Global priorities for HIV/AIDS intervention research

The relative social isolation of the socially marginal groups most affected by HIV/AIDS and the difficulties they face in accessing health care makes them most vulnerable to HIV infection.

Abstract

In the earliest days of the HIV/AIDS epidemic contextual enquiry centered mainly on identification of risk behaviors and their determinants. Its aim was to enable the assessment of baseline levels of risk to identify social and behavioral factors associated with risk-related behavior and to alert public health agencies policymakers and decision makers to the need to act quickly. Such research has confirmed the diversity of human sexual and drug-related behavior. Surveys of AIDS-related knowledge attitudes and practices and of efforts to understand risk behavior and intervention research focus on efforts to encourage individuals to change behavior so as to reduce HIV-related risk dominated contextual inquiry research. During the middle years of the epidemic researchers acknowledged the need to understand more about sexual and drug-related meanings and the health cultures within which they exist in order to develop effective HIV/AIDS prevention programs. The greater interest in culture and context was reflected by a growth in the number of intervention studies centering on and based within the community. The relative social isolation of the socially marginal groups most affected by HIV/AIDS and the difficulties they face in accessing health care makes them most vulnerable to HIV infection. Youth and women lack the resources and the power to protect themselves against unsafe sex. Awareness of these issues has stimulated research within the current phase of intervention inquiry. This current phase revolves around structure of society and how it contributes to vulnerability of various groups. It also centers on identifying ways to help these groups. For example in Thailand there is a requirement that sex workers should use condoms with all clients which has the support of the sex workers and brothel owners. In Zambia where men sexually exploit women in their commercial activities female fish traders have formed economic cooperatives to protect themselves against HIV/AIDS.