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Understanding how PrEP is made successful: Implementation science needs an evidence-making approach.
Anthony K J Smith1, Kari Lancaster1, Tim Rhodes1,2
1Centre for Social Research in Health, UNSW Sydney, Sydney, Australia.
Next-generation HIV pre-exposure prophylaxis (PrEP) requires understanding implementation science. An
Area of Science:
- Implementation Science
- Public Health
- HIV Prevention
Background:
- Oral pre-exposure prophylaxis (PrEP) for HIV has been available for a decade.
- The next generation of PrEP, including long-acting formulations, is anticipated.
- Uneven international PrEP implementation highlights the need for contextual understanding.
Purpose of the Study:
- To explore the evolution of PrEP and advocate for an 'evidence-making' approach.
- To understand how implementation contexts shape PrEP's translation and effects.
- To recognize that interventions and their contexts co-evolve.
Main Methods:
- Literature review and conceptual analysis.
- Exploration of implementation science principles.
- Framing implementation as 'evidence-making events'.
Main Results:
- PrEP implementation is shaped by local contexts and health systems.
- Interventions and implementation contexts are co-constituted and evolve together.
- Challenging universal assumptions about intervention effects is crucial.
Conclusions:
- An 'evidence-making' approach is vital for next-generation PrEP.
- Implementation science must view processes as co-evolving events.
- Harnessing localized possibilities will optimize PrEP's future impact.
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