medRxiv [Preprint]. 2026 Sep 17:2026.09.16.26363245. doi: 10.64898/2026.09.16.26363245.
ABSTRACT
INTRODUCTION: HIV care and treatment programs around the world continue to evolve in response to changes in clinical guidelines, evidence-based practices, domestic and donor funding for the HIV response, new technological developments, and changing weather patterns. Since 2009, the International epidemiology Databases to Evaluate AIDS (IeDEA) research consortium has conducted periodic surveys to document the characteristics of participating clinics and the availability of HIV-related services across diverse settings-information that provides important context for understanding variations and trends in HIV care outcomes. This paper describes the protocol for IeDEA's 2026 site assessment survey, launched in August 2026.
METHODS AND ANALYSIS: This cross-sectional descriptive study aims to document HIV-related services and practices among clinics in 42 countries. The survey explores the characteristics and services provided at HIV care and treatment sites participating in IeDEA in 2026, along with real-world adoption and implementation of evidence-based service delivery strategies for people living with or at risk of HIV. Designed for self-administration, the survey questionnaire was developed through two complementary processes: a review of questions and data collected through IeDEA's prior consortium-wide surveys and an open call to IeDEA investigators for new survey content to advance a timely implementation science agenda relevant to the global HIV community. Survey materials and links to an online REDCap questionnaire will be distributed to 232 eligible clinics across IeDEA in September 2026, with a deadline of November 30, 2026, for completion. Planned analyses will examine the following topics: HIV care amidst funding constraints; the roll-out of differentiated service delivery models; pre-exposure HIV prophylaxis; long-acting injectable antiretroviral therapy (ART); prevention, screening and/or treatment services for viral hepatitis, mental health and substance use disorders, cardiovascular disease, and cancers among PLHIV; the integration of HIV care with other health services; and clinic vulnerability to extreme weather events.
ETHICS AND DISSEMINATION: A "non-human subjects" research designation was determined by the Vanderbilt University Medical Center Human Research Protections Program. Survey findings will be shared with local partners and stakeholders across IeDEA, disseminated at regional and global conferences, and published in peer-reviewed journals.
STRENGTHS AND LIMITATIONS OF THIS STUDY: Strengths of this study include gathering data for a global cohort of 232 HIV clinics across 42 low-, middle- and high-income countries, reflecting real-world adoption and implementation of treatment guidelines and evidence-based practices for HIV prevention, care and management across diverse settings during a period of substantial changes in funding for the HIV response. Further strengths include a rigorous process for survey development that combined an in-depth review of data and findings from prior International epidemiology Databases to Evaluate AIDS (IeDEA) surveys with new investigator-driven content focused on implementation science questions related to the HIV response and key gaps in the literature.Study limitations include potential recall and social desirability biases inherent in self-reported data, as well as selection biases that may determine clinic participation. Additionally, while clinics participating in the global IeDEA research consortium are reflective of real-world HIV care delivery, they may not be nationally or regionally representative.
PMID:42780201 | PMC:PMC13596588 | DOI:10.64898/2026.09.16.26363245