Science Speaks covered AIDS 2014 with live coverage and guest posts and is continuing this week with insights on issues raised during the week. The following post is by Helen Cornman, Deputy Director, AIDSFree, JSI
When I first started working in HIV in 1988, I was a young social work student who believed the counseling and HIV prevention education programs that I was involved with actually worked. I was surrounded by other social workers who were the backbone of those early prevention and care programs in the U.S. Those programs offered services to those who often needed the most basic services: assistance navigating the health care system, a hot meal delivered, funeral arrangements, a compassionate bedside counsel, or just a caring hand. I was mentored and surrounded by many powerful social workers who were revered within the HIV world and honored at the conferences alongside the medical researchers and policy advocates.
When I began working in the international HIV arena in the early 90’s, I immediately noticed a difference. The first few years were spent in the field where social workers have unfortunately always experienced a lower status. However, once I returned, I was dismayed and sincerely disappointed to realize that in the international HIV arena in the U.S., our status was not much better. The MD, epidemiologist, and masters in public health reigned supreme in this world and we were relegated to hiding our status. I no longer proudly acknowledged I was a social worker, but rather let most folks believe I was an MPH for years.Then, early in the 2000’s, voluntary counseling and testing surged as a possible link to prevention of mother-to-child transmission and anti-retroviral treatment programs . Suddenly there was an interest in counseling again, and social work emerged as a viable means to an end, although, it was short-lived as other biomedical combination prevention options cropped up and the field moved on. Once again counseling was seen as an afterthought.
Yet, at the 20th International AIDS Conference in Melbourne, there is hope that more than 20 years after the first social workers were caring for the first people living with HIV, the world is now realizing the importance of social services and how it will affect the epidemic going forward. We have heard at this conference that a study from Zambia has found that a program of couples voluntary counseling and testing is more effective in itself in reducing transmission within couples than the partner living with HIV starting antiretroviral therapy without any element of couples work and greatly enhanced the preventive effect of antiretroviral treatment. The emphasis on pre-exposure prophylaxis, with the release of the iPrEx study of pre-exposure prophylaxis (iPrEx OLE), made it clear that sexual health and adherence counseling will need to accompany effective pre-exposure prophylaxis programming. Lucie Cluver of the University of Oxford stressed that ‘cash plus care’ programs aimed towards adolescents in sub-Saharan Africa may be a very effective intervention, one that will need to be implemented and supported by social workers.
We cannot move forward in this moment of the epidemic without realizing the power of providing social support alongside medical provisions. For human beings are also social beings, ones who have needs of a caring hand to guide them through the paperwork, the maze of health care services and the basic need for human touch. Social workers will bring this caring hand and much more. They will bring the power of relationships and an interdisciplinary approach to create sustainable solutions for an AIDS-free generation.