Amsterdam 2015
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| Abstract #2058 - Martin Fishbein Memorial Plenary | ||||
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Session: 1.5: Martin Fishbein Memorial Plenary (Plenary) on Tuesday @ 12.30-14.30 in C103 Chaired by Kees Rietmeijer, Barbara Hedge, Kevin Malotte Authors: Presenting Author: Dr Richard Wolitski - Centers for Disease Control and Prevention, United States |
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| Additional Authors: | ||||
| Aim: To stimulate thought and discussion regarding the role of social and behavioral science in this new era of HIV prevention. | ||||
| Method / Issue: We are now in a new era in HIV prevention. It is an era that was ushered in by remarkable advances in the use of antiretroviral medications to prevent HIV transmission. Pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) have been shown to be highly efficacious and to have the potential to dramatically reduce new HIV infections if they are prescribed, affordable, and used by those at greatest risk for acquiring or transmitting HIV. It is unlikely, however, that this potential can be fulfilled without the active involvement of social and behavioral scientists. Prescribing, obtaining, and taking medication are all behaviors that are affected by a wide range of personal, social and structural influences. The challenges are reflected in the fact that even though syphilis and gonorrhea can be treated and cured, these infections persist. | ||||
| Results / Comments: This new era of HIV prevention requires a new focus for social and behavioral science. The successful application of the theory of reasoned action (and other theories) requires a clear understanding of the target audience, the target behavior, as well as the attitudes, beliefs, and norms affecting intention to perform the behavior. In this era, it is critically important that the target audience include health care providers who may not consistently screen, recommend and prescribe PrEP and ART to those for whom it is indicated. More research and interventions are needed to support recognition of personal risk, disclosure of risk behavior to health care providers (including behaviors that are stigmatized), HIV testing, and medication adherence. The multitude of prevention options available today requires research and interventions to help individuals understand the relative efficacy of different risk reduction strategies as well as how to choose strategies that they will be able to use in a consistent and sustained manner. The psychological and social consequences and context of HIV infection are also changing in this new era. The finding that HIV transmission may not occur when the virus is adequately suppressed has tremendous implications for mental health of people living with HIV and their relationships with uninfected persons. It may also lead to substantial shifts in HIV stigma and change our current understanding of the bases and operation of HIV-related stigma. | ||||
| Discussion: The end of HIV and AIDS have been predicted before. It is naïve to assume that the mere existence of new and more effective tools will end the HIV pandemic. Achieving the end of HIV and AIDS will require that we better address long-standing psychological, behavioral, social, and structural barriers that limit the reach and effectiveness of HIV prevention. Overcoming these barriers will require a robust and refocused behavioral and social science agenda that optimizes the delivery, use, and impact of the full array of effective HIV prevention interventions. | ||||
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