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APHA Scientific Session and Event Listing

Recorded presentation

Salaam Semaan, DrPH, Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, E-02, Atlanta, GA 30333, 404-639-8870, svs5@cdc.gov

Background: Addressing macro-level determinants of risk reduction is crucial given the global HIV epidemic and the modest effect of interventions for personal and interpersonal determinants of risk. Friedman and colleagues outline 6 research areas and 21 questions concerning the social, political, and economic environments influencing risk behaviors. Methods: We provide a commentary on Friedman's call for structural-level determinants and interventions by focusing on psychoactive drug users. We focus on the paper's recurrent themes, such as marginalized populations, vaccines, and government policies. Results: Viewing drug addiction as only an individual responsibility, without addressing societal values of equity and justice, can do harm to people and to society. Both lack of social and economic opportunities and societal marginalization of drug users worsen problems of addiction. Although recommendations were first made in 1982 to vaccinate injection drug users for hepatitis B, a high proportion of drug users and their partners have not received this vaccine. Only two studies have focused on human papillomavirus (HPV) among drug users, despite the imminent availability of a vaccine for HPV and the association of HPV with cervical cancer. Research and action need to address societal causes of addiction, of drug treatment shortage, of widespread incarceration of users; and to improve relationships between health care providers and drug users, and integration of coordinated and well-funded services for drug users. Conclusions: Because no single intervention approach is sufficient, a comprehensive effort to examine and address macro-level determinants of infection with HIV is urgently needed for all populations at risk.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

(
• discuss a number of social-biomedical interactions and of ways in which such interactions can increase our success with HIV prevention and treatment efforts (
• articulate ways in which social factors and biomedical interventions affect HIV prevention and treatment interventions for drug users and for other populations at-risk, as a case example (
• pinpoint how to study and influence macro-level social factors as they they determine HIV risk behaviors and effectiveness of prevnetion and treatment interventions

Keywords: Behavioral Research, Drug Addiction

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation