The Social and Behavioral Sciences Research Network: Shaping a Contemporary Agenda for Research in HIV.

We have previously produced supplements detailing the activities of the Social and Behavioral Research Network (SBSRN). They first documented the planning that went into the establishment of the network, the papers that were presented at the first scientific meeting in Philadelphia in 2008, and specially, the establishment of a Mentoring Day for new investigators or investigators transitioning to working in the area of social and behavioral sciences in HIV. The SBSRN was first established in 2005 to address the need for greater cross-CFAR collaboration and integration of behavioral/social sciences with clinical and basic sciences. R.J.D. and G.M.W. from Emory University CFAR (at the time) and M.B.B. and D.S.M. at the Penn CFAR met in 2005 after an invited talk by R.J.D. and G.M.W. at Penn (Table 1).

TABLE 1.

SBSRN Conferences, Host CFARs, and Conference Themes

That initial discussion focused on shared challenges and opportunities as behavioral scientists working within the CFAR program, a predominantly biomedical enterprise. Those initial discussions and shared enthusiasm for broader collaborations across the CFAR program, led to a decision to hold a planning meeting of social and behavioral scientists affiliated with CFARs from across the country. The purpose of that planning meeting was to assess the opportunities and interest in forming an organized group to promote and support social and behavioral sciences within the CFAR program. The planning meeting was held in Atlanta, March 27–28, 2006; hosted by the Emory CFAR and jointly supported by the Penn (J. Hoxie, PI) and Emory (J. Curran, PI) CFARs. At the planning meeting, participants representing 14 CFARs agreed on the importance of forming an organized effort to share tools and strategies that would promote integrated research and stimulate cross-CFAR collaborations. The group also established initial research priorities that were considered most critical for confronting the HIV epidemic; however, it was also recognized that as the HIV epidemic evolved, priorities needed to be responsive and forward looking to insure ongoing relevance in confronting HIV. Participants selected the name “Social and Behavioral Science Research Network” and agreed to rotate the meeting across CFARs, permitting different CFARs to host the annual conference.[1] The host CFAR would develop a theme for the conference derived from current priority research areas and the host CFAR's specific scientific expertise. The planning meeting also conceptualized the structure of the SBSRN meetings to include a Mentoring Day, before the scientific meeting, devoted to mentoring early career investigators. Conference presentations were prioritized: (1) if they involved multiple CFARs, (2) if social/behavioral scientists collaborated with clinical/basic scientists in the research, and (3) if they used other CFAR core resources. The keynote presentations would be delivered by nationally prominent HIV experts to provide a state-of-the science overview. Subsequently, the conference would include breakout sessions to permit more in-depth discussions of the presentation. An executive committee was elected [DiClemente & Wingood (Emory CFAR), Metzger & Blank (Penn CFAR)] and charged with planning the first national conference in Philadelphia in 2006. A supplement from NIAID to the Penn CFAR (PI-James Hoxie) funded the first National SBSRN Conference in Philadelphia, October 10-12, 2006. That first conference was successful based on an evaluation of participants' feedback; 90% rated the scientific sessions as “excellent or good.” The 145 registrants represented 32 institutions 15 CFARs, and 17 other institutions [ie, universities, foundations, and National Institutes of Health (NIH) institutes]. Buoyed by participant feedback, the structure of the Philadelphia conference, which included a Mentoring Day before the Scientific Meeting, served as a model for all subsequent SBSRN meetings.

Since that time, the SBSRN has been successful in helping to shape the future research agenda for social and behavioral sciences in HIV, and has moved beyond investigators from CFARs to include those involved with the Population Study Centers, supported through NICHD, the AIDS Research Centers, supported through NIMH, and now to anyone interested in participating. Increasingly, community members have been actively engaged through Community Advisory Boards and by including reactions from community members to keynote addresses and panels.

The current supplement combines the proceedings from the past 2 SBSRN meetings, the 2017 meeting that was held from October 18–24, 2017, and hosted by the University of California at San Francisco, and the 2018 Meeting hosted by the Mid-Atlantic CFAR Consortium (MACC) in Bethesda from August 8–10, 2018. The MACC consortium brought together social and behavioral science investigators from the CFARs at the DC CFAR and their participating institutions (American University, Children's National Medical Center, DC Department of Health, Georgetown University. George Washington University, Howard University, Veterans Affairs Medical Center, and Whitman-Walker Health), the Johns Hopkins University CFAR, and the Penn CFAR and their participating institutions (University of Pennsylvania, Children's Hospital of Philadelphia, and the Wistar Institute). The theme of the San Francisco meeting was “Getting to Zero and Ending HIV” and the theme of the Bethesda meeting was “Behavioral Strategies for Optimizing Biological Interventions for HIV Prevention and Care. These 2 meetings were highly synergistic and it is a pleasure to provide the proceedings here.

The first paper is provided by Maureen Goodenow and Paul Gaist, “The Importance of HIV/AIDS-Related Behavioral and Social Sciences Research at the NIH and Beyond,”[2] and really sets the stage for the rest of the papers. Dr. Goodenow is currently the Director of the Office of AIDS Research at NIH where she provides oversight of the HIV portfolio and Dr. Gaist is the Director of Social and Behavioral Sciences at Office of AIDS Research. Dr. Gaist has been deeply involved with the SBSRN meetings for many years and has helped to shape our mission as well as served as a mentor on Mentoring Day over the past several years.

