Table 3.

Public Health Practice-Driven Research Priorities in HIV Prevention and Care Continuum Research

Problem	Examples of Practice-Driven Research Questions
Too few people who are at risk for HIV infection take PrEP	• Which model of PrEP delivery in STD Clinics results in the highest proportion of patients starting PrEP? • How can health departments increase provider capacity to prescribe PrEP in the jurisdiction? • Can PrEP navigators identify people in need of PrEP and generate PrEP demand or should navigators focus on persons referred for assistance?
Too many people who start PrEP discontinue it	• How can we distinguish “appropriate” from “inappropriate” PrEP discontinuations? • How much do PrEP navigation programs impact PrEP retention and at what unit cost? • What models of PrEP delivery are most effective at retaining patients in the long term?
Many people living with HIV are unaware of their status	• How can health departments effectively align their testing efforts with the most affected populations? • How can health departments most effectively increase HIV testing in Emergency Departments, jails and primary care settings, and in what situations should each of these activities be prioritized? • How can HIV molecular surveillance data be used to efficiently identify undiagnosed PLWH?
Viral suppression among persons living with HIV is too low	• How much benefit does same-day ART initiation provide compared to initiation within 1-2 weeks after diagnosis? • What modifiable factors function as the greatest drivers of unsuppressed viral load and what factors define the level of patient need for high intensity services? • What intervention strategies improve durable viral suppression among persons with substantial barriers to care?
Racial/ethnic disparities in PrEP use, HIV incidence, and viral suppression reflect health inequities	• How should health departments estimate PrEP need and uptake by subgroup? • What interventions increase sustained PrEP use in highly affected groups in which PrEP use is lagging? • What models of care most effectively reduce racial disparities in viral suppression?
HIV incidence is increasing among people who inject drugs	• What are the comparative HIV case finding outcomes of efforts to reach marginalized PWID for HIV testing? • How should services to provide PrEP and HIV care be prioritized and implemented in the context of an outbreak? • How do syringe services program policies (e.g. one-to-one or unlimited exchange) impact population coverage?