2008 Annual Report for the Ad Hoc Committee on Psychology and AIDS

Committee Members and Staff

Members

Cheryl Gore-Felton, PhD Chair (2008)
Stephen Brady, PhD
Ralph Di Clemente, PhD
Ramani Durvasula, PhD
Tomas Soto, PhD
Janet St. Lawrence, PhD

Staff Liaison

John Anderson, PhD
Robert Beverly

Mission, Background & Committee Composition

The mission of the Committee on Psychology and AIDS (COPA) is to guide the development and implementation of the American Psychological Association’s organizational response to the HIV/AIDS epidemic. Members of COPA carry out this mission each year by attending two, face-to-face meetings held in conjunction with the spring and fall consolidated board and committee meetings and by participating in monthly, one-hour conference calls.  Additionally, members of COPA regularly communicate with AIDS Office staff and each other by e-mail and phone in order to plan and implement the committee’s various initiatives. 

The Ad Hoc Committee on Psychology and AIDS (COPA) was established by the APA Council of Representatives for an initial three year period in 1990, reauthorized for an additional five years in 1993, reauthorized for an additional five years in 1998, reauthorized for an additional five years in 2003, and reauthorized for an additional five years in December 2008.

In 2008, COPA’s membership was diverse in terms of race/ethnicity, gender, and sexual orientation - one heterosexual, African-American woman; one heterosexual, Indian-American woman; one gay, Latino man; one heterosexual, Caucasian woman; one heterosexual  Caucasian man; and one Caucasian, gay man.  

Since its formation in August 1990, the membership of COPA has traditionally consisted of six demographically and professionally diverse psychologists with extensive HIV/AIDS experience as well as one non psychologist with community-based HIV/AIDS experience who is   self identified as an HIV+ individual.  The term of the most recent community member ended in March of 2007. 

In the fall of 2007, COPA proposed to its parent board, the Board for the Advancement of Psychology in the Public Interest (BAPPI), a revision of COPA membership that would enable community perspectives to be obtained from a variety of individuals who live openly with HIV/AIDS (PLWHA).  The proposed revision of COPA membership was approved by BAPPI and APA governance staff in December 2008.  Instead of having just one non-psychologist member, COPA now identifies and involves different PLWHAs for different initiatives of COPA.  This procedure enables COPA to identify individuals with specific expertise related to the specific topics scheduled for discussion. This change was needed because HIV/AIDS research and practice has become highly specialized as efforts are tailored to address distinct sub-populations with each sub-population having specific needs and issues for which there is a need for specialized expertise.  It became untenable to expect that one person could fully or accurately reflect “the community perspective” on such a diverse array of matters. 

COPA has established ongoing relationships with the National Association of People Living with AIDS (NAPWA) and the National Minority AIDS Council (NMAC) for the purpose of recruiting PLWHAs for specific meetings and specific discussions.  This process ensures more meaningful engagement of affected communities because those participating in specific discussions are chosen for their unique capacities to offer consultation about the topic at hand.  Additionally, this approach enables COPA to strengthen its relationships with the two major, Washington-based, national organizations representing people living with HIV/AIDS.  By forging this new way of relating to these national organizations, COPA has also strengthen its HIV/AIDS advocacy work which is more effective when done in collaboration with representatives from affected communities. 

In the years to come, COPA intends to fill its seven formal positions with psychologists who are APA members.  Participation of PLWHAs recruited through NAPWA and NMAC for their specific expertise on topics slated for discussion will occur on an ongoing basis.

Major Activities in 2008

During the past year, COPA performed a variety of consultative functions and also developed and implemented numerous projects. Ongoing consultations and projects are briefly summarized below:

Policy and Advocacy Activities Related to HIV/AIDS

Daniel E. Dawes, JD, Senior Legislative and Federal Affairs Officer for Government Relations of the Public Interest Directorate worked with members of COPA and APA AIDS Office in the following areas during the past year:

  1. Developing, training and mobilizing a state-based HIV/AIDS advocacy network of psychologists and other behavioral and social scientists; 

  2. Exploring ways in which the University of California at San Francisco (UCSF) Center for AIDS Prevention Studies HIV/AIDS policy research program might collaborate with APA’s HIV/AIDS advocacy efforts; 