The next paper is provided by Newcomer[3] entitled “Response to the HIV Epidemic: Perspectives from a Retired Project Officer.” For the past several years the SBSRN has been giving the Newcomer Award to a scientist who has been foundational to advancing social and behavioral science in HIV. Susan introduced Coates[4] in 2017 who provides his remarks in “The Fight Against HIV is a Fight for Human Rights: A Personal Reflection.” The following paper is provided by Kelly[5] who received the Newcomer Award in 2018 and his remarks follow in “10 Things We Need to Do to Achieve the Goals of the End the HIV Epidemic (EtHE) Plan for America.”

The next papers include the Keynote addresses from the San Francisco and Bethesda meetings. Auerbach[6] has been a leading social and behavioral scientist and advocate for many years and her remarks follow in “Getting to Zero Begins with Getting to 10.” That paper is followed by one by Drs. Sten Vermund and Marie Brault entitled “Treatment as Prevention: Concepts and Challenges for HIV Prevention”[7] where they review the work that found HIV plasma load to correlate with transmission risk, that demonstrated that antiretroviral therapy could reduce genital tract viral expression, and that showed early treatment to be clinically advantageous to persons living with HIV and that their HIV-uninfected sexual partners were protected from infection. Next, Dr. Kenneth Mayer presents a paper entitled “PrEP 1.0 and Beyond: Optimizing a Bio-Behavioral Intervention.”[8] Mayer has been a leading proponent of PrEP and provides a deeply insightful analysis of the promise and pitfalls of that innovation.

The next paper comes from a panel at the San Francisco meeting where Drs. Vincent, Sevelius, Lippman, Linnemayr, and Arnold present “Identifying Opportunities for Collaboration Across the Social Sciences to Reach the 10-10-10: A Multilevel Approach.”[9]

The next section includes 2 papers describing the establishment of the inaugural MACC Scholars program, the first is by Limaye et al, entitled “The Mid-Atlantic Center for AIDS Research Consortium (MACC) Scholars Program: A Multi-Institutional Approach to Mentoring the Next Generation of Underrepresented Scientists”[10] that describes the intentions and design of the Scholars program from the perspective of the program developers, and another one by Brown et al entitled “Increasing Diversity and Capacity in HIV Behavioral and Social Science Research: Reflections and Recommendations from the Inaugural Cohort of the Mid-Atlantic CFAR Consortium (MACC) Scholars Program,”[11] which describes the process from the perspective of the scholars themselves. The convergence and divergence of the two perspectives reminds us that “where you stand determines what you see.” Bauermeister et al presented a paper based on his presentation in Bethesda entitled “Testing the Testers: Are Young Men who Have Sex with Men Receiving Adequate HIV Testing & Counseling Services?”[12] They do a great job examining the impact of a mHealth intervention for young MSM and the impact on use of prevention and treatment services.

Finally, the supplement presents three papers that were outgrowths of the SBSRN activities. The first is a paper by Denis, Morales, Wu, Metzger and Cheatle entitled “Association between Diagnoses of Chronic Non-cancer Pain, Substance Use Disorder and HIV-related Outcomes in People Living with HIV,”[13] The next one is by Ruiz et al[14] entitled “Using Interrupted Time Series Analysis to Measure the Impact of Legalized Syringe Exchange on HIV Diagnoses in Baltimore and Philadelphia.” Next, Ariadna Capasso, R.J.D., and G.M.W. present a timely paper entitled “Pregnancy Coercion as a Risk Factor for HIV and Other Sexually Transmitted Infections among Young African American Women.”[15] These authors found pregnancy coercion was associated with a range of adverse sexual health outcomes and HIV/STI-related behaviors and attitudes among African American women and conclude that these findings underscore the need for promoting gender-equitable social norms in HIV prevention interventions. Last but not least, the supplement includes a paper by Rubtsovaet al entitled “Prevalence and Correlates of Self-Rated Successful Aging among Older Women Living with HIV.”[16]

The papers contained in this supplement provide a snapshot of the research currently being conducted by behavioral and social scientists working in the area of HIV prevention and care and they present an overview of the research presented and discussed at the annual meetings of the SBSRN. The SBSRN meeting has now become a highly valued, shared resource for HIV/AIDS investigators around the country. It is uniquely focused on promoting interdisciplinary HIV research and places a high priority on interactions among behavioral, clinical, and basic science investigators, NIH program officials, and early career investigators, particularly those from under-represented racial and ethnic groups. These papers also reflect the evolving research priorities of the HIV epidemic, one of the initial goals of the SBSRN annual meetings—to help define the future research agenda for social and behavioral scientists working in HIV/AIDS.

By all objective measures, the SBSRN has been an unqualified success. Since its inception, the meetings have presented cutting-edge research and have been attended by an average of 149 participants representing a broad range of scientific disciplines, areas of expertise, career tenure, and geographic region. Over 230 early career investigators (nearly 40% from under represented racial/ethnic groups) have participated in the mentoring day. Although continued and uninterrupted support for the planning and implementation of the SBSRN has proven to be challenging, we are motivated by the past successes of the SBSRN and see great opportunities for supporting investigators engaged in the fight against HIV. The SBSRN will continue to foster interdisciplinary collaborations by providing a forum for established investigators from a variety of disciplines, early career investigators, and NIH program officials to present and discuss current science and help mentor the next generation of behavioral and social scientists in interdisciplinary HIV prevention, treatment, and basic research.