Dr. Christopher Duncombe
Dr. Christopher Duncombe

IAPAC Vice President for Programs, Dr. Christopher Duncombe, chaired a gathering of HIV researchers on March 3, 2019, to discuss the development of an urban AIDS-focused implementation science agenda. The expert advisory meeting preceded the annual Conference on Retroviruses and Opportunistic Infections (CROI), which is taking place March 4-7, 2019, in Seattle.

Dr. Duncombe discussed how the Fast-Track Cities initiative presents an opportunity for implementation science studies aimed at identifying and taking to scale promising new strategies to accelerate the attainment of the initiative’s 90-90-90 and getting to zero targets. IAPAC’s desired objective is to leverage the Fast-Track Cities network by funding clinician and community researchers to conduct implementation science studies that address barriers to optimized HIV prevention and care continua.

Implementation science is an evolving field of research that aims to enhance public health by promoting the adoption of effective interventions, policies, and strategies in diverse real-world settings. An expert in the field, Dr. Elvin Geng of the University of California, San Francisco, noted at the meeting that there remains no single definition for “implementation science” among the research community. However, he added that a number of common themes have emerged within the existing body of research. These themes include gap mapping, understanding and closing these gaps in care, and exploring the tension between generalizability and context. Dr. Geng noted that the field of implementation science places an emphasis on interdisciplinary approaches that encompass expertise in epidemiology, statistics, anthropology, sociology, health economics, political science, policy analysis, ethics, and other fields. The hallmarks of good implementation science, according to Dr. Geng, are a strong theoretical justification, design for external and internal validity, the pursuit of conceptualization and specification of implementation strategies, and attention to outcomes.

The meeting also included representatives from the Joint United Nations Programme on HIV/AIDS (UNAIDS), as well as the Office of AIDS Research and the National Institute of Mental Health, which operate under the National Institutes of Health in the United States, and researchers from other academic institutions. Also in attendance was Dr. Maggie Czarnogorski, Head of Innovation and Implementation Science at ViiV Healthcare, which is an HIV industry leader in supporting a growing community of researchers, policy makers, community organizations, and advocates interested in advancing an implementation science agenda. ViiV Healthcare is also an early supporter of and longtime partner with IAPAC in advancing myriad activities and programs across 40 Fast-Track Cities worldwide.

As previously noted, the meeting, titled “Leveraging Fast-Track Cities for Implementation Science,” took place ahead of the CROI 2019 Conference in Seattle. News emerged on the conference’s second day of a second patient in London whose HIV is reportedly in remission. While expressing “cautious optimism that this development may some day yield a cure for HIV,” IAPAC President/CEO Jose M. Zuniga stressed that “sustained investment in innovative research is as important as implementation science around the acceleration of uptake of new medicines, diagnostics, and technologies.”