AIDS, Sexual Behavior, and Intravenous Drug Use (1989) / Chapter Skim
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6 Barriers to Research
6 Barriers to Research
Pages 359-371
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From page 359... ...
This is particularly true for STDs and, as the previous chapters of this report have made clear, for halting the spread of HIV infection. Awareness of the role that the social and behavioral sciences can play in (resigning and implementing preventive strategies in health promotion and disease control has increased significantly during the past two decades.
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From page 360... ...
Writing three years later, the IOM/NAS Steering Committee on Health and Behavior (Hamburg et al., 1982:Chapter 19) echoed these conclusions and urged increased funding, multidisciplinary collaborative research programs, and a number of other specific actions: increasing the number of behavioral scientists appointed to meclical school faculties, expansion of M.D.-Ph.D.
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From page 361... ...
The key role of prevention in the control of the AIDS epidemic has led to a renewed appreciation of the need for behavioral and social research. As early as 1985, the Office of Technology Assessment iTabulations from the biennial Survey of Doctorate Recipients conducted by the National Research Council's Office of Scientific and Engineering Personnel indicate that the estimated number of behavioral and social sciences Ph.D.s employed in medical schools increased steadily from 2,229 in 1977 to 4,730 in 1985 and remained at this level (4,694)
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From page 362... ...
questioned whether adequate funds were being devoted to behavioral research on AIDS prevention strategies: By directive tof the Department of Health and Human Servicesi, the response to AIDS has concentrated on research into the biology of AIDS. Psychological and social factors related to AIDS, the service needs of AIDS patients, and public education and prevention have not been considered funding priorities....
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From page 363... ...
In the preceding chapters of this report, the committee has recommencled the funding of specific research efforts to better understand the behaviors that transmit HIV infection. In addition to removing the barriers imposed by a history of underfunding of basic social and behavioral research, the committee believes that current AIDS research efforts are often hindered by clearance procedures imposed by the Office of Management and Budget (OMB)
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From page 364... ...
Given the urgent unmet research needs related to AIDS, ways to speed up research must be found. The committee-recommencIs that serious consicleration be given to exempting research on HIV infection and AIDS from the requirements of the Paperwork Reduction Act.
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From page 365... ...
It is claimed, for example, that poor communication between public health officials and the gay community impeded early prevention efforts (ShiTts, 1987~. As "outsiders," public health officials were sometimes unaware of the behavioral patterns, social habits, and political sensitivities that required consideration in planning intervention strategies.
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From page 366... ...
A key ingredient in UCSF's ability to forge these links has been the university's flexibility regarding appointment policies and its willingness to appoint minority-scientists with service delivery backgrouncis in the community to staff positions equivalent to those of research scientists recruited from academia. So, for example, UCSF was able to appoint a talented black female physician without a research background in AIDS to the junior faculty to work on AIDS prevention research.
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From page 367... ...
Thus, CDC's traditional mode of disease control does not fit the neecis of the AIDS epidemic, and the agency has had to evolve rapidly to mount a prevention strategy based on behavioral change and education. When the AIDS epidemic began, CDC employed fewer than 40 Ph.D.-level behavioral scientists, and the agency had limitecl connections with the behavioral science community.
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From page 368... ...
only 11 social scientists (Table 6-1~. The involvement of more such scientists might bring to the agency social and behavioral research skills that are needled to complement the biomedical skills of physicians and other biological scientists in disease prevention.
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From page 369... ...
The role played by NCHS staff has been constrained, however, by the agency's incomplete integration into CDC's AIDS activities. The committee recommends that the CDC AIDS program increase its staff of persons knowIecigeable about survey sampling and survey design, ant} that it exploit the methodological expertise of the National Center for Health Statistics.
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From page 370... ...
Use of these mechanisms would provide PHS management with flexibility in meeting changing staffing needs. Therefore, the committee recommencIs the use of PHS fellowship programs ant} {PAs as an interim means for rapidly enlarging the cacire of senior behavioral and social scientists working on AIDS programs at CDC ant} other PHS agencies.
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From page 371... ...
Although it may be too early to prescribe the format of such programs, it is not too early for those concerned with graduate training to begin planning to integrate this material into graduate and postgraduate curricula. Similarly, federal agencies (including the National Institutes of Health; the Alcohol, Drug Abuse, and Mental Health Administration; the Centers for Disease Control; and the Health Resources and Services Administration must begin to consider how their programs can be used to ensure that appropriately trained researchers will be available for future work to halt the spread of AIDS.
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