A SNaPshot of our Work in Vietnam

Vivian Fei-ling Go, PhD
University of North Carolina, Gillings School of Global Public Health

William Miller, MD, PhD
University of North Carolina, Gillings School of Global Public Heath

ABSTRACT:
This talk will examine the challenges and opportunities of scaling an evidence-based HIV intervention beyond research settings and into routine care. Using the SNaP implementation trial in Vietnam as a case study, we compare standard versus tailored implementation strategies for scaling a systems navigation and psychosocial counseling intervention across 42 HIV testing clinics in 10 provinces. While both approaches achieved high penetration and ART uptake, tailored implementation produced significantly higher fidelity and improved viral suppression, highlighting the importance of context-responsive implementation support. We will discuss how implementation leadership, organizational readiness, and local adaptation shaped implementation success and sustainment, as well as the tensions between fidelity and pragmatism that emerge during scale-up. The findings offer insights into when and why tailoring adds value and provide practical lessons for implementing complex interventions at scale in resource-constrained health systems.