CROI 2024: Reporting from Community Breakfast Club Session 1

Spotlight on Social and Behavioural Science at CROI 2024

Speakers:

Dr. LaRon Nelson, Yale School of Nursing, CROI Scientific Program Committee

Dr. Sari Reisner, University of Michigan, CROI Scientific Program Committee

Moderator:

Dr. Nicoletta Policek, European AIDS Treatment Group

Monday 4 March 2024

In the first of the three CBC sessions, moderated by Dr. Nicoletta Policek, considerations were made on the importance of contextualising the intersectionality of HIV determinants within a social space that transcends scientific and medical borders. Dr. LaRon Nelson opened the discussion emphasising how integrating social and behavioural science into the core of research and interventions can lead to better trial designs and outcomes, stressing the importance of fostering collaboration and involvement of both younger and established researchers in the field.

Dr. Sari Reisner emphasised that social and structural factors significantly shape the HIV epidemic, affecting how science is conducted. Understanding and addressing these multi-level determinants driving the epidemic is crucial and while new biomedical technologies are promising, integrating social and behavioural components remains a challenge that could be addressed by starting to recognise the necessity of growing partnerships between biomedical and social sectors to elevate community science.

In this year’s CROI programme, although there was an overall increase in content on social and behavioural sciences, covering topics such as HIV stigma in Beirut, drug use stigma, gender health stigma, and sex work stigma, with some sessions focusing on the experiences of displaced people and refugees and the impact on treatment adherence, and how people are navigating these challenges, social and behavioural science content remains mostly limited to posters, with a notable absence in discussions around the social aspects of HPV and HIV cure research. The need to enhance visibility through platforms like oral presentations remains pivotal. The points raised engendered an open discussion, which emphasised the need to also challenge existing funding schemes to prioritise the inclusion of community and social science components in research protocols.

There is a growing recognition of the ethical imperative to integrate social and translational sciences into research; it’s no longer sufficient to pursue biomedical solutions without incorporating community science. While efforts have focused on developing new HIV prevention and treatment methods, the emphasis must shift towards ensuring real-world impact rather than just efficacy in clinical trials. Long-acting injectables serve as an example of this gap between trial success and real-world effectiveness, highlighting the complexities overlooked during initial development.

Projects like HPTN 096 underscore the importance of community-driven approaches and coalitions, peer support networks and social media to address stigma and accessibility issues. Another study on the dual prevention pill, which combines PrEP and oral contraception into a single pill and that aims to assess its accessibility and acceptability among potential users was mentioned. The replacement of a counselling module proposed by community members to understand women’s preferences in family planning clinics and collect provider perspectives with a randomised control trial showed how women’s preferences and needs were once again overlooked and that, in practice, community voices and needs must still be adequately represented.

It is necessary for the language of community science to become more intentional and guide the evolution of scientific language, with research becoming more culturally sensitive and contextually relevant, including trauma-informed approaches and acknowledging language as a form of violence.

Moving forward, collaboration between diverse stakeholders—political, social, cultural, and community—is essential to overcoming challenges securing funding and navigating institutional scepticism and achieving meaningful progress in public health. Such collaborative efforts must be supported by both governmental and private funders and led by the diversity of communities and their activism to ensure their success and long-term sustainability, because… without community there is no research.

Click here to watch the recording of the session!