Infectious Disease
Next Steps in Designing for Diffusion of Pre-Exposure Prophylaxis: Demonstration Projects
What will it take to achieve what U.S. Secretary of State Hillary Rodham Clinton called, in a 2011 address, an ‘AIDS-free generation'?… This goal requires an ambitious implementation-science agenda.1 One of the sharpest arrows in the implementation and dissemination quiver is the demonstration project. Many governments use demonstrations to study and to showcase interventions, from breastfeeding programs to wastewater treatment facilities to smart grid technologies. Yet demonstrations are of differing types, with varied objectives.Primary Care and Public Health Partnerships for Implementing Pre-Exposure Prophylaxis
Efforts to implement pre-exposure prophylaxis (PrEP) to priority target populations throughout the U.S. will require strategic planning, political will, and collaborative partnerships between primary care and public health. Work in other health areas1–6 and models2,7 of linkages between primary care and public health provide both guidance and examples that may be adapted readily to PrEP delivery. Moreover, a recent IOM report8 provides a road map for integrating primary care and public health to improve population health.Introducing Wicked Issues for HIV Pre-Exposure Prophylaxis Implementation in the U.S.
Following U.S. Food and Drug Administration approval and the issuance of interim guidance documents for oral antiretroviral pre-exposure prophylaxis (PrEP) use in the U.S., there is urgent need to begin addressing the complex, multi-stakeholder, and rapidly evolving (i.e., “wicked”) issues posed for the safe, effective, and appropriately targeted use of PrEP for prevention of the sexual acquisition of HIV infection. In this supplement1–18 to the American Journal of Preventive Medicine, a series of articles is presented from diverse research and implementation disciplines to explore key issues and identify conceptual frameworks, practice models, resources, and experiences to advance the discussion of how best to introduce, disseminate, and evaluate PrEP as a new component of HIV prevention services in the U.S.
