AIDS2012: Thought Leaders to Discuss Social Inequities Fueling Epidemic

The International Center for Research on Women (ICRW) on July 24 will co-host an event to launch a new global research consortium that will focus on investigating how to best address social inequalities that drive HIV.  The event is part of this week’s International AIDS Conference in Washington, D.C. 

Called STRIVE, the consortium is made up of six partners, including ICRW in Washington, D.C., and its Asia regional office in New Delhi, India, as well as other organizations from Tanzania, India and South Africa. The six-year effort is funded by the UK Department for International Development and managed by the London School of Hygiene & Tropical Medicine. 

“STRIVE represents an opportunity to build more evidence for what our research at ICRW has long shown—that a biomedical approach alone will not slow the rate of HIV infection throughout the world,” said Katherine Fritz, director of ICRW research and programs in global health. “It’s imperative that we also tackle the sometimes unseen but powerful forces at play – like poverty and gender inequality – that continue to make people more vulnerable to HIV and impede their access to critical treatment and prevention services.” 

The official kick off of STRIVE will include an introduction to the partner organizations and a panel discussion with leaders from around the world who are engaged in efforts to craft HIV programs that respond to the social, economic and political forces shaping the epidemic. 

STRIVE will aim to understand how forces such as gender inequality and violence, poor job prospects, stigma, and social norms around alcohol consumption fuel the AIDS epidemic – as well as undermine the effectiveness of HIV treatment and prevention programs. Researchers also will investigate what programs are effectively tackling these social, political and economic factors and how they can be expanded affordably. Finally, experts will determine how best to translate the STRIVE research into policy and on-the-ground programs. 

“If we intend to eliminate HIV from the planet,” Fritz said, “we have to design innovative programs that address these macro-level drivers of HIV risk by linking and engaging with development sectors outside of health.” 

Globally, there has been a resurgence in biomedical approaches – such as antiretroviral treatment as a prevention tool and medical male circumcision – to address the HIV epidemic.  At the same time, the global economic downturn has amplified calls to streamline HIV programs by concentrating funding into programs with proven impact. This has caused some governments and donor agencies to shy away from investing in multi-sectoral programs to address structural influences on the epidemic. Few of these types of programs have rigorous evidence of effectiveness. 

“This is why ICRW and its STRIVE partners believe that generating evidence to support the viability of addressing how social, political and economic issues in HIV programming is more important than ever,” Fritz said. 

Although ICRW’s specific contribution to STRIVE is still being finalized, Fritz suggested that ICRW could build on an existing body of work that examines the links between high alcohol consumption and HIV transmission. Under the consortium, researchers from ICRW’s Washington office also may address how to reduce stigma that inhibits pregnant women living with HIV from using services that could prevent transmission of the virus to their babies. 

Meanwhile, researchers based in New Delhi will expand Parivartan, an ICRW program for boys focused on changing norms around masculinity and violence against women. The expanded approach will now incorporate girls, and links between gender norms and violence, substance and alcohol use, sexuality and HIV. Under STRIVE, ICRW researchers also will document the adaptation and implementation of a stigma-reduction framework into five key sectors to advocate for a possible integration into India’s National AIDS Control Policy. 

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Gillian Gaynair is ICRW’s senior writer and editor.