Improving Use of Novel HIV Prevention and Treatment Options through Behavioral and Communication Science
Dianne Rausch, Ph.D.
Division of AIDS Research
Goal:The goal of this concept is to encourage research to improve the use of novel HIV prevention and treatment options (i.e., methods other than a daily oral pill) through behavioral and communication science research. Research topics may include, but are not limited to studies of individual, interpersonal, and structural factors that are barriers and facilitators to use of these novel methods; development and testing of behavioral interventions to encourage use; and implementation science research to optimize delivery of these novel HIV prevention and treatment options in a way that reduces health disparities.
Despite effective biomedical HIV treatment (antiretroviral therapy; ART) and prevention (Pre-Exposure Prophylaxis; PrEP) in the form of a once daily pill, UNAIDS estimates that 1.7 million people were newly infected with HIV in 2019, with nearly 700,000 HIV-related deaths globally. Drop off along the ART and PrEP cascades has limited the effectiveness of these interventions.
Novel biomedical HIV prevention and treatment options, including an HIV vaccine, vaginal ring, long-acting injection, a monthly oral pill, patches, and multipurpose devices to prevent both HIV and pregnancy, are advancing through the development pipeline. In the past year, the FDA approved a once-monthly injection for HIV treatment, and the World Health Organization recommended the dapivirine vaginal ring for HIV prevention for women, which will facilitate regulatory approval in many countries. Candidate HIV vaccines have advanced to late stage clinical trials, providing hope for a prevention strategy that might eradicate HIV. These novel options will give people choices for HIV prevention and treatment and may help to reduce the drop off in use along the ART and PrEP cascades.
With novel HIV prevention and treatment methods new issues may arise around complexity, choice, and equity. Barriers to use may differ for these novel methods. Vaccine hesitancy concerns may require that new interventions be developed to specifically address context and trust. Further, it is important to ensure equal access to these novel methods, and to deliver them in a way that reduces disparities in HIV outcomes. Behavioral science approaches can motivate use and improve adherence of these novel products. In addition, communication about these new options will be critical for addressing public expectations, empowering audiences who have diverse life circumstances and beliefs, and improving product uptake and use. The lag time in development and availability of some HIV products provides an opportunity to focus on evidence-based communication approaches that inform audiences and combat misinformation. Thus, research is needed to understand barriers and facilitators to use of these novel methods; develop and test novel behavioral interventions and communication strategies to address unique barriers to these new options; and implementation research to optimize delivery of these options, particularly in ways that reduce health disparities.