ArticleJournal of acquired immune deficiency syndromes (1999)2024
Contextual Factors Influencing Implementation of HIV Treatment Support Strategies for Female Sex Workers Living With HIV in South Africa: A Qualitative Analysis Using the Consolidated Framework for Implementation Research.
Article in Journal of acquired immune deficiency syndromes (1999), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Determinants and Strategies for Implementation of an Adapted Data to Care Vertical HIV Prevention Intervention in a South African Context.AIDS and behavior · 2026Article
- Bridging implementation science and policy change: a Global South perspective.Frontiers in health services · 2026Review
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundFemale sex workers (FSWs) face a confluence of multilevel barriers to HIV care. In South Africa, 63% of FSWs are living with HIV and <40% are virally suppressed. The objective of this analysis was to identify implementation determinants of 2 HIV treatment support strategies.
methodsThe Siyaphambili trial tested a decentralized treatment provision and an individualized case management strategy aimed to support FSWs living with unsuppressed HIV viral loads. We identified a nested sample of trial participants using maximum variation sampling (n = 36) as well as a purposively selected sample of implementors (n = 12). We used semistructured interview guides, developed using the Consolidated Framework for Implementation Research (CFIR) and deductively coded the transcripts using CFIR, systematically assessing the strength and valence of implementation. We compared construct ratings to determine whether any constructs distinguished implementation across strategies.
resultsAcross 3 CFIR domains (innovation characteristics, inner setting, and outer setting), 12 constructs emerged as facilitating, hindering, or having mixed effects on strategy implementation. The relative advantage, design, adaptability, and complexity constructs of the innovation characteristics and the work infrastructure construct of the inner setting were strongly influential (±2 or +2). While the majority of construct valence and strength rating (9-12) were not distinguishing across strategies, we observed 3 weakly distinguishing CFIR constructs (relative advantage, complexity, and available resources).
conclusionsGiven the potential benefits of differentiated service delivery strategies, identifying the relative importance of implementation determinants facilitates transparency and evaluation, supporting future strategy design and implementation. Optimizing implementation will support addressing inequities in HIV care and treatment services.
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Registered trials
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