Men who have sex with men (MSM) are disproportionately affected by HIV, accounting for two-thirds of HIV cases in the United States despite representing ∼5% of the adult population. Delivery and use of existing and highly effective HIV prevention and treatment strategies remain suboptimal among MSM. To summarize the state of the science, we systematically review implementation determinants and strategies of HIV-related health interventions using implementation science frameworks. Research on implementation barriers has focused predominantly on characteristics of individual recipients (e.g., ethnicity, age, drug use) and less so on deliverers (e.g., nurses, physicians), with little focus on system-level factors. Similarly, most strategies target recipients to influence their uptake and adherence, rather than improving and supporting implementation systems. HIV implementation research is burgeoning; future research is needed to broaden the examination of barriers at the provider and system levels, as well as expand knowledge on how to match strategies to barriers—particularly to address stigma. Collaboration and coordination among federal, state, and local public health agencies; community-based organizations; health care providers; and scientists are important for successful implementation of HIV-related health innovations.

中文翻译：

---

美国男男性行为者有效 HIV 干预的决定因素和策略实施研究的系统评价


男男性行为者 （MSM） 不成比例地受到 HIV 的影响，尽管占成年人口的 5%，但仍占美国 HIV 病例的三分之二。在 MSM 中，现有且高效的 HIV 预防和治疗策略的提供和使用仍然不理想。为了总结科学现状，我们使用实施科学框架系统地回顾了 HIV 相关健康干预措施的实施决定因素和策略。关于实施障碍的研究主要集中在个体接受者的特征（例如，种族、年龄、药物使用）上，而较少关注交付者（例如，护士、医生），很少关注系统级因素。同样，大多数策略的目标是影响接受者的接受和依从性，而不是改进和支持实施系统。HIV 实施研究正在蓬勃发展;未来的研究需要扩大对提供者和系统层面障碍的检查，并扩大有关如何将策略与障碍相匹配的知识——特别是解决耻辱感。联邦、州和地方公共卫生机构之间的合作和协调;社区组织;医疗保健提供者;科学家对于成功实施与 HIV 相关的健康创新非常重要。