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“Your Package Could Not Be Delivered”: The State of Digital HIV Intervention Implementation in the US

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Abstract

Purpose of Review

Despite continuous innovations and federal investment to create digital interventions addressing the HIV prevention and care continua, these interventions have not reached people in the U.S. at scale. This article reviews what is known about U.S. implementation of digital HIV interventions and presents a strategy to cross the research-to-practice chasm for these types of interventions.

Recent Findings

We conducted a narrative review of U.S.-based original research on implementation of digital HIV interventions and identified few studies reporting on implementation determinants, strategies, processes, or outcomes, particularly outside the context of effectiveness trials. To supplement the literature, in 2023, we surveyed 47 investigators representing 64 unique interventions about their experiences with implementation after their research trials. Respondents placed high importance on intervention implementation, but major barriers included lack of funding and clear implementation models, technology costs, and difficulty identifying partners equipped to deliver digital interventions. They felt that responsibility for implementation should be shared between intervention developers, deliverers (e.g., clinics), and a government entity. If an implementation center were to exist, most respondents wanted to be available for guidance or technical assistance but largely wanted less involvement.

Summary

Numerous evidence-based, effective digital interventions exist to address HIV prevention and care. However, they remain “on the shelf” absent a concrete and sustainable model for real-world dissemination and implementation. Based on our findings, we call for the creation of national implementation centers, analogous to those in other health systems, to facilitate digital HIV intervention delivery and accelerate progress toward ending the U.S. epidemic.

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Funding

This publication was supported by grants from the National Institutes of Health: R01MH118213 (Mustanski), P30AI117943 (Mustanski & D’Aquila), R01MH129207 (Macapagal), and P30AI117943 Supplement (Mustanski & Benbow).

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  1. Dennis H. Li and Kathryn Macapagal are co-first authors.

Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Dennis H. Li, Kathryn Macapagal & Brian Mustanski

  2. Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA

    Dennis H. Li, Kathryn Macapagal, Melissa Mongrella, Rana Saber & Brian Mustanski

  3. Center for Dissemination and Implementation Science, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Dennis H. Li

  4. Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Dennis H. Li, Kathryn Macapagal & Brian Mustanski

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Li, D.H., Macapagal, K., Mongrella, M. et al. “Your Package Could Not Be Delivered”: The State of Digital HIV Intervention Implementation in the US. Curr HIV/AIDS Rep (2024). https://doi.org/10.1007/s11904-024-00693-1

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