(identity, development, and dynamics) and behavior change models.
3.5 The committee recommends that NIAAA, NIDA, and NIMH expand the research effort examining social and structural factors (such as class, race/ethnicity, gender relations, and community) that increase risk for AIDS, affect progression of disease, and provide points of intervention. This might require research that takes as the unit of analysis the social context and relationship (e.g., dyads, families, communities) in which HIV occurs—as opposed to the individual at risk of or who has HIV.
3.6 The committee recommends that NIAAA, NIDA, and NIMH, in conjunction with other NIH institutes, develop new and existing woman-controlled HIV/STD prevention methods (e.g., female condoms and microbicides) and examine the social and behavioral issues related to their use.
3.7 The committee recommends that NIAAA, NIDA, and NIMH support basic and applied research on the maintenance of behavior change, for example, risky sexual behavior and alcohol and other drug-using behavior, including the prevention of relapse. (The committee notes that this has been recommended in previous NRC reports—AIDS: The Second Decade, 1990; AIDS, Sexual Behavior, and Intravenous Drug Use, 1989—but has not been attended to adequately.)
3.8 The committee recommends that NIAAA, NIDA, and NIMH expand funding for HIV intervention research initiatives, particularly those that: (1) have rigorous evaluation components; (2) investigate motivations, intentions, and barriers in addition to behavior change; (3) include outcome measures in addition to behavior change, such as HIV seroprevalence, STD rates, and pregnancy rates; and (4) target a full range of racial/ethnic, gender, and cultural groups for the purpose of assessing between-group differences.
3.9 The committee recommends that NIAAA, NIDA, and NIMH support research that estimates the number of HIV infections averted by current prevention efforts and that includes cost estimates for these efforts.