The global HIV response is leaving children and adolescents behind. Because of a paucity of studies on treatment and care models for these age groups, there are gaps in our understanding of how best to implement services to improve their health outcomes. Without this evidence, policymakers are left to
extrapolate from adult studies, which may not be appropriate, and can lead to inefficiencies in service delivery, hampered uptake, and ineffective mechanisms to support optimal outcomes.
Implementation science research seeks to investigate how interventions known to be efficacious in study settings are, or are not, routinely implemented within real-world programs. Implementation science has a clear role to play in facilitating understanding of how the multiple complex barriers to HIV services for children and adolescents prevent effective interventions from reaching more children and adolescents living with HIV, and is well positioned to redress gaps in the HIV response for these age groups.
This article provides a call to focus more on children and youth with HIV and provides thoughtful perspectives on
- what questions can implementation science answer for pediatric and adolescent HIV testing, treatment and care
- how to build partnerships across the divide of service delivery and research
- overcoming ethical and regulatory hurdles of data collection with children
- meaningfully involving children and caregivers
- disaggregating data with youth populations