In the Public Interest
Around the time I started working at APA in 1987 the critical nature of HIV/AIDS had become clear, and as is the case with most public health crises, the Public Interest Directorate rallied to bring psychology's contributions to the fight and created the Office on AIDS. I'm sad to report that most of the people who first worked in that office are now deceased.
Recently, the Joint United Nations Programme on HIV/AIDS and the World Health Organization (WHO) lowered estimates of the number of people living with HIV/AIDS: 33 million worldwide, compared with an estimate of 40 million in 2006. WHO also predicts that 2.5 million people will become infected with HIV this year, a 40 percent decrease from last year. According to the 2007 AIDS Epidemic Update, the lower estimates are a function of better sampling methods and reductions in risky behaviors, especially in sub-Saharan Africa.
Those at particular risk
But the news about the U.S. epidemic is not as good. For more than a decade, the Centers for Disease Control and Prevention (CDC) estimated that 40,000 new infections occur in the United States each year. Recently, more refined testing techniques and data analyses have indicated that new infections are more likely to range between 55,000 and 60,000 per year (Brown, 2007). What is uncertain is whether the American HIV epidemic is growing or is simply larger than anyone thought.
The challenges posed by HIV/AIDS are particularly daunting in communities of color where the spread of the virus continues due to poverty, unequal access to health care, lower educational and employment attainment, language barriers, racism, discrimination, homophobia, social stigma and denial. Although blacks make up less than 13 percent of the U.S. population, they accounted for 49 percent of new HIV/AIDS diagnoses in 2005. By comparison, Hispanics accounted for 18 percent, whites 31 percent, Asians/Pacific Islanders 1 percent, and American Indians/Alaska Natives less than 1 percent, according to the CDC.
How APA is responding
To address the HIV/AIDS crisis in communities of color, many things need to happen. Researchers need to be trained and supported to better understand what is happening and what works in various subpopulations where trends are most alarming (e.g., black men who have sex with men, heterosexual black and Latina women, incarcerated populations, young gay men of color, etc.). Research findings need to be translated into effective and practical interventions that can be packaged and diffused to community-based organizations. Front-line providers need technical assistance and training to ensure that evidence-based interventions are adapted to the unique cultural needs of targeted populations.
The Public Interest Office on AIDS under the leadership of Dr. John Anderson is doing an outstanding job of working with federal partners and APA members to make these critical things happen. Last May, the Office on AIDS and the National Institute on Drug Abuse sponsored a highly successful research development workshop for psychology researchers interested in HIV/AIDS, substance abuse/use and minority communities. Building on this effort, APA submitted a grant proposal to the National Institute of Mental Health to fund the development of an Internet-based research mentorship program for research-ers interested in developing careers in the area of HIV/AIDS prevention research with racial and ethnic communities.
Since 1996, the APA Office on AIDS Behavioral and Social Science Volunteer Program, funded by CDC, has worked to build the capacity of community-based organizations and health departments to adapt, tailor, implement and evaluate evidence-based interventions. The program provides free, ongoing technical assistance through its national network of psychologists, sociologists, anthropologists and public health experts.
The Office on AIDS has also demonstrated national leadership in training front-line providers about mental health aspects of HIV/AIDS. This mission is particularly important because studies have shown that a very high proportion of Americans who receive HIV-related care also have mental health and substance abuse problems. Since 1991, the APA HIV Office for Psychology Education Program has trained more than 27,000 front-line providers.
Unfortunately, the challenges of HIV/AIDS are still with us and so Public Interest and the APA Office on AIDS will continue to wage the fight against this pandemic using the unique and invaluable contributions of psychological science and practice.
Brown, D. (2007, December 1). Estimate of AIDS Cases in U.S. Rises: New Test Places the Rate of Infection 50% Higher. Washington Post. Retrieved December 16, 2007, from http://www.washingtonpost.com
UNAIDS, (2007) AIDS epidemic update: December 2007. Geneva, Switzerland: Joint United Nations Programme on HIV/AIDS and World Health Organization.