AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #95 - Moving from efficacy to effectiveness in HIV prevention: using implementation science to improve practice in the field
Authors: Presenting Author: Ms. Alice Gandelman - California STD/HIV Prevention Training Center
Additional Authors: Director Patricia Coury-Doniger, Director Terry Stewart, Prof. Cornelis Rietmeijer,
Aim: • Summarize key challenges in the implementation of evidence- based interventions (EBIs) • Identify strategies organizations have used to effectively overcome challenges • Provide resources to improve EBI implementation
Method / Issue: As evidence-based interventions (EBIs) continue to be recommended, many HIV prevention behavioral interventions with proven research efficacy are increasingly being implemented by organizations around the world. Diffusion of these interventions occur in the United States, through the Diffusion of Effective Behavioral Intervention (DEBI) program. Internationally, PEPFAR (President’s Emergency Plan for AIDS Relief) is strongly encouraging the use of EBIs for HIV prevention in countries hardest hit by the HIV epidemic and some countries, including Kenya, Uganda, and South Africa, are aggressively moving to adapting and rolling out EBIs in their jurisdictions. EBI implementation in the field has raised issues that must be addressed to ensure intervention fidelity, and relevance for communities prioritized for these interventions. These include: accurate assessment of the factors contributing to risk in prioritized communities, selection of appropriate EBIs, organizational capacity to correctly implement, and adaptations needed to better meet specific community needs. Challenges in the field, such as staff turnover, client recruitment and retention, and social and economic factors affecting participation must also be addressed.
Results / Comments: The CDC-funded Behavioral Intervention Prevention Training Centers (BIPTCs) are charged with increasing capacity of organizations funded to implement EBIs through the development and delivery of training and technical assistance (TA). During the last decade, the BIPTCs have provided training on 10 different EBI, as well as supplementary program skills, and conducted TA for several thousand HIV prevention providers in the US. More recently, the BIPTCs have been involved in laying the groundwork for EBI implementation in southern Africa. We will provide an overview of the common challenges experienced by organizations implementing EBIs, and how they have been most successfully addressed.
Discussion: Issues to be addressed during the workshop include: factors to consider during assessment, combination prevention approaches that inform intervention selection, adaptation strategies to maintain fidelity, and integration approaches to maximize limited resources (e.g., prevention and care integration, STD/HIV/TB integration, etc.). Examples from the US and from Africa will be presented. Participants will be asked to identify priority issues, and interactive activities will be utilized to enhance participation and skill-building.
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