Fostering Effective Interventions through Supportive Grant-Making: Embedding Social-Justice Centered Implementation Science into Working with HIV Service Organizations in the US South

Background and Purpose: The Southern US is the epicenter of the fight against HIV in the U.S. Seemingly intractable structural inequalities, such as stigma and discrimination, continue to drive the HIV epidemic in the South. Southern community-based HIV service organizations (SCBHSO) provide life-saving services to marginalized groups living with or at risk for HIV. To successfully end the epidemic, SCBHSOs must address root causes of disproportionate HIV risk as well implement evidence-based interventions (EBIs) to engage people in HIV treatment and prevention services. Implementation science offers methodologies to guide EBI incorporation into complex organizational contexts to improve outcomes. However, for EBIs to be effective with communities that are marginalized, social justice needs to be meaningfully operationalized and integrated into practice.  Despite the potential of a social justice-centered implementation science approach, there is little understanding about the ways in which implementation science can be grounded in social justice practice. Using the capacity building work at the HIV and Wellness Center as a case study, this presentation will discuss a social justice-centered implementation science framework which can be used to build more socially just and clinically effective organizations.

Methods: This Case Study will reflect on the authors’ work at an HIV and Wellness Center housed in a social work college which focuses on capacity building with SCBHSOs. Authors will discuss best practices by drawing on a literature review, the EPIS framework (Aarons et al., 2011) and ‘notes from the field’ to describe the Center’s use of implementation science to support SCBHSOs’ efforts to bridge social justice and evidence based practice.  

Results: The HIV and Wellness Center provides capacity building to CBHSOs in the US South through training and resources/grants. Focusing on the Exploratory phase of the EPIS framework, three best practices with CBHSOs emerge to support a social justice centered implementation science process. Operationalizing social justice goals must be embedded throughout every phase of the EBI implementation.  For example, the Meaningful Involvement of People living with HIV principles were integrated into projects as they were being developed. Meaningful collaboration between academic partners and organizations should be centered on knowledge sharing, transparency, and resisting the colonial gaze of research(ers) Finally, centers/academics should not only focus on the research, but must focus on providing training and working with the organization to promote organizational culture change grounded in justice. For our Center, that meant providing trainings centered in healing justice, trauma informed care with a structural lens and harm reduction approaches.

Conclusion: The body of research on social determinants of health urges us to integrate social justice into every aspect of direct service work in the pursuit of lasting, meaningful individual and social change. This case study demonstrates how social justice-centered implementation science can operationalize social justice priorities in the context of evidence based practice to create mutuality between social and clinical goals.

Aarons, G.A., Hurlburt, M. & Horwitz, S.M. (2011). Advancing a conceptual model of evidence-based practice implementation in public service sectors. Administration and Policy in Mental Health, 38(1), 4-23.