LeverAging StraTegies to Maximize ImpLementation and Effectiveness for HIV (LAST MILE)
🏛 National Institutes of Health (HHS-NIH11)
✓ Free, no account · Source: Grants.gov · Last verified Oct 18, 2026
Can you apply?
This grant is for organizations conducting HIV research through effectiveness trials in real-world settings. Eligible applicants include research institutions, universities, and organizations with capacity to conduct clinical trials and implement HIV prevention or treatment programs. The program supports collaborative work across all U.S. regions, focusing on prevention, treatment, and management of HIV and associated coinfections in populations of any age. Proposed studies must bridge clinical research findings to real-world implementation using hybrid designs, pragmatic trials, or combined efficacy-effectiveness approaches.
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Key dates
- Sep 24, 2026 Applications open
- Oct 18, 2027 Application deadline in 364 days
- Jul 1, 2028 Award announced
- Jul 1, 2028 Project start
Program description
The National Institute of Allergy and Infectious Diseases (NIAID) seeks to advance its mission through the LeverAging StraTegies to Maximize ImpLementation and Effectiveness for HIV (LAST MILE) program. This program will encourage collaborations to perform effectiveness trials that incorporate implementation in real-world settings. Examples include combined efficacy-effectiveness trials, pragmatic trials, and hybrid effectiveness-implementation studies. The intent is to bridge findings from traditional clinical trials to real-world implementation. The work will focus on populations across various points of care for prevention or treatment of HIV and its associated coinfections and comorbidities occurring in any age group. The goal of this program is to advance cross-cutting areas of HIV research, including clinical, behavioral and social sciences, epidemiology, and implementation science. This program aligns with the NIH mission to implement advances in HIV/AIDS research. Grant authorities that allow NIAID to forecast this opportunity are as follows: Sections 301 and 405 of the Public Health Service Act as amended (42 USC 241 and 284) and under Federal Regulations 42 CFR Part 52 and 2 CFR Part 200.
Who can apply
Eligible applicants
How to apply
Application links
Key dates & requirements
Required documents
- SF-424 (R&D) application form
- Project Narrative (Research Strategy)
- Budget and Budget Narrative
- Biographical Sketches (key personnel)
- Support Letters (implementation sites, collaborators)
- Letters of Institutional Support
- Relevant compliance documentation (IRB approvals, DSMB plans)
Program contact
- 👤 Division of AIDS Epidemiology Branch, Basic Sciences Program
- 📧 EB@niaid.nih.gov
- 📞 Please contact via e-mail.
Funding track record
Recent awards under CFDA 93.855 from the last 3 years — real organizations that won funding through this same program.
Top 10 Largest Recent Awards
-
$246,626,852
-
$201,437,825
-
$197,316,803
-
$180,737,624
-
$147,765,880
-
$116,817,868
-
$93,394,862
-
$89,845,851
-
$85,436,674
-
$84,525,882
Top States by Funding
- CA 9 awards $818.0M
- MA 6 awards $616.6M
- NY 8 awards $420.5M
- TX 3 awards $292.4M
- GA 5 awards $265.7M
Source: USAspending.gov — federal spending transparency. Data covers last 3 years.
Funding history
Annual funding for this program — Federal obligations (CFDA 93.855). How funding has trended year over year.
| 2024 | $4,073,812,529 | |
| 2025 | $4,378,235,639 | |
| 2026 est. | $4,299,426,996 |
FAQ
Who can apply for LAST MILE funding?
Research institutions, universities, and organizations with HIV research capacity and implementation experience. Both large and small organizations may apply.
What types of studies does LAST MILE support?
Combined efficacy-effectiveness trials, pragmatic trials, and hybrid effectiveness-implementation studies. All must test HIV prevention or treatment in real-world settings.
Is cost sharing required?
No, this is a fully funded cooperative agreement with no required cost share.
What is the deadline and can I apply multiple times?
The deadline is October 18, 2027. Check NIH guidelines on resubmission policies for specific details on reapplication windows.
What populations and research areas are eligible?
Studies across all age groups addressing HIV prevention, treatment, coinfections, and comorbidities using clinical, behavioral, social, or implementation science approaches.
💡 Tips for applicants
- Design your study to bridge efficacy findings into real-world settings. Show how your trial will generate implementation evidence, not just clinical efficacy data.
- Emphasize collaboration and partnerships. Include letters from implementation sites demonstrating their commitment to the research and their real-world context.
- Address health equity explicitly. Specify which populations you serve and how your design addresses disparities in HIV care and prevention.
- Align your study design with one of the three mechanisms: combined efficacy-effectiveness, pragmatic, or hybrid effectiveness-implementation. Be clear which applies.
- Plan for sustainability beyond the grant. Describe how findings will be translated into practice and how partnerships will continue after funding ends.
⚠️ Common mistakes
Applications underestimate implementation complexity. Many propose standard efficacy trials without genuine real-world adaptation or meaningful implementation science components. Weak partnerships weaken proposals significantly. Vague language about how research will "impact practice" fails without concrete dissemination and uptake plans. Proposals ignoring health equity considerations are less competitive in current NIH climate.
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