ArticleJournal of acquired immune deficiency syndromes (1999)2025
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.
Article in Journal of acquired immune deficiency syndromes (1999), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Comparative Workflow Modelling of HIV Status-Neutral Care Implementation in Six High-Burden Jurisdictions in the United States: A Qualitative Study.Journal of the International AIDS Society · 2026Article
- Lessons From Building a Large, Public HIV-Related Database in Support of the Ending the HIV Epidemic in the US Initiative.JMIR formative research · 2026Article
- Implementation Determinants of Scaling up and Disseminating HIV-Prevention and Treatment Services to Latino MSM in Three Ending the HIV Epidemic Priority Jurisdictions: A Rapid Qualitative Analysis.AIDS and behavior · 2026Article
- Barriers to Same-Day Pre-exposure Prophylaxis (PrEP) Implementation in Federally Funded HIV Clinics Within High-Burden Areas of the U.S.: A Coincidence Analysis.AIDS and behavior · 2026Article
- Pre-implementation findings on the barriers and potential solutions to initiate same-day antiretroviral therapy among people who inject drugs in Malaysia.The International journal on drug policy · 2025Article
- Rapid ART, Rapid PrEP, and Status Neutral Implementation in Ryan White-Funded Clinics: Results From a Multisite Survey.Journal of acquired immune deficiency syndromes (1999) · 2025Article
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Authors and funding
20 authors.
Funding
Abstract
backgroundAlthough rapid antiretroviral therapy (ART) and same-day pre-exposure prophylaxis models (henceforth "rapid START") are feasible, acceptable, and cost-effective in various contexts, significant barriers have hindered their broader implementation and scalability in the United States. Ryan White-funded clinics are cornerstones for HIV services, yet strategies are urgently needed to facilitate equitable rapid START adoption across contexts. This study aimed to identify common factors influencing rapid START to inform strategies applicable throughout jurisdictional settings.
methodsThe Network for Implementation Science in HIV examined the current implementation of rapid START among diverse Ryan White Part A-D-funded organizations across seven Ending the HIV Epidemic jurisdictions across the United States. Semistructured interviews (n = 13) were administered from March 2023 to August 2024, with HIV leadership across jurisdictions to identify rapid START implementation determinants and strategies to catalyze rapid START delivery. Data were deductively analyzed using the Consolidated Framework for Implementation Research.
resultsProminent barriers to rapid ART implementation across settings included provider/patient hesitancy and awareness gaps, siloed care systems, and funding complexities. Prominent implementation facilitators included learning collaboratives, technology integration, and clear contracting language. Key constraints to same-day pre-exposure prophylaxis implementation included funding inequities and suboptimal client/patient awareness, whereas enablers included integrated care models, availability of starter packs, and medication-assistance programs.
conclusionsSeveral consistent key barriers and facilitators spanned multiple Ending the HIV Epidemic jurisdictions despite contextual differences (eg, Medicaid expansion). Collaborative efforts between system leaders and service providers were universally characterized as essential for equitable adoption and penetration of rapid START models.
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