Ending Stigma through Collaboration and Lifting All to Empowerment

ESCALATE (Ending Stigma through Collaboration and Lifting All To Empowerment) is the first-of-its kind training and capacity-building initiative specifically designed to address HIV-related stigma that creates barriers at multiple levels of the HIV care continuum.


NMAC created ESCALATE to reflect its mission and relationship to the communities of people with HIV. NMAC “leads with race” as the burdens of the HIV/AIDS epidemic are most deeply felt in racial and ethnic minority communities.

HIV-related stigma intersects with the multiple stigmas communities impacted by HIV experience based on their race, ethnicity, sexual orientation, gender identity, social status, mental health and substance use, and relationship to sex work or incarceration. Only by viewing HIV stigma through these multiple lenses can we address its deep and insidious impacts.

To meet the goals of ESCALATE, NMAC has partnered with Abt Associates (Abt), TRX Development Solutions (TRX), and NORC at the University of Chicago (NORC).

The Challenge

ESCALATE works across multiple levels of the Ending the HIV Epidemic in the U.S. (EHE) initiative and the HIV National Strategic Plan (HIV Plan) to address internalized and externalized HIV-related stigma. Support is provided to agencies funded by the Health Resources and Services Administration HRSA) HIV/AIDS Bureau's (HAB) Ryan White HIV/AIDS Program (RWHAP).

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Focus Population

ESCALATE is open to all Ryan White HIV/AIDS Program Recipients (Parts A, B, C, & D). This includes community-based organizations, federally qualified health centers, health departments, planning councils, and planning bodies. Recipients interested in applying can do so as Stigma Reduction Teams.

Stigma Reduction Teams will represent a collaboration between community and Ryan White HIV/AIDS Program Recipients. Stigma Reduction Teams consist of one person living publicly with HIV from the community and at least one RWHAP partner. A Stigma Reduction Team may have multiple RWHAP partners, but must always have one person with HIV from the community as a partner.

Through participation in training, TA, and LCs, Stigma Reduction Teams will support people with HIV in urban, rural, and Native communities; Ryan White Care Providers, Planning Councils, in urban, rural, and Native communities, with a special focus on transgender/gender non-conforming individuals, men who have sex with men, and the Black/African American community.

The Model

The ESCALATE program offers three tracks to mitigate and eliminate stigma in HIV-related service provision in the United States.

While ESCALATE will have a strong focus on recruiting participants from within the 57 jurisdictions identified in the Federal Plan to End the HIV Epidemic in the United States, ESCALATE is open to all Ryan White HIV/AIDS Program recipients (Parts A, B, C, & D) regardless of jurisdiction.

  • New and Innovative Training: Training is designed to reduce HIV-related stigma through evidence-informed interventions and strategies with an emphasis on cultural humility for HIV service systems, organizations, and individuals. Training is designed to meet the needs of individual RWHAP care providers (e.g., clinicians, administrators, patient navigators) who acknowledge the impact of HIV-related stigma on their client populations and communities. These individuals are ready to create change but may not have the organizational capacity needed to create change across their clinical setting.

  • Technical Assistance (TA): ESCALATE provides tailored TA to individual organizations by assessing TA needs, aligning TA activities and learning opportunities to those needs, and assessing the impact of TA on organizational behavior and change. TA participants will be matched with TA Coaches and Subject Matter Experts to address organization-specific goals through intensive 1:1 TA.

  • Learning Collaboratives (LC): ESCALATE will implement two LCs with RWHAP recipients/sub-recipients to address HIV stigma experienced by their staff and clients. The first LC (LC1) will run from October 2021 to November 2022 with up to eight (8) organizations implementing stigma-reduction initiatives. LC1 members will participate in a multi-session, facilitated Learning Collaborative focused on stigma and cultural humility. LC1 members will have the opportunity to test adaptations to evidence-based stigma-reduction strategies, tools, and practices as well as learn from subject matter experts and peers implementing similar stigma-reduction initiatives with similar populations of focus.


  • NMAC: Training
  • Abt Associates: Technical Assistance
  • NORC at the University of Chicago: Learning Collaborative
  • TRX Development Solutions: Project Evaluation

ESCALATE is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) and the Minority HIV/AIDS Fund as part of a financial assistance award totaling $1,640,827, 100 percent funded by HRSA/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA/HHS, or the U.S. Government.

Contact Information

Project Contacts:

Terrell Parker
Project Manager

HRSA Contacts:

PO Name
LaQuanta P. Smalley, MPH, BSN, RN, CPN
PO Title
Nurse Consultant – Clinical & Quality Branch
PO Phone
(301) 443-0995


Funding Mechanism: Cooperative Agreement

Recipient Organization: NMAC

Grant number: U69HA39478

Project Period: 9/1/2020 - 8/31/2024