Implementing Implementation Science: An Approach for HIV Prevention, Care and Treatment Programs
Barrot H. Lambdin,
Ifeoma C. Udoh,
Elvin H. Geng,
Though great progress has been realized over the last decade in extending HIV prevention,
care and treatment in some of the least resourced settings of the world, a substantial gap remains
between what we know works and what we are actually achieving in HIV programs. To address this, leaders have called
for the adoption of an implementation science framework to improve the efficiency and effectiveness of HIV programs.
Implementation science (IS) is a multidisciplinary scientific field that seeks generalizable knowledge about the magnitude
of, determinants of and strategies to close the gap between evidence and routine practice for health in real-world settings.
We propose an IS approach that is iterative in nature and composed of four major components: 1) Identifying Bottlenecks
and Gaps, 2) Developing and Implementing Strategies, 3) Measuring Effectiveness and Efficiency, and 4) Utilizing
Results. With this framework, IS initiatives draw from a variety of disciplines including qualitative and quantitative
methodologies in order to develop new approaches responsive to the complexities of real world program delivery. In order
to remain useful for the changing programmatic landscape, IS research should factor in relevant timeframes and engage
the multi-sectoral community of stakeholders, including community members, health care teams, program managers,
researchers and policy makers, to facilitate the development of programs, practices and polices that lead to a more
effective and efficient global AIDS response. The approach presented here is a synthesis of approaches and is a useful
model to address IS-related questions for HIV prevention, care and treatment programs. This approach, however, is not a
panacea, and we will continue to learn new ways of thinking as we move forward to close the implementation gap.
Keywords: AIDS, antiretroviral therapy, HIV, HIV Prevention, HIV treatment, implementation science, key populations,
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