A journey to HIV prevention research: From social psychology to social health via multidisciplinarity

Whole person HIV services: a social science approach

PURPOSE OF REVIEW

Globally, approximately 38.4 million people who are navigating complex lives, are also living with HIV, while HIV incident cases remain high. To improve the effectiveness of HIV prevention and treatment service implementation, we need to understand what drives human behaviour and decision-making around HIV service use. This review highlights current thinking in the social sciences, emphasizing how understanding human behaviour can be leveraged to improve HIV service delivery.

RECENT FINDINGS

The social sciences offer rich methodologies and theoretical frameworks for investigating how factors synergize to influence human behaviour and decision-making. Social-ecological models, such as the Behavioural Drivers Model (BDM), help us conceptualize and investigate the complexity of people's lives. Multistate and group-based trajectory modelling are useful tools for investigating the longitudinal nature of peoples HIV journeys. Successful HIV responses need to leverage social science approaches to design effective, efficient, and high-quality programmes.

SUMMARY

To improve our HIV response, implementation scientists, interventionists, and public health officials must respond to the context in which people make decisions about their health. Translating biomedical efficacy into real-world effectiveness is not simply finding a way around contextual barriers but rather engaging with the social context in which communities use HIV services.

HIV Health literacy beyond the biomedical model: an innovative visual learning tool to highlight the psychosocial complexities of care

The HIV care continuum represents a linear clinical pathway from testing to viral suppression; however, it does not capture the psychosocial complexities of contemporary HIV care. We developed an innovative and appealing visual learning resource to extend the scope of HIV health literacy beyond biomedical constructs. Based on the lived experiences of recently diagnosed people living with HIV in Queensland, the "Journeys through the HIV Care Continuum" Map presents the continuum as a complex journey incorporating challenges such as poor health literacy, health service access and stigma alongside facilitators to care, including emotional and peer support. Designed for audiences who may not access academic literature, the Map can be used to facilitate conversations between recently diagnosed people living with HIV and peer navigators, and as a learning tool for health professionals, carers and students. The Map highlights opportunities to support PLHIV in meaningful ways that will reduce stigma and promote care access.

Social Robot Co-Design Canvases: A Participatory Design Framework

Design teams of social robots are often multidisciplinary, due to the broad knowledge from different scientific domains needed to develop such complex technology. However, tools to facilitate multidisciplinary collaboration are scarce. We introduce a framework for the participatory design of social robots and corresponding canvas tool for participatory design. The canvases can be applied in different parts of the design process to facilitate collaboration between experts of different fields, as well as to incorporate prospective users of the robot into the design process. We investigate the usability of the proposed canvases with two social robot design case studies: a robot that played games online with teenage users and a librarian robot that guided users at a public library. We observe through participants’ feedback that the canvases have the advantages of (1) providing structure, clarity, and a clear process to the design; (2) encouraging designers and users to share their viewpoints to progress toward a shared one; and (3) providing an educational and enjoyable design experience for the teams.

Underlying factors related to HIV/AIDS prevention: investigating the willingness to take pre-exposure prophylaxis among men-who-have-sex-with-men in Germany

BACKGROUND

This study investigates the willingness of men-who-have-sex-with-men (MSM) to use HIV pre-exposure prophylaxis (PrEP). Research in the HIV/AIDS field typically relies on clinical and epidemiological studies, thereby often excluding social dimensions of the illness as well as factors explaining its prevention. The current study analyzes HIV-prevention through an interdisciplinary theoretical approach. It aims to comprehensively understand the mechanisms associated with the willingness to take PrEP among MSM in terms of psychological, social, behavioral, cultural, and demographic factors.

METHODS

We analyze data from the survey "Gay Men and AIDS" conducted in Germany in 2013 prior to market approval for PrEP. Analyses were performed using the statistical software SPSS 25.0, while results were visualized using the R programming language.

RESULTS

We find that perceived risk of infection, social norms (anticipated HIV-stigma), practices (e.g. regular condomless sex), and socio-demographic factors (young age, being single) all have a positive effect on the willingness to take PrEP, while education reveals a negative, and income no effect.

CONCLUSIONS

Results indicate that beyond well-established socio-psychological mechanisms of health behavior, social factors play a crucial role in understanding the willingness of PrEP uptake. This study enriches existing health behavior theories with sociological concepts such as social norms and social practices.

People don't live on the care cascade: The life of the HIV care cascade as an international AIDS policy and its implications

This article analyses how the HIV care cascade, an analytical tool, has become a policy practice that determines the direction and content of international AIDS policy. It traces the development of the cascade through from its emergence around 2011 to its position framing global AIDS policy by 2018. The article distinguishes between the cascade model as a mapping tool and the care cascade as a policy that aims to end the AIDS epidemic. It then argues that the move from an analytical to a policy tool has important implications, both for the scope of policies and for policy-relevant research. It concludes by considering its implications in determining policy direction. The qualitative research that informs the article is based on published care cascade research and policy documents, and observations of the presentations and discussions at the 2012 and 2018 International AIDS Conferences (IAS). The article uses textual analysis to develop its argument.

Doing Histor{y/ies} of Health Psycholog{y/ies}

Academic (sub)disciplines develop in time and place when particular ideas/practices are nurtured within social, gendered, cultural, community, economic and political contexts. Different histories employ different analyses, some with external views of scientific outputs describing research and practice, and others with internal, behind-the-scenes examinations of these developments, through oral histories and personal recollections. This collection, written by historians of (social) science, or practitioners or pioneering participants, uses different historiographical methods to contextualize health-related activities within the sub-discipline of health psychology and the evolving critical and/or community approaches. The papers connect the evolving health psycholog{y/ies} with changing socio-political circumstances in different countries.

Interlaced strands: Health psychology in Brazil from an autobiographic perspective

The presence of psychology in Brazilian Health Settings is closely related to two socio-political movements: for the creation of the Brazilian Unified Health System in 1990 and for Psychiatric Reform. Each had a multidisciplinary stance closely associated with a socially committed approach to healthcare delivery and connected with prior experiences that influenced its policies, among them the National AIDS Programme. These developments are told as a tale that interlaced autobiographical data and the long road to a universal healthcare system that shaped the relationship between psychology and health in the country.

A journey in the field of health: From social psychology to multi-disciplinarity

“Health psychology” is a newer sub-discipline whose research methodologies, theories, and practices were borrowed from diverse areas of psychology. It appeared later in France than in the United States or United Kingdom. In 1966, I adopted a perspective between anthropology and psycho-sociology of medicine. I never have self-identified as a “Health Psychologist”, continuing to work outside of disciplinary boundary constraints, but studied health questions moving first from psychology (and anthropology), through social psychology to sociology. By the 1980s, I adopted an even broader multi-disciplinary approach to health, as the HIV/AIDS epidemic urgently challenged health researchers/practitioners, in France and worldwide.