Summary
The transmission of HIV/AIDS is interwoven with individual behavior and social context. Without expansion of the research base in the social and behavioral sciences, and without inclusion of social and behavioral sciences as integral components of biomedical interventions, the campaign against AIDS will be incomplete and less effective than it could be.
The Institute of Medicine (IOM), with support from the Office of AIDS Research at the National Institutes of Health, convened a workshop committee to consider the contributions of the social and behavioral sciences to AIDS prevention, assess the current understanding of the epidemic, draw new insights to help guide further research on the complex issues associated with the epidemic, and identify important research questions and relevant methodologies needed for the future. The workshop was held in June 1995 and this report summarizes the presentations and discussions of the workshop with reference to key insights from the commissioned background and response papers, which were prepared at the committee's request. The workshop extended the review of preventive interventions targeted at individual behavior change found in the 1994 IOM report, AIDS and Behavior: An Integrated Approach. Thus, focused on more social-level analyses, this workshop summary and the accompanying background papers are useful companion documents to the earlier IOM report.
A major theme of this workshop summary for policymakers is that programs to encourage and bolster use of social and behavioral methods in research supported by the National Institutes of Health, the Centers for Disease Control and Prevention, and other agencies will be good investments for the
future. Efforts to prevent HIV/AIDS will require broader perspectives than those that have been applied in the past and the focus of research should not only include the natural course of the physical illness, but also include the social course of the disease. Innovative research strategies need to go beyond the study of individuals to examine the social contexts, including couples, partners, networks, communities, and global issues, for their effects on risk for and diffusion of HIV. Further, such social contexts may also represent critical points of intervention for HIV prevention programs.
Strategic planning and interagency cooperation could help determine the types of interdisciplinary collaborations required to achieve maximal results and to foster such collaborations. These collaborations will further require a wide variety of behavioral and social scientists, including psychologists, anthropologists, historians, economists, sociologists, and political scientists.
It is clear that HIV is transmitted from person to person in differing patterns, which depend on the relationships, local environments, ethnic or community values, economics, and other factors that underpin individual behavior. Participants at the workshop emphasized the importance of understanding and considering these factors, based on an expanded research base, in the design, implementation, and much-needed evaluation of HIV preventive interventions.