HIV Prevention, Treatment and Care Activities Among Key Populations and People Living with HIV in Thailand under the President's Emergency Plan for AIDS Relief (PEPFAR) | CDC RFA GH20 2006

Frequently Asked Questions (FAQs)

What is this funding opportunity?

This is a CDC Notice of Funding Opportunity (NOFO) under PEPFAR issued as a cooperative agreement. It focuses on providing targeted technical assistance to strengthen HIV prevention, treatment, and care services in Thailand, especially in provinces and facilities where service gaps are slowing progress.

What is the program trying to achieve in Thailand?

The award aims to accelerate both the coverage and the quality of effective HIV services by embedding hands-on support and technical guidance into public and other health facilities in priority areas. The emphasis is on improving systems and performance across the HIV service cascade rather than simply paying for direct service delivery.

Why is Thailand a focus for this technical assistance?

The opportunity is framed around Thailand's concentrated HIV epidemic, estimated at about 440,000 people living with HIV and roughly 15,000 deaths in 2018. The NOFO highlights that key populations, particularly men who have sex with men (MSM) and transgender women, still trail UNAIDS 95-95-95 goals on testing, treatment uptake, and viral suppression.

Which populations are prioritized in this opportunity?

The NOFO highlights key populations and people living with HIV, with repeated emphasis on MSM and transgender women due to ongoing gaps in testing, treatment uptake, and viral suppression. The activities are designed to improve outcomes for people living with HIV and to reduce new infections among those at substantial risk.

Which geographic areas are emphasized?

The work is intended to prioritize provinces and facilities where service gaps are limiting progress. Bangkok is specifically highlighted as having the highest HIV burden and the weakest clinical cascade performance, making it a critical area of emphasis.

Is this grant meant to fund direct HIV service delivery?

The description emphasizes technical assistance and systems strengthening rather than simply funding direct service delivery. The project is aimed at improving how facilities and programs find cases, link people to care, maintain treatment, confirm viral suppression, and use reliable data to manage performance.

What types of prevention and case-finding strategies does the NOFO prioritize?

The NOFO prioritizes more proactive approaches to identifying people with HIV and those at highest risk. Examples mentioned include active case-finding strategies such as index testing and the use of rapid recency testing to better understand and respond to recent transmission patterns.

What is index testing in the context of this opportunity?

Index testing is described as identifying and offering services to contacts of people diagnosed with HIV. It is included as an active case-finding strategy to improve identification of people who may have HIV and link them to appropriate services.

What is rapid recency testing used for in this program?

Rapid recency testing is included as a way to better understand and respond to recent transmission patterns. The intent is to help programs target and adjust prevention and case-finding approaches based on more timely insights about recent infections.

How does PrEP fit into this funding opportunity?

The NOFO emphasizes expanding and optimizing pre-exposure prophylaxis (PrEP) as a key prevention tool for populations at substantial risk, including MSM and transgender women. The broader intent is to reduce HIV incidence while improving the efficiency of outreach and service delivery.

What treatment and care improvements are expected under the award?

The NOFO focuses on improving clinical cascade performance through specific service delivery enhancements. Priority activities include supporting same-day antiretroviral therapy (ART) initiation, strengthening retention in care, and improving viral load testing coverage and follow-up so viral suppression is measured and acted upon.

What does same-day ART initiation mean in this opportunity?

Same-day ART initiation refers to supporting processes so that people diagnosed with HIV can start antiretroviral therapy immediately. It is highlighted as a priority approach to improve treatment uptake and accelerate progress along the treatment cascade.

What does the NOFO say about retention in care?

Retention in care is a stated priority, with emphasis on strengthening systems so patients do not drop out over time. This is presented as a key driver of improved viral suppression and overall cascade performance.

How is viral load testing addressed in the opportunity?

The NOFO highlights improving viral load testing coverage and follow-up. The intent is not only to increase measurement of viral suppression, but also to ensure results are acted upon to improve patient outcomes and program performance.

What is multi-month scripting and why is it included?

Multi-month scripting (dispensing longer supplies of ART to stable patients) is highlighted to reduce clinic burden and improve patient convenience. It is presented as an operational enhancement that can support retention and continuity of treatment.

Does the opportunity mention specific ART regimens?

Yes. The NOFO mentions supporting Thailand's transition to the preferred tenofovir/lamivudine/dolutegravir (TLD) regimen where clinically appropriate.

How is tuberculosis (TB) addressed in this HIV-focused program?

The opportunity underscores integration of TB prevention through TB preventive therapy (TPT). This reflects the ongoing importance of TB as a major comorbidity and cause of illness among people living with HIV.

What are the expectations for data systems and monitoring?

Improving data quality and data use is described as a significant operational expectation. Recipients are expected to strengthen monitoring systems, help facilities identify and close cascade gaps, and ensure data are accurate and timely enough to guide decisions and demonstrate progress toward targets.

Does the opportunity include regional or cross-country knowledge sharing?

Yes. The NOFO includes a regional knowledge-sharing component. Recipients are expected to coordinate with partners to disseminate technical assistance approaches and best practices from Thailand and across the region through workshops, study tours, technical assistance visits, and online platforms.

What is the intended value of Thailand's experience beyond Thailand?

The NOFO indicates an intent to position Thailand's lessons learned as useful to neighboring or regional countries working toward similar 95-95-95 goals, by sharing approaches and best practices through organized knowledge-exchange activities.

What is the award mechanism and what does it imply?

The mechanism is a cooperative agreement, which means CDC is expected to have substantial involvement in program direction and oversight, rather than operating as a purely pass-through funder.

What is the NOFO identifier and CFDA number?

The NOFO is identified as CDC RFA GH20-2006. The CFDA listing provided is 93.067.

Who is eligible to apply?

Eligibility is described as unrestricted, meaning it is open to any entity type, subject to any additional eligibility clarifications that may be included in the full notice.

How much funding is available?

CDC projected approximately $1,000,000 in total funding for the first year, contingent on availability of funds.

How many awards does CDC expect to make?

The notice indicates an expectation of two awards.

Is there a maximum award amount (ceiling) per award for Year 1?

The notice lists the Year 1 award ceiling as "0 (none)." In context, this typically indicates that the notice is not setting a specific per-award cap even though it provides an overall anticipated total funding amount.

When was the opportunity posted and when were applications due?

The opportunity was posted in early January 2020, with an original application deadline in early March 2020.

How were applications required to be submitted and what was the submission time requirement?

The NOFO specifies electronic submission, with submissions due by 11:59 p.m. Eastern Time on the closing date.

What kind of partnerships or coordination are expected from the recipient?

Recipients are expected to work closely with national and local stakeholders and multiple implementing partners so that improvements align with Thailand's national AIDS program and can be scaled or replicated where they are most needed.

What does "targeted technical assistance" look like according to the description?

Based on the description, targeted technical assistance includes embedding hands-on support and technical guidance into facilities, improving operational processes across testing through viral suppression, strengthening data systems, and coordinating dissemination of approaches and best practices through both in-country and regional channels.