This issue looks at the history, current state, and future of HIV science
Despite the continuous necessity and importance of HIV/AIDS-related research and practice, we saw a drop in presentations relating to HIV/AIDS programming at recent APA meetings.
There are misconceptions about HIV/AIDS as an issue of the past, solved mainly by biological discoveries, given the present zeitgeist and, in particular, the reduced federal emphasis on and financing for social and behavioral sciences. In response, we submitted a 2017 collaborative symposium presentation on behalf of the Committee on Psychology and AIDS, titled "Past, Present, and Future of HIV/AIDS Science and Practice in Psychology," to highlight the vital role of psychologists in combating the pandemic. Our discussion was then designated as a 125th APA anniversary talk, was videotaped, provided Continuing Education Credits (CEs), and was then featured with a prominent blog on HIV.gov to emphasize the vital importance of behavioral approaches in improving biological advances. In summary, our symposium examined the contributions of social and behavioral sciences over the last three decades, emphasizing the importance of psychologists in the design and implementation of culturally sensitive, accessible, holistically focused HIV prevention, care, and treatment that is integrated into biomedical services.
The Psychological Front Lines of the HIV/AIDS Epidemic
From the beginning, and even now, psychology has been at the forefront of the HIV/AIDS epidemic. Psychologists have made major contributions to HIV/AIDS prevention, intervention, knowledge, and practice by planning, implementing, and evaluating behavioral and mental health issues. From identifying at-risk behaviors and demographics to identifying and operationalizing behavioral change, to acknowledging the role of individuals as well as community, policy, and global perspectives and influences, psychology has played a major role in HIV (Chesney, 1993). Kelly and colleagues (1993) identified a number of behavioral science priorities in the second decade of HIV/AIDS in order to "urgently" address the demand for psychological interventions in HIV prevention. Psychologists were to play a key role in containing the pandemic, according to the agenda. Implementing community trials of behavioral change models, conducting community-level interventions with those who are most vulnerable to HIV infections, cultivating partnerships between HIV research and community service organizations, and mobilizing research findings into community and public policy arenas are just a few of the recommendations made by the authors. Interdisciplinary cooperation in the field of psychology were also mentioned as a way to bring together resources and perspectives that could help to improve pre-existing HIV preventive programs.
Considerable progress has been made in reducing the transmission of HIV/AIDS during the last 30 years, with significant advancements in treatment services, research, and public health and policy. Despite the fact that modern therapies have made HIV a manageable chronic disease, clinical concerns such as co-occurring mental disorders, addiction, and health inequities call for more social and behavioral study and intervention. Stigma, for example, is one of the most pervasive impediments to HIV prevention, treatment retention, and adherence to care, despite being one of the lowest priority (Mahajan et al., 2008). Psychologists, on the other hand, can help to better understand the impact of stigma in healthcare access, utilization, and retention, as well as analyze whether "traditional" HIV/AIDS methods should be applied universally across communities to account for contextual and cultural variables (Airhihenbuwa & Obregon, 1994). Psychologists who investigate the social and cultural determinants of health and well-being can thereby contribute perspectives to the science and practice of HIV/AIDS prevention and treatment. Psychologists, for example, have made substantial contributions to the integration of behavioral health into HIV/AIDS medical care (Farber et al., 2012). Continued progress in understanding HIV/AIDS-related disorders such as depression and addiction, as well as stigma reduction and evidence-based behavioral therapies (Bryant et al., 2014; Weiss, Tobin, Lopez, Simons, Cook, & Jones, 2014) is required.
The Opioid Epidemic and HIV/AIDS
The statewide opioid crisis has just been labeled a public health emergency, and with it, an increase in HIV epidemics as a result of the opioid crisis. It's no surprise that the outbreaks of infectious diseases caused by injection drug addiction have been concentrated in counties and towns with high rates of poverty and unemployment, as well as minimal resources and services to prevent outbreaks. Consequently, regardless of any biomedical progress, prevention and treatment services address social and behavioral issues such as understanding the roots of trauma in substance use, addiction, health-care accessibility, provider stigma, and the implementation of behavioral services such as the syringe-services program. Although the opioid epidemic is beyond the scope of this newsletter, the ongoing need for psychologists to contribute with the skills we have to offer in our unique social and behavioral science training underscores the ongoing need for psychologists to continue to contribute with the skills we have to offer in our unique social and behavioral science training. This involves everything from community outreach and psychoeducation to mental health research and service, as well as public health advocacy and funding for the most vulnerable populations.
This issue of the Psychology and AIDS Exchange newsletter continues to draw attention to historical, current, and future challenges linked to HIV/AIDS science and practice in psychology, building on what we presented at the 2017 APA Annual Convention. The current newsletter is not intended to be a full list of all pertinent HIV/AIDS concerns; rather, it focuses on areas that have received little attention. Innovations in integrating medical and behavioral health treatments, as well as sociopolitical issues of gender discrimination and transgender identity and health, are highlighted in science and practice. The issues covered in this newsletter help to put the challenges that persons at risk and people living with HIV/AIDS face in the United States and around the world into context. Health care gaps and HIV risk factors are fueled by socioeconomic concerns, injustice, cultural beliefs, and gender-based violence. The three articles in this issue provide evidence-based perspectives on these pressing issues, emphasizing the importance of social and behavioral approaches and services in combating the epidemic. Without addressing behavior modification for HIV/AIDS prevention and intervention, biomedical improvements can only go so far. Theory-based, comprehensive behavioral intervention services in psychology can help increase HIV treatment adherence and lower HIV transmission risks (Kalichman et al., 2011; Marazzo et al., 2014).