Adolescent HIV Prevention and Treatment Implementation Science Alliance (AHISA) Rachel Sturke, PhD Deputy Director and Senior Scientist Center for Global Health Studies Fogarty International Center

Focus on Adolescents AIDS is the leading cause of death for adolescents in SSA. Of the 2.1M adolescents living with HIV, 80% live in SSA. Barriers to HIV prevention and treatment in this age group: access to health services, gender-based violence, harmful cultural and social norms Interventions require a multifaceted approach

Implementation Scientists AHISA Platform Goal: enhance the effective use of evidence and help overcome implementation challenges related to prevention, screening and treatment of HIV among adolescents (ages 15 to 24) in sub-Saharan Africa Implementation Scientists Program Implementers Policy- makers By catalyzing collaboration and communication among implementation scientists, program implementers and policymakers An innovative platform made up of 15 teams

Ensure that future research is responsive to the local context; AHISA Objectives Facilitate dialogue and exchange of ideas between researchers, implementers and decision-makers; Enhance communication and collaboration between these communities to enable more effective translation of evidence into health policies and programs; Ensure that future research is responsive to the local context; Think together about the emergent implementation science agenda. Modeled after the NIH PMTCT Implementation Science Alliance

Connecting Research to Policy and Implementation in the PMTCT Alliance Researchers and users of research evidence have different perspectives on what evidence is most useful Researchers and policymakers ask different questions Different stakeholder audiences Defining rigor and sufficient rigor for scalability The tension between generalizability and local context

Steering Committee Members AHISA NIMH NIAID Desmond Tutu HIV Found. USAID OAR NICHD EGPAF UNICEF CDC OGAC WHO Steering Committee Members Partnerships from PMTCT and ICs have invested in the model -NIH ICs, WHO, CDC, EGPAF, USAID All CGHS projects are guided by SC

Selected through a competitive process AHISA Members Teams are composed of NIH-Funded Scientists In-Country Partners, including government representatives, research collaborators, and program implementers Selected through a competitive process Diverse disciplines working across HIV Prevention Treatment & Adherence Life Transitions importance of having researchers work with in-country implementers and decision makers Teams applied to the alliance together they were given the opportunity to bring in 1 or 2 in-country partners as defined here Had to have a research focus on IS and ad health (can see sheet for more details about the teams) Teams naturally divided themselves into these categories Prevention includes risk factors and is as diverse as PrEP, testing, condom use Treatment includes linkage to care, stigma, living with HIV, PMTCT Transition includes pediatrics to ad, and ad to adult 15 teams from 11 countries

Alliance Activities Inaugural meeting (May 2017) IS Training (January 2018) Joint-NIMH Meeting (October 2018) Proposal Development Workshop (Fall 2019) CIPHER IS Research Priority Setting (Spring/Fall 2017) IAS Satellite Session (July 2018) End-User Engagement Meeting (February 2019) Launched in 2017, we expect the Alliance in its current iteration to meet four times over two years We’re half way through and there is a lot of interest to continue Ongoing: Stay-Free NISA Steering Committee Participation

First AHISA Forum Goal: Exchange ideas and information among the members, identify the most significant challenges to implementing proven interventions for prevention and treatment of HIV among adolescents, and collectively set goals and next steps for AHISA. Themes Next Steps IS study designs Engage youth Stigma Social determinants: Address hostile environments Adolescent sexuality and sex ed Health services Build IS capacity among members Develop an IS research agenda Integrate end-users in the Alliance and within policy and program development and implementation This first meeting brought the Alliance teams together

Implementation Science Training Goal: To provide Alliance members with an in-depth overview of the theory, operational and evaluation approaches to implementation science; methods to assess barriers in implementation science and strategies/tools to overcome them; and options for dissemination of results Implementation Outcomes Implementation Science Theory, Frameworks, and Models Implementation Determinants Implementation Strategies Documentation and Evaluation of Implementation Research Projects Sessions TW009774- UNC Wits AIDS Implementation Research and Cohort Analyses Training Grant (2014- ) Small group work sessions were held throughout for groups to apply concepts to real-life, case study examples

Expected Deliverables Overview publication Special Issue Supplement Highlight the role of evidence in the policy-making process to understand the interrelationships stakeholders involved in programmatic transition and insights on how to overcome these challenges. Document the utility and impact of the Alliance model. Dissemination White papers and participation in relevant meetings and conferences. Webinars hosted on UNICEF’s community of practice, which has an audience of researchers, implementers, and policymakers. Webinar topics: Topics will be focused around the select, high-priority themes, including how to effectively engage users of research evidence prevention and modifiable risk factors, adherence and linkage to care and treatment, and transition to adult care.

Expected Outcomes & Impacts Country-led and complimentary initiatives Country-led IS initiatives and/or alliances Improved engagement among researchers, implementers, and policymakers Research partnerships between AHISA members- cross-regional research, data sharing, and research development Impacts on health policy/programming AHISA-relevant research Increase in successful IS applications Increase in publications related to IS and adolescent HIV authored by AHISA members and partners Catalyze AHISA-relevant funding Research partnerships between AHISA members- including cross-regional research, data sharing, and research development

Thank you