Tennessee Center for AIDS Research (TN-CFAR) Implementation Science Consultation Hub

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Project Summary Human Immunodeficiency Virus (HIV) infection remains a significant public health problem in the United States (US). Despite the availability of safe and effective HIV treatment (antiretroviral therapy, ART) and prevention (pre-exposure prophylaxis, PrEP), there remains a significant proportion of people living with diagnosed HIV who have not achieved viral suppression and a significant proportion of people at risk for HIV acquisition who have not accessed PrEP. The Centers for Disease Control and Prevention estimates that there were 30, 635 people newly diagnosed with HIV in the US in 2020, with 51% located in the South. In 2019, only 56.8% had achieved viral suppression. Similarly, among the estimated 1.2 million people in the US eligible for PrEP only about 25% have accessed it. The field of implementation science provides researchers with the critical tools to address this evidence-practice gap. The development of tailored strategies designed facilitate implementation of evidence based practices can address issues with provider knowledge and self-efficacy, facilitate team communication, improve organizational culture, and create streamlined clinical systems that simplify care delivery. However, many HIV health services researchers do not have formal implementation science training or mentorship in this area. For these reasons, the United States EHE Plan and the National Institutes of Health (NIH) have prioritized the training of a multi-disciplinary workforce needed to conduct high-priority HIV research. Therefore, the overarching goal of this proposal is to continue the work of our Tennessee Center for AIDS Research Implementation Science Hub. We plan to continue supporting IS work through the provision of technical assistance, mentorship, education, and consultative services to NIH EHE implementation science awardees. The Tennessee-CFAR is uniquely positioned to serve as an Ending the HIV Epidemic IS Hub for several important reasons. First, the Tennessee Center for AIDS Research (TN-CFAR) is located in the US South, a region of the country disproportionately impacted by a high HIV burden and low numbers of PrEP users, and our team has experience addressing the prevalent social determinants of health that plague the region including racism, stigma, and socioeconomic deprivation. Second, the proposed TN- CFAR IS Hub team brings complementary expertise in implementation science, mixed methods research, epidemiology, clinical HIV care and treatment, health equity, and community engagement needed for success in carrying out HIV implementation science studies. Third, the team has long-standing collaborations with colleagues in Memphis/Shelby County, Tennessee, a Phase I EHE Priority jurisdiction that would facilitate participation in multi-site HIV implementation science hub studies. We expect that TN-CFAR Implementation Science Hub activities will help EHE awardees and their communities in reaching EHE goals through leveraging our unique academic, public health, and community-based partnerships.