Executive Summary: NIH Symposium: Mentoring Early Stage Investigators Conducting Implementation Science in HIV and Aging

Candice Beaubien, M.P.H., National Institute on Aging
David Chang, Ph.D., NIH Office of AIDS Research
Vasudev R. Rao, M.B.B.S, National Institute on Mental Health
Amber Wilson, M.P.H., NIH Office of AIDS Research

Introduction

A symposium titled “Mentoring Early Stage Investigators Conducting Implementation Science in HIV and Aging” was held on October 24, 2025, during the International Workshop on Aging & HIV in Washington, D.C. The event focused on advancing implementation science (IS) in HIV and aging while supporting the development of early stage investigators (ESIs) and strengthening mentor-mentee collaborations critical to sustaining the field. The symposium had three primary objectives, which underscore the essential role of mentorship ecosystems and IS approaches in translating HIV research into real-world, equitable care for people aging with HIV:

• Describe current applications of IS in HIV and aging research, including work addressing comorbidities;
• Showcase the research trajectories of ESIs conducting IS in HIV; and
• Highlight effective mentorship models that support the transition from mentored research to independent investigation.

The symposium was organized by the National Institutes of Health (NIH) Office of AIDS Research (OAR), National Institute on Aging (NIA), and National Institute of Mental Health (NIMH). Although representatives from the NIH were unable to facilitate the event or participate due to the U.S. government shutdown, Kristine Erlandson, M.D., M.S. (University of Colorado Anschutz Medical Campus), graciously served as moderator on behalf of the organizing institutes. NIH is grateful to its partners for executing the event and for their shared commitment to supporting the next generation of HIV investigators.

Dr. Erlandson conveyed remarks prepared in advance by OAR Director Geri Donenberg, Ph.D., emphasizing the importance of IS in closing the gap between research and practice, as well as NIH’s continued commitment to HIV and aging research across the full translational spectrum – from basic discovery through implementation – and to addressing the needs of older adults with HIV, including long-term and lifetime survivors.

Framing Implementation Science in HIV and Aging

Steven Safren, Ph.D., American Board of Professional Psychology, University of Miami
Dr. Safren provided a foundational overview of IS and its relevance to HIV research. Dr. Safren contrasted the relatively standardized pathways for drug development with the less formalized processes for developing, disseminating, and scaling psychosocial and behavioral interventions. He emphasized that IS is essential because effective interventions require both human behavior change and system-level capacity for delivery. Dr. Safren became involved in IS because his mentees were conducting studies that required implementation research. Dr. Safren discussed the importance of using appropriate IS terminology – such as clearly distinguishing implementation outcomes from determinants – when designing studies and applying for funding. He highlighted his work on a hybrid effectiveness-implementation trial in South Africa aimed at extending the reach of evidence-based depression treatments in HIV clinics, illustrating how IS can enhance population-level impact.

Developing an Implementation Science Research Program: Mentorship to Independence

Audrey Harkness, Ph.D., University of Miami
Dr. Harkness described her pathway into HIV-related IS, which emerged from observing persistent challenges in engaging community members in pre-exposure prophylaxis (PrEP) and affirmative mental health interventions. She explained how mentored career development awards enabled her to systematically identify determinants of implementation gaps and to design strategies to improve intervention reach. She emphasized that mentorship was critical in helping her learn how to conceptualize implementation problems, navigate community-based research challenges, and ultimately transition to independent funding. Dr. Harkness noted that implementation gaps are common and that listening to implementers and communities is essential. She recommended that researchers interested in engaging in HIV-related IS begin by looking for elements taken for granted in current procedures – such information often is illuminating about implementation. She emphasized that intervention recipients are vital, irreplaceable contributors, but not the only partners in IS, and she encouraged ESIs to seek formal training while assembling mentoring teams with complementary expertise.

Applying Implementation Science to HIV Research

Anandi Sheth, M.D., M.Sc., Infectious Disease Society of America, Emory University
Dr. Sheth discussed her path from an HIV clinician-scientist to an implementation scientist. Drawing on her experience during the early rollout of daily PrEP, Dr. Sheth described how limited uptake among women revealed critical implementation gaps that could not be addressed through efficacy research alone. She highlighted IS as a powerful approach for translating evidence into equitable, person-centered HIV care, particularly for aging populations. Dr. Sheth emphasized the importance of engaging frontline providers and community partners and noted that investigators do not need to be implementation scientists to incorporate IS methods; rather, they can seek targeted training and build collaborations. She also identified challenges unique to HIV IS, including complex care settings, heterogeneous populations, and limited standardization of implementation outcomes, underscoring the need for sustained investment in partnerships.

Responding to Innovation and Shifts in HIV Care

Lauren Collins, M.D., M.Sc., Emory University
Dr. Collins focused on how advances in HIV treatment and increased longevity have reshaped both clinical care and research priorities. Dr. Collins noted that although people with HIV are living longer, they experience a high burden of non-AIDS comorbidities, resulting in significantly fewer healthy years compared with the general population. She discussed her work examining comorbidities among women with HIV to inform screening and prevention strategies. Dr. Collins also described IS studies that leverage community-academic partnerships to engage Black women in co-creating tools to support linkage to long-acting injectable antiretroviral therapy (ART). She emphasized that future HIV research will increasingly intersect with aging and long-acting ART and encouraged ESIs to respond to clinical paradigm shifts with rigorous implementation-focused research, strong mentorship, and meaningful community engagement.

Discussion and Key Takeaways

During the discussion, panelists identified several training and career development resources relevant to HIV-related IS, including the Inter-Centers for AIDS Research (CFAR) Implementation Science Fellowship, the HIV, Infectious Disease and Global Health Implementation Research Institute (HIGH IRI), and the HIV Implementation Science Coordination Initiative (ISCI). Participants also emphasized the value of seminal IS literature for grounding study design.

Panelists addressed concerns that IS may be too slow to influence clinical practice, emphasizing that IS and implementation efforts are complementary. A central goal of IS is to ensure that interventions are delivered equitably and efficiently. Thoughtful intervention development and implementation planning increase the likelihood that limited resources are used effectively and sustainably. Panelists further emphasized that systems, providers, and communities must be supported as partners in implementation, rather than bearing disproportionate responsibility for change.

View the recording of the symposium on YouTube.