Operational Research to Improve HIV Prevention in the United States

Abstract

The HIV/AIDS epidemic in the United States continues despite several recent noteworthy advances in HIV prevention. Contemporary approaches to HIV prevention involve implementing combinations of biomedical, behavioral, and structural interventions in novel ways to achieve high levels of impact on the epidemic. Methods are needed to develop optimal combinations of approaches for improving efficiency, effectiveness, and scalability. This article argues that operational research offers promise as a valuable tool for addressing these issues. We define operational research relative to domestic HIV prevention, identify and illustrate how operational research can improve HIV prevention, and pose a series of questions to guide future operational research. Operational research can help achieve national HIV prevention goals of reducing new infections, improving access to care and optimization of health outcomes of people living with HIV, and reducing HIV-related health disparities.

Adherence to Antiretroviral Therapy Among HIV-Infected Adults in the United States

“…As such, our estimates help inform how we are doing as a nation with regard to adherence—one of the primary determinants of treatment success for HIV-infected persons and the key to maximizing the final step in the HIV care continuum—and highlight key barriers to improvements in adherence. Although CDC has identified several effective behavioral interventions that improve adherence (Charania et al, 2014), information about which interventions are most effective for which populations in specific settings is still needed (Amico & Orrell, 2013; Herbst et al, 2012). Our findings support the importance of multiple targeted strategies to improve adherence: youth- and woman-centered care; treatment of psychosocial comorbidities; promotion of less complex and more tolerable regimens; improving patients’ information, motivation, and skills regarding adherence; and continued monitoring to promote consistent adherence over time.…”

A Review of Self-Testing for HIV: Research and Policy Priorities in a New Era of HIV Prevention

“…In a recent article, authors from the CDC highlighted the need for strategies to strengthen implementation of HIV self-testing [32]. The 2012 annual letter of the Bill and Melinda Gates Foundation suggests that widespread HIV testing could be achieved through use of an “inexpensive saliva test that can be used privately” [33].…”

Sisters Empowered, Sisters Aware: Three Strategies to Recruit African American Women for HIV Testing

“…One-third of African American women received an AIDS diagnosis within a year of testing HIV positive (CDC, 2011c). Effective strategies are urgently needed to increase early HIV testing and access to health care for this population to reduce disparities in HIV/AIDS diagnoses (Herbst et al, 2012). Additionally, strategies to increase access to partners of persons diagnosed with HIV are needed to ensure their ability to receive testing services and treatment for those who test positive.…”