Until now, most behaviorally based AIDS prevention research has focused on the individual as the locus for risk analysis, intervention, and evaluation. Although this is important, it must also be recognized that all individual behavior is embedded in and influenced by its social and physical environment. Individual social cognitions, health attitudes, and personal habits are heavily influenced by family members, peers, local community members, and the media. But broader social forces such as economics, politics, and international affairs also shape individual decisions and personal practices.
The workshop summarized here was organized and overseen by a separate steering committee, but grew out of a larger project at the Institute of Medicine (IOM) that resulted in the 1994 report AIDS and Behavior: An Integrated Approach. The original project assessed the balance between biomedical and behavioral research in the AIDS research programs at the National Institute of Mental Health, National Institute on Drug Abuse, and National Institute on Alcohol Abuse and Alcoholism, but it did not have as part of its charge the task of reviewing the broad social science base of behavior and how it relates to AIDS. After publication of the report, there was some concern that an important piece of work was missing from the committee's charge and that a more diverse set of disciplines deserved consideration. The workshop summarized in this report provided an opportunity to consider the potential contributions of the social and behavioral science base for AIDS prevention, to question the current understanding of the epidemic, to draw new insights to help guide further research on complex issues, and to identify important research questions and relevant methodologies.
The Institute of Medicine, with support from the Office of AIDS Research at the National Institutes of Health, brought together a diverse group of scientists, clinicians, and advocates for a one-and-one-half-day meeting. Many of the researchers were experienced in the AIDS field, while others were distinguished social and behavioral scientists whose work has not focused on AIDS. Some researchers came from the tradition of clinical social science investigation, while others saw risk behaviors in a broad social, political, economic, and cultural context. Thus, new and broader views were brought to bear on examination of research opportunities.
Four primary presentations were made during the workshop. These presenters based their comments in part on commissioned background papers they had prepared for the IOM. Each presentation was followed by discussant commentary and by an open discussion with other invited participants. Three panel presentations also were prepared and presented on specific topics (See Appendix A and Appendix C for the workshop's agenda and titles of commissioned background papers and responses). The organization of this summary differs from the workshop agenda in order to be more accessible to the reader. Its content, examples, and conclusions, however, were presented at the workshop