  3. Planning a briefing on mental health and HIV/AIDS issues related to the reauthorization of the Ryan White Care Act for the Senate Health Education Labor and Pensions (HELP) Committee, in collaboration with NAPWA; 

  4. Briefing members of Congress on the need to include report language in the reauthorization of the Substance Abuse and Mental Health Services Administration (SAMHSA) to prioritize HIV/AIDS training for mental health providers;

  5. Members of COPA explored ways to recruit more people to apply for the William Bailey Congressional Fellowship. Members distributed information about the fellowship to multiple electronic listserves and contacted potential students, student groups, and colleagues to encourage qualified individuals to apply. Members also solicited feedback from past fellows to assess ways of improving its marketability. Members recommended that the fellowship be linked more closely to other post-doctoral HIV/AIDS fellowships so participants would not regard the experience as somewhat unrelated to the pursuit of an academic career.  

Educational Pipeline for Ethnic Minority Researchers

For the past several years, members of COPA worked on strategies to promote and enhance the educational pipeline for minority HIV/AIDS researchers. During the summer and fall of 2007, members of COPA and APA Office on AIDS staff worked on a proposal for funding to train minority researchers in HIV/AIDS through the National Institute of Mental Health (NIMH) Research Education Grant (R25) mechanism. 

In March of 2008, the Office on AIDS received $734,000.00 to provide three years of funding support for a new program called, Cyber Mentors: A Sustainable Model for Developing Minority HIV Researchers.  This innovative and sustainable research mentorship program is designed to prepare behavioral scientists for successful independent research careers in HIV/AIDS prevention. The two-year long mentorship program utilizes state of the art distance learning technologies (e.g., webcasts, online classrooms, etc.) to teach mentees how to: (1) submit a successful NIH grant application for HIV prevention research associated with communities of color; (2) develop professional relationships that support their research efforts; and, (3) facilitate the development of an institutional environment that supports a program of HIV prevention research..  Program staff and members of the APA Ad Hoc Committee on Psychology and AIDS (COPA) developed and implemented procedures to recruit, evaluate, and select an initial group of 15 mentees who were subsequently matched with volunteer mentors. 

Members of COPA also worked with APA AIDS Office staff to: 

  1. Develop procedures for evaluating career development plans of mentees; 

  2. Develop procedures for evaluating requests for funds to be submitted by mentor/mentee dyads; 

  3. Revise recruitments announcements and procedures in light of lessons learned from first round of recruitment; 

  4. Develop a strategy for securing future funding for the Cyber Mentor Program; and 

  5. Develop procedures for making the best use of NING, an online professional network site that the Cyber Mentors Program is using for mentees to network with one another.

International HIV/AIDS Issues

During the spring of 2008, members of COPA and staff of the APA Office on AIDS collaborated with the Society for Women and AIDS in Africa (SWAA) and the Kenyan Psychological Association (KPsyA) to develop and submit a proposal to the President 's Emergency Plan for AIDS Relief (PEPFAR) New Partner Initiative (NPI), a five-year unified U.S. Government initiative, directed by the Office of the U.S. Global AIDS Coordinator, and implemented in collaboration with the U.S. Departments of State (DoS), Defense (DOD) and Health and Human Services (HHS), the U.S. Agency for International Development (USAID), and other U.S. Government Agencies. The Office on AIDS was invited to submit a full proposal after receiving a highly favorable review of a five-page concept paper submitted to USAID in October of 2007. 

The proposal requested funding to build the local capacity of community-based organizations (CBOs) to address the effects of trauma and violence on HIV/AIDS prevention and care among women between the ages of 15 and 50 in the Coast Province of Kenya. The proposed program was designed to build the respective capacities of SWAA and KPsyA to scale up a culturally-adapted, evidence-based intervention using the existing structure of SWAA in Kenya (SWAK) as well as the national, provincial, district, and local offices in the 41 African countries served by SWAA. 

During October of 2008, the APA Office on AIDS received the notification that the proposal was not unsuccessful in obtaining funding. Feedback from reviews of the proposal suggested that revising the proposal and resubmitting it to USAID was unlikely to be worthwhile since APA does not have a track record of HIV/AIDS work on the ground in Africa. Members of COPA