T H E   W H I T E   H O U S E

National Institutes of Health #5

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To conduct and support behavioral and social science research to further understanding of the determinants and processes that influence behaviors associated with HIV transmission and to develop and improve HIV prevention intervention strategies.

Support research to develop and evaluate social and behavioral interventions at the societal, community, organizational, and individual levels to reduce HIV transmission by reducing HIV-related risk behaviors and increasing protective behaviors. Multi-site and cross-national studies are encouraged.

Studies have demonstrated that HIV-related risk behaviors can be measured and modified. In response to the evolving epidemic, an expanded HIV prevention research agenda is called for on what works, for whom, where, for how long, and at what cost.

1. Develop and evaluate the effectiveness and cost-effectiveness of demographically and culturally appropriate behavioral and social interventions in different domestic and international settings and populations to reduce high-risk HIV-related behaviors and HIV transmission (e.g. through safer sexual practices, increased use of condoms and other barrier methods, use of sterile injection equipment, and reduction of high-risk drug-related behaviors).
2. Support research on a range of HIV prevention strategies in a variety of settings for both emerging populations and groups that continue to be at high risk for HIV.
3. Support research to increase the effectiveness and cost-effectiveness of drug abuse, mental health, and alcoholism treatment, including the development of new pharmacotherapies, to reduce HIV-related risk behavior in different settings and populations.
4. Support research (including multi-site and cross national studies) on comprehensive interventions that integrate various HIV and STD prevention and family planning approaches.
5. Support research to improve the access to, delivery of, evaluation, and cost-effectiveness of services that reduce HIV risk behaviors and transmission.
6. Design and test interventions to increase recruitment, retention, and adherence to protocols for HIV prevention research, including prophylactic vaccines.
7. Support research to improve the transfer of effective interventions to and from community planning processes.

Support basic research to strengthen the understanding of determinants and processes that influence HIV-related risk behaviors and the consequences of HIV disease.

Understanding the basic factors influencing behavior and behavior change at the societal, community, organizational, and individual levels is necessary for the development of interventions to prevent the transmission of HIV and to ameliorate its adverse consequences. Research is needed to define the behavioral, psychological, cognitive, and social consequences of HIV infection, disease progression, and treatment.

1. Develop models of behavior and behavior change that integrate biological, psychological, and social perspectives to explain and predict the acquisition, change, and maintenance of HIV-related behaviors among individuals and groups in various settings.
2. Study the social, structural, and cultural factors such as class, ethnicity, sexual identification, age, and gender that influence HIS-related behavior, affect access and delivery of care, and determine intervention strategies.
3. Study the development and maintenance of HIV-related risk and preventive behaviors in specific social contexts such as the sexual dyad, peer groups, social and drug-using networks, families, and communities.
4. Conduct research on decision-making processes, which may include disclosure of one's HIV-status, choice of treatment options, and adoption of protective behaviors.
5. Support research to understand the processes of how communities become involved in HIV intervention research.
6. Identify the behavioral, psychological, cognitive, and social consequences of HIV disease for HIV-seropositive individuals, their support systems (e.g. partners, family members, and other care givers), and their communities.
7. Support studies in animal models in behavior and behavior change relevant to HIV infection and prevention.
8. Conduct research that identifies the social and behavioral factors affecting recruitment, retention, and adherence in clinical trials.
9. Conduct research on the barriers to preventive actions based on lack of trust and misinterpretations of meaning of information related to HIV.

Support research for the discovery, development, and evaluation of strategies for preventing or minimizing the negative physical, psychological, cognitive, and social consequences of HIV, including stigmatization of persons with or at-risk for HIV infection. Support research strategies for promoting effective health care utilization among persons with HIV infection.

Enhancement of the quality of life of seropositive individuals and facilitation of HIV treatment require further research on interventions to affect the physical, behavioral, psychological, cognitive, and social consequences of HIV infection, disease progression, and treatment. Research is also needed to improve delivery of care to diverse population groups.

1. Develop and evaluate interventions for promoting quality of life and to delay or prevent physical, behavioral, psychological, cognitive, and social consequences.
2. Promote research to identify and remove barriers to effective health care utilization among persons with or at-risk of HIV infection, including access, engagement, follow-up, and adherence to health and social services across the care continuum (e.g. testing and counseling, health care-seeking behavior, adherence, case management, and home/hospice care). This strategy may entail developing and testing innovative models of treatment delivery for HIV disease at all illness stages.
3. Develop and evaluate interventions for promoting increased recruitment, adherence, and retention, especially in underrepresented populations, in HIV treatment and clinical trials.
4. Test models of care-giving for people living with HIV disease, their significant others, extended family members, and care providers.
5. Develop and evaluate interventions for preventing social stigmatization of persons with or at-risk of HIV infection and AIDS in different settings (e.g. workplaces, schools, health care facilities, and prisons).

Support research to advance innovative quantitative and qualitative methodologies to enhance HIV behavioral and social science research.

Behavioral and social science methods have greatly advanced our understanding of HIV transmission and health maintenance. Further refinement of established methods and rapid development of emerging technologies are essential to continued improvement of our knowledge of HIV-related behaviors; our understanding of linkages between HIV-related risk behaviors, transmission, and disease progression; and the evaluation of interventions.

1. Develop improved qualitative and quantitative methodologies for studying behavioral and social factors associated with HIV, including improved methods for validating self-report data, improved measurement tools for surveys, and the measurement of change over time.
2. Develop improved sampling strategies for sub-populations and culturally and linguistically sensitive and appropriate research instruments.
3. Develop improved methods and techniques for dealing with subject attrition and missing data.
4. Encourage secondary data analysis by developing techniques to protect confidentiality and by using of meta-analysis.
5. Develop and refine techniques for measuring social networks associated with HIV.
6. Develop and refine research techniques for measuring responses by organizations to HIV and for characterizing organizations working in the HIV field.
7. Encourage studies that will support multi-site studies and cross-national comparisons.
8. Develop and refine mathematical models for linking behavior change interventions with reduction in HIV transmission.

All populations.

Researchers, clinicians, community and patient representatives, and NIH-affiliated advisory councils and committees.

NIH #1 - Appendix B: Research

NIH #2

NIH #3

NIH #4

NIH #5

NIH #6