The Ending the HIV Epidemic in the U.S. (EHE) initiative set a goal to virtually eliminate new HIV infections in the U.S. by 2030. This ambitious and unprecedented goal was predicated on decades of scientific discovery delivering the necessary tools: highly sensitive tests to diagnose HIV infection, effective interventions to prevent and treat infection, and cutting-edge technologies to identify outbreaks. Implementation research to end the HIV epidemic is the focus of a July 2022 special issue of the Journal of Acquired Immune Deficiency Syndromes (JAIDS). Access to the supplement is open and has been organized by the Implementation Science Coordination Initiative (ISCI), housed at the Third Coast Center for AIDS Research spanning Northwestern University, University of Chicago, and numerous public health and community partners in Chicago.
This special issue reports findings from 2019-2022 Center for AIDS Research (CFAR) and AIDS Research Center (ARC) EHE supplement projects, as well as other larger domestic HIV implementation research studies funded by the National Institutes of Health. The articles included in the issue cover all geographic regions of the United States, including urban as well as rural locations. Equally important is the fact that the studies focus on priority populations, including sexual minority men, Black and Latina cisgender women, and transgender people. Readers will find articles in this issue address all four pillars of the U.S. Department of Health and Human Services’ EHE initiative: prevent, treat, diagnose, and respond.
One article, led by NIH Office of AIDS Research Senior Science Advisor Dr. Mary Glenshaw, provides an overview of the NIH’s role in EHE. Another led by officials from CDC, HRSA, and NIH describes the inter-agency collaborations that enabled EHE’s signature science partnerships. The JAIDS issue also includes papers reporting results of implementation trials, such as the paper by Dr. Sylvie Naar of the Florida State University College of Medicine's Department of Behavioral Sciences and Social Medicine and colleagues that tested a set of implementation strategies designed to improve Motivational Interviewing competence in youth HIV services providers.
Implementation science is a relatively new field that is seeing rapid adoption among HIV researchers who want to work with communities on strategies for effective implementation of these lifesaving innovations. The articles in this special issue showcase a range of implementation science approaches and can serve as examples to researchers and practitioners who want to join this initiative and develop their knowledge on applying implementation practices to their own research and communities.
Of the 27 articles in this special issue, 17 showcase findings from the one-year FY2019 CFAR/ARC EHE supplement projects supported by ISCI activities, while the additional 10 articles describe other domestic HIV implementation research studies. For example, readers interested in the state of the science on barriers and facilitators of PrEP can read a systematic review paper on the delivery and use of PrEP by Dr. Dennis Li and colleagues who used an implementation science lens to measure determinants.
In addition, those interested can also access the innovative online ISCI HIV Implementation Literature Review Dashboard to search for the latest findings by key populations served, geographic region, and other important contextual factors. The dashboard is an interactive data tool comprised of hundreds of US studies that identify multilevel determinants of HIV implementation and is available for use now. It will be updated later with literature on determinants and strategies for PrEP, testing and HIV care.
To highlight the contents of the JAIDS supplement, ISCI will be hosting a satellite symposium at the 2022 International AIDS Conference in Montreal titled, “Leveraging Implementation Science to End the HIV Epidemic in the United States: Highlighted Findings from a JAIDS Special Issue.” Following opening remarks from Dr. Maureen Goodenow, Director of the NIH Office of AIDS Research, authors of select studies in the special issue will present their findings. Other scholars will review the challenges, evidence gaps, and future directions in the field of implementation research.
ISCI provides high-quality technical assistance for EHE-funded implementation research teams and creates opportunities to share generalizable knowledge to help end the HIV epidemic in the US. ISCI provides interactive tools, decision support for researchers, curriculum for practitioners, HIV implementation science resources, and much more. All tools are publicly available at HIVimpsci.northwestern.edu.
The authors are co-directors of the Implementation Science Coordination Initiative.