Beyond Survival: Harnessing Sustainability Frameworks to Assess and Support Programs Implementing Bundled...

Objectives. To evaluate the sustainability of bundled interventions aimed at expanding the delivery and utilization of HIV care and treatment services, tackling socio cultural health determinants, and improving health outcomes for Black women with HIV. Methods. We used quantitative data from the Program Sustainability Assessment Tool (PSAT) to examine sustainability capacity across sites in the United States. Qualitative data from monthly call forms completed by site staff (n = 199), annual site visit reports (n = 24), and one-on-one key informant interviews (n = 76) informed organizational and contextual factors influencing sustainability capacity. Results. A total of 59 stakeholders completed the PSAT. The initiative's overall sustainability score was high (mean = 5.1; range = 3.8-6.6), with sites reporting favorably on program adaptation (mean = 5.8; range = 4.4-6.8), program evaluation (mean = 5.6; range = 3.9-7.0), and organizational capacity (mean = 5.6; range = 3.8-7.0) domains. Adaptability and responsiveness to client needs and sociopolitical contexts were determined valuable; establishing an evaluation infrastructure, capacity to integrate Black Women First (BWF) initiative activities within organizational operations, and environmental support facilitated sustainability. Conclusions. Interventions for Black women with HIV can be sustained and should be pursued and embedded consistently in community and health service organizations. (Am J Public Health. 2025;115(S1):S28-S37. https://doi.org/10.2105/AJPH.2024.307790).