Human Immunodeficiency Virus (HIV) infection is a major public health problem. Treatment (antiretroviral therapy, ART) and prevention (pre-exposure prophylaxis, PrEP) services are underutilized, resulting in a substantial proportion of people living with HIV (PWH) who have not achieved viral suppression, and people at risk for HIV acquisition who have not accessed PrEP. There is a critical need to understand gaps in the delivery of evidence-based interventions, with a particular focus on improving care delivery through implementation science (IS). IS holds the potential to bridge the evidence-to-practice gap. Although IS knowledge has expanded rapidly in recent years, further integration of IS into HIV research is needed. IS will accelerate the adoption and reach of evidence-based care delivery by facilities and providers, improve the fidelity of care delivery, and ensure the sustainability of quality HIV prevention and care services.

Following a needs assessment conducted with Tennessee CFAR investigators and partners, as well as the priorities laid out by the US Ending the HIV Epidemic (EHE) Plan and the National Institutes of Health (NIH), we propose to establish a CFAR Implementation Science Core (ISC) to integrate IS research within research projects at all phases of study. Our ISC team, led by Carolyn Audet (Director), PhD, Muktar Aliyu, MD, DrPH, MPH (Co-Director), and Lauren Brown, PhD (Assistant Director), is ideally positioned to provide innovative IS consultation, partnership, and mentorship in the following ways: 1) complementary but distinct expertise in IS methods, including study design, measurement, and frameworks, as evidenced by leadership of multiple federally-funded projects to improve implementation of HIV testing and treatment (e.g., R01MH113478, R34MH124496, R34MH127975, U01PS005240, and U2GPS001063). 2) Experience in providing IS collaborative partnerships and mentorship: Dr. Audet leads one of nine funded IS Hubs and is Associate Director for the Vanderbilt Center for Clinical Quality and Implementation Research. Dr. Brown, Assistant Professor at Meharry, leads community-engaged IS HIV research. 3) Experience to lead a formal IS fellowship designed to equip researchers with advanced IS skills. Our team serves as mentors for multiple IS fellowship programs across the US and globally, including HIGH-IRI (Washington University), the Johns Hopkins University IS Fellowship, and HIGH-IRI Africa (University of Kwa-Zulu Natal).

Through three primary innovations, with a transdisciplinary focus on health outcomes across a broad range of populations, community engagement and dynamic evaluation, we will provide the three-pronged services of IS consultation, partnership, and mentorship. We will conduct on-going needs and opportunity assessments of investigators to tailor and refine our approach over time. The ISC will help investigators expand their work in IS to promote the translatability, practicality, and transferability of CFAR research.

• SPECIFIC AIM 1: Establish the Implementation Science Consultation Program (IS-Consult) to support Tennessee CFAR investigators and their community partners. 

• SPECIFIC AIM 2: Provide ongoing Implementation Science Collaborative Partnerships (IS-Partner) to HIV investigators and community partners, integrating IS concepts, frameworks, and outcomes into funded projects. 

• SPECIFIC AIM 3: Provide Implementation Science Mentorship (IS-Mentor) to researchers and their community partners to advance sustainable IS expertise to End the HIV Epidemic. 

The ISC is well-poised to support HIV researchers to lead rigorous, contextually appropriate IS projects that address the needs of local communities and advance Ending the HIV Epidemic goals. The ISC augments the capacity of researchers to translate effective HIV interventions into improved health outcomes through the application of IS methods. We leverage existing community partnerships to build trust and create evidence that matters to our most-impacted communities. 

The Implementation Science Core provides four key services to support HIV researchers:

• Clinic: Ad hoc sessions to support grant writing, manuscript preparation, protocol development, or the development of roadmap/toolkits for integrating implementation strategies and outcomes into effectiveness trials

• Partnership: Intensive support sessions for teams looking to incorporate implementation science elements into ongoing and future trials, with a focus on long-term, substantive collaboration 

• Grant Studio: A one-time consultative session where researchers receive feedback from a panel of implementation science experts on the planning, design, implementation, translation, or dissemination of their work

• Mentorship: A series of sessions designed for early career investigators seeking coaching and guidance in implementation science

To request any of these services, please complete this survey.