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Publication Profiles

Policymaker Perspectives on Implementation Determinants of Rapid ART and Same-Day PrEP in Seven Priority Jurisdictions for Ending the HIV Epidemic: A Multisite Qualitative Study

Citation

Katomski AS, Pachicano AM, Zamantakis A, et al. Policymaker Perspectives on Implementation Determinants of Rapid ART and Same-Day PrEP in Seven Priority Jurisdictions for Ending the HIV Epidemic: A Multisite Qualitative Study. J Acquir Immune Defic Syndr. 2025;98(5S):e192-e204. doi:10.1097/QAI.0000000000003619

Implementation stage:

Pre-Implementation

Implementation outcomes reported:

Not applicable

Continuum target addressed:

ART initiation, PrEP initiation

Geography:

Maryland, Illinois, Texas, Alabama, California

Study Participant Classification:

Implementer(s)

Plain Language Objectives

The researchers interviewed HIV program leaders in seven priority areas about starting HIV treatment or prevention medication immediately. They wanted to find barriers and supports shared across jurisdictions so future implementation strategies could work in different local systems.

Plain Language Abstract

Rapid initiation of HIV treatment and same-day pre-exposure prophylaxis can be acceptable and feasible, but US implementation remains uneven. From March 2023 through August 2024, researchers conducted 13 semistructured interviews with HIV leaders representing Ryan White-funded organizations across seven federal priority jurisdictions. They used an implementation framework to compare factors affecting rapid treatment and same-day prevention. Common barriers to rapid treatment included provider or patient hesitancy, limited awareness, disconnected care systems, and complex funding. Learning collaboratives, technology integration, and clear contract language were viewed as supports. For same-day PrEP, respondents emphasized funding inequities and limited client awareness; integrated care, starter medication packs, and medication-assistance programs were considered facilitators. Despite differences such as Medicaid policy, leaders consistently described collaboration between system leaders and service providers as essential. These qualitative findings represent 13 leadership perspectives and do not measure how often each determinant occurred. The study identified strategies but did not test whether they increased equitable adoption, medication initiation, or clinical outcomes.

Key Takeaways

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Publications

Barriers/Facilitators

Science Frameworks

Implementation Science Frameworks

Outcomes

Community Partnerships

Welcome to the Dashboard

This dashboard provides an accessible way to explore national and jurisdictional findings from implementation science research supporting the Ending the HIV Epidemic initiative. The homepage gives you quick access to major sections of the site and highlights key insights drawn from ongoing research and community partnerships.

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At the top of the page, you’ll find four main sections that guide your experience:

  • About explains the purpose of the dashboard, the research framework guiding this project, and how to interpret the data and publications included here.
  • Results presents visual summaries, charts, and findings from implementation science activities conducted across EHE jurisdictions.
  • Publications provides access to peer-reviewed articles, research outputs, and additional documentation relevant to EHE implementation science.
  • Community highlights survey findings, community partnerships, and engagement activities that support and shape local EHE strategies.

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