In the 1980s, in an era when HIV/AIDS was largely stigmatized and feared, psychologists Jeffrey Kelly, PhD, and Janet St. Lawrence, PhD, refused to bury their heads in the sand. "All of my patients were dying, and I needed to help them," remembers St. Lawrence, who, along with Kelly, conducted psychotherapy primarily with gay and bisexual men at the University of Mississippi Medical Center.
Struggling to get funding, the two researchers were among the first to study at-risk populations to glean insights into the types of programs that might help prevent AIDS. Their work revolutionized AIDS education efforts and laid the groundwork for those who followed, including Gary William Harper, PhD, who is involved in HIV/AIDS prevention efforts at the community level, says APA Office on AIDS director John Anderson, PhD.
For that reason, APA's Ad Hoc Committee on Psychology and AIDS is honoring the work of Kelly, St. Lawrence and Harper with its 2004 leadership awards--taking the unusual step of awarding two in the distinguished leader category because Kelly and St. Lawrence did so much of their groundbreaking work together.
"The work that these two did to fight AIDS was unprecedented in both scale and substance," says Anderson. "And now Gary Harper is training the next generation of psychologists doing work to fight AIDS through communities and community-based organizations."
Raising community awareness
That groundbreaking work done with community-based groups got started with Kelly and St. Lawrence's work at the University of Mississippi, where the two developed one AIDS education program, among others, that taught gay community leaders AIDS prevention strategies. The program's approach--identifying social leaders among men who frequent gay bars, teaching them about the seriousness of AIDS and how it could be prevented and asking them to share that information with others in the community--proved a success and has since been a much-copied public health education strategy.
"We took what we knew from clinical psychology, behavioral change technology, drew what we knew from our clinical work, and applied it to an intervention to see if it would work--and it did," says St. Lawrence. "From there we adapted it as risk profiles changed. Initially [HIV/AIDS] was something that affected gay men, but our understanding improved as we realized that it was being transmitted to other populations."
In 1988, Kelly and St. Lawrence secured a National Institute of Mental Health grant to replicate the program and study its results in four major cities. Anderson says he admires St. Lawrence and Kelly for having the backbone to do AIDS research at a time when many research institutions were discouraging it.
"This work was done in the late '80s, when there was still a massive amount of stigma revolving around the disease," Anderson says. "They sometimes even had to hide what they were doing; they were truly pioneers."
Since then, as a research and behavioral interventions chief for sexually transmitted diseases at the U.S. Centers for Disease Control and Prevention, St. Lawrence has continued the prevention work in many demographic groups, including women, adolescents, prison populations and minorities.
For his part, Kelly, now director of the Center for AIDS Intervention Research at the Medical College of Wisconsin, is credited with being one of the first researchers to apply cognitive behavioral group interventions to HIV-prevention research and one of the first to recognize the value of undertaking studies to empirically validate successful HIV-prevention interventions, says psychologist Maria Isabel Fernandez, PhD, of the University of Miami School of Medicine.
Kelly continues to develop targeted community intervention plans both at home and abroad, particularly in high-risk communities in Central and Eastern Europe, where he says political, social, cultural and behavioral changes, along with a collapse of the public health infrastructure, have contributed to rapid spreading of HIV.
Blazing a similar trail
Building on the work of Kelly and St. Lawrence, Harper, co-director of the Center for Community and Organization Development and psychology professor at DePaul University in Chicago, is emerging as a new leader in the development of HIV interventions and innovative approaches to teaching and research.
Harper has focused particularly on HIV prevention among minority youth, giving a voice to often otherwise unheard populations, says Anderson. For example, he has helped develop Project VIDA, a community-based HIV/AIDS service organization in Chicago's Latino communities. There he's evaluated the success of programs and worked to improve them, offered administrative support and trained staff.
Harper is an innovative teacher as well, says Anderson. He developed an undergraduate course that focuses on HIV/AIDS, which includes a week of intense immersion in community-based HIV-prevention programs in Chicago. He's also written scholarly articles on and advocated for the formation of community-university partnerships to enhance delivery of community-based HIV-prevention services.
"He has a tremendous ability to engage staff, volunteers and clients in discussions of research principles--making them easy to understand and integrate into practice," says longtime colleague Mark Ishaug, director of the AIDS Foundation of Chicago. "Gary has excelled at integrating research with the delivery of HIV-prevention services."