The importance of context in implementation research

J Acquir Immune Defic Syndr. 2014 Nov 1;67 Suppl 2:S157-62. doi: 10.1097/QAI.0000000000000322.


This article describes the pertinence of context in HIV/AIDS implementation research. Without attending to context and how it interacts with interventions, national protocols for HIV/AIDS interventions are likely to fail or underperform. With its focus on what works, for whom, under what contextual circumstances, and whether interventions are scalable, implementation research yields context-sensitive designs and enhances the likelihood of scale-up for equitable outcomes. A framework for implementation science is presented alongside a review of published HIV/AIDS protocols for complex interventions. A case study of the South African Prevention of Mother-to-Child Transmission of HIV program highlights the application of complex system improvement principles in developing adaptive and context-sensitive scale-up designs. Preliminary recommendations are provided that can be used to characterize context when reporting interventions and describing how context can be accounted for in implementation strategies.

MeSH terms

  • Female
  • HIV Infections / complications
  • HIV Infections / prevention & control
  • HIV Infections / therapy*
  • Humans
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Pregnancy
  • Pregnancy Complications, Infectious / prevention & control
  • Pregnancy Complications, Infectious / therapy*
  • South Africa