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.

中文翻译：

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“您的包裹无法投递”：美国数字艾滋病毒干预实施状况

审查目的

尽管不断创新和联邦投资来创建数字干预措施来解决艾滋病毒预防和护理的连续性，但这些干预措施尚未大规模惠及美国人民。本文回顾了美国实施数字艾滋病毒干预措施的已知情况，并提出了一项跨越此类干预措施研究与实践鸿沟的策略。

最近的发现

我们对美国关于实施数字艾滋病毒干预措施的原始研究进行了叙述性回顾，并发现很少有研究报告实施决定因素、策略、过程或结果，特别是在有效性试验之外。为了补充文献，我们在 2023 年对代表 64 种独特干预措施的 47 名研究人员进行了调查，了解他们在研究试验后的实施经验。受访者高度重视干预措施的实施，但主要障碍包括缺乏资金和明确的实施模式、技术成本以及难以确定有能力提供数字干预措施的合作伙伴。他们认为，实施责任应由干预措施开发者、提供者（例如诊所）和政府实体共同承担。如果存在实施中心，大多数受访者希望获得指导或技术援助，但很大程度上希望减少参与。

概括

存在许多基于证据的有效数字干预措施来解决艾滋病毒预防和护理问题。然而，它们仍然“束之高阁”，缺乏具体且可持续的现实世界传播和实施模式。根据我们的发现，我们呼吁建立类似于其他卫生系统的国家实施中心，以促进数字艾滋病毒干预措施的实施，并加快结束美国流行病的进程。