African Americans, who make up 13 percent of the U.S. population, are disproportionately affected by AIDS, accounting for nearly 49 percent of newly diagnosed HIV/AIDS cases nationwide. About 500,000 African Americans are now living with HIV/AIDS.
Yet there are very few African American HIV/AIDS researchers, due to historical, social and other factors that prevent them from training in the biomedical, behavioral and social aspects of HIV/AIDS research.
In response to the shortage, researchers from the UCLA Center for Culture, Trauma and Mental Health Disparities and the UCLA AIDS Institute have developed a series of recommendations that could reverse the trend and lead more African American researchers into the field. The recommendations are outlined in an article published in a supplement to the April issue of the American Journal of Public Health (available online at www.ajph.org/cgi/content/full/99/S1/S48).
"The most effective behavior-change policies allow for individuals to be part of the solution and not the problem," said lead author Dr. Gail Wyatt, professor of psychiatry and biobehavioral sciences at the Semel Institute for Neuroscience and Human Behavior at UCLA. "We need African American experts who are at the forefront of HIV/AIDS prevention."
The researchers have identified four institutional factors, as well as two individual factors, that limit the number of African Americans pursuing HIV/AIDS research.
Institutional factors include limitation of early career decisions and a lack of exposure to research, research socialization and mentoring. For example, African American college students often don't receive research training early in their careers, so they may not be experienced in pulling together a team of strong research collaborators. In addition, some department chairs may think it is "too late" for doctoral graduates to move into a research career, and there are few senior African Americans to mentor and encourage a new generation of African American HIV/AIDS investigators.
Compounding this situation are individual factors. Given the scarcity of role models, African American students may have negative perceptions about their own competence as HIV/AIDS investigators, and there is limited support for culturally congruent research.
To boost the ranks of African American HIV/AIDS researchers, the study authors make the following seven recommendations to universities and other institutions of higher learning, and private and government funders of research and training:
- Fund research that encourages partnerships with historically African American and minority-serving institutions, such as the National Medical Association and the Association of Black Psychologists, so that clinically trained professionals can participate in and learn more about HIV/AIDS research.
- Provide for retraining of established researchers who wish to shift their focus to HIV/AIDS.
- Continue to offer loan-repayment programs for graduate education.
- Incorporate mentorships into graduate and professional training programs.
- Encourage universities and training programs to recognize mentors whose students pursue HIV/AIDS research, and establish awards that recognize the work of African American investigators in the field.
- Develop and use culturally congruent theories and measures in HIV/AIDS research.
- Require training in cultural competence for federal staff, reviewers and mentors.
"HIV/AIDS research conducted by highly trained African Americans should be the norm and not the exception," the authors conclude. "Such researchers add an important voice and level of expertise to HIV prevention that can only be enhanced by implementing programs to increase the representation of African American investigators in NIH-funded research. A concerted effort to remove barriers to funding and career trajectories to ensure that HIV/AIDS research addresses the most affected populations is needed."
In addition to Wyatt, study authors included John K. Williams, Tina Henderson and LeKeisha Sumner, all of the UCLA Department of Psychiatry and Biobehavioral Sciences.
The National Institute of Mental Health (NIMH) and the UCLA AIDS Institute funded this study.
The UCLA Center for Culture, Trauma and Mental Health Disparities is a unique new interdisciplinary, center funded by the NIMH that promotes research into the behavioral, biological, psychological and social factors associated with trauma among ethnic minorities. The Center faculty aim to understand how depression, post-traumatic stress disorder, and other mental health outcomes affect men and women who may not seek or receive effective care. This understanding would help healthcare professionals create new strategies to reduce mental health disparities among these groups.
The UCLA AIDS Institute, established in 1992, is a multidisciplinary think tank drawing on the skills of top-flight researchers in the worldwide fight against HIV and AIDS, the first cases of which were reported in 1981 by UCLA physicians. Institute members include researchers in virology and immunology, genetics, cancer, neurology, ophthalmology, epidemiology, social science, public health, nursing, and disease prevention. Their findings have led to advances in treating HIV, as well as other diseases, such as hepatitis B and C, influenza and cancer.
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