Friday, 24 June 2011 17:49

Building on Social and Political Sciences to Accelerate the HIV Response

HIV is a profoundly social disease, its causes and consequences deeply embedded in the social, cultural and political processes that shape national development, social institutions, civil society, interpersonal relations and everyday lives. Yet, the significant role of the social and political sciences in shaping the HIV responses has declined over the past decade as the focus on treatment and biomedical prevention technologies has grown stronger.

The IAS Governing Council, recognizing that social and political science research are essential to addressing the global pandemic, selected social and political sciences as one of the organization's four major policy advocacy priorities through 2012. The others are Towards an HIV Cure; HIV Professionals and Human Rights; and Drug Policy with a focus on opioid substitution therapy. The IAS is taking a leadership role and initiating activities and projects in these four areas while continuing to work on several other important issues through partnerships and representation.

A Change in Paradigm

The UNAIDS "Know your epidemic, know your response" framework consists of clearly identifying the modes of transmission in one specific geographic area and within a particular setting and its launch was an acknowledgment that treatment and biomedical prevention technologies alone cannot reverse the spread of HIV. While epidemiological and surveillance data, surveys, assessments and mapping are useful, well-proven tools, HIV/AIDS experts must reach a deeper understanding of the environments in which HIV continues to spread in order to develop effective programmes. In "Know your epidemic, know your response", all actors, including AIDS activists, academics and researchers from all disciplines, and governmental and bilateral institutions, must pay attention to behavioural and social conditions that determine access to and use of HIV information and services.

Inputs from Social and Political Sciences Are Critical

Going beyond the distinction between generalized and concentrated epidemics, social and political scientists draw upon their disciplines to reinforce and enhance the global HIV response. Because HIV/AIDS is a social disease, it requires analysis of both the what (biomedical factors) and the how (environmental factors). Social and political sciences have already played a significant role in providing evidence on the how – the economic and societal drivers of HIV, such as social and cultural norms, beliefs, and values, as well as the political context and related institutions and networks that shape the epidemic. In the face of an international financial crisis and aid effectiveness controversies, much more must be done to increase the understanding of HIV as the sum of multiple singular epidemics driven by a diversity factors. Even though there are theoretical debates in the social sciences about the individual's capacity to act against the structural determinants and the influence of these determinants on the individual's capacity for action, the economic and structural drivers must be carefully studied as a part of the daily context in which people live, become infected and fight HIV.

Contribution of Social and Political Sciences to Date

An International AIDS Society report prepared by Susan Kippax and Martin Holt of the University of New South Wales and titled "The state of social and political science research related to HIV", found that some researchers believe the role of social and political sciences has not been fully recognized and, as a result, the research is under-funded.1 According to Jerome Kagan, this situation is grounded in the nature of social and political sciences.2 Social scientists rely heavily on difficult-to-comprehend semantic networks with a great emphasis on socio-cultural and historical conditions that give rise to different behaviours or practices. Because their outcomes largely refer to local and particular phenomena, they are not generalizable.

Compared to political scientists however, social scientists, including economists, anthropologists, sociologists and public health experts, have been far more active in studying the epidemic. As noted by Alex De Waal, Vihn-Kim Nguyen and other imminent scientists in this field, political scientists' investment in systematic research has remained relatively low and, as a result, the added value of political sciences to the global HIV response remains limited. The study of politics – defined as an attempt to understand how members of a group arrive at the resolution to do or not do certain things and why they arrive at those decisions instead of others – has key knowledge to bring to HIV/AIDS stakeholders in relation to governance or decision-making.

Scientists from both disciplines agree that social and political sciences can play a greater role at various levels of the HIV response: at the international level, for instance, as one looks at the relations of power that link governments and funders or communities and funders, or at the national levels, considering existing political institutions or cultural values that determine the capacity for action of one individual and thereby influence the potential social change resulting from policy and law reform, for example. Alex de Waal stated that "we still lack solid evidence and analysis on what public health measures work and why".3

Moving Forward

The IAS has long recognized that social and political sciences are often not sufficiently reflected in its work nor represented at the conferences it convenes or in the larger HIV response. Given the added value that social and political sciences bring to the response and considering the number of IAS members engaged in these fields, the IAS is addressing these concerns.

As a start, the Governing Council formed a social and political sciences working group and in 2009 the IAS commissioned the Kippax and Holt the Report, which assesses the barriers and incentives for the greater participation of social and political sciences in HIV research.

Subsequently, the IAS convened two meetings in conjunction with the XVIII International AIDS Conference (AIDS 2010) in Vienna. One focused on planning the "Thinking Politically about HIV" workshop recently held in Bangkok, Thailand, and the other on strategies to increase the quality and content of social and political sciences in future AIDS conferences. Following these meetings, a number of decisions and initiatives have been carried out or are planned.

"Thinking Politically about HIV" was held in April 2011 and organized by UNAIDS and the IAS with support from La Trobe University and RTI International.

Organizers of the 6th IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2011) reworked the track categories to offer more opportunity for abstracts from social and political sciences. In addition, Dr. Kippax will deliver a plenary lecture on social barriers to HIV prevention.

The IAS and its partners are planning a number of activities in the lead up to and during the XIX International AIDS Conference in Washington, DC in July 2012. Tentative plans include a preconference meeting on social and political sciences, focusing on the structural elements of comprehensive HIV prevention. Connections with important social and political science research centres and individual researchers – both established and young – will be developed and strengthened and organizers will make deliberate efforts to encourage the submission of abstracts in these fields.

In a more pragmatic way and responding to the wish of IAS members to be further involved in the IAS's social and policy work*, the secretariat will mobilize and draw on members' expertise to conduct research in the field of social and political sciences.

There are numerous ways to use and benefit from social and political sciences. The IAS, as a conference custodian and organizer, will aggressively and methodically seek to ensure that social and political research is presented and taken out of isolation in order to build bridges between the different scientific communities focused on natural and social facts.

 

Author: Bernard Kadasia

31 May 2011

 

1 Kalipeni E, Craddock S, Oppong JR, Ghosh J, eds. HIV and AIDS in Africa: beyond epidemiology. Malden, MA, Blackwell Publishing, 2004.

2 Kagan J. The Three Cultures: Natural Sciences, Social Sciences, and the Humanities in the 21st Century. Cambridge, England and New York, Cambridge University Press, 2009.

3 de Waal A. AIDS and power: why there is no political crisis—yet. London, New York, Cape Town, Zed Books, 2006.

*Respondents who wished to be contacted to get involved in IAS policy/advocacy work were asked to select any of the four priority areas they would like to contribute to. Out of 847 respondents, 47% of indicated that they want to be contacted for issues around social and political sciences. IAS membership survey, International AIDS Society, 2011.

Originally published at: http://www.iasociety.org/Article.aspx?elementId=13619

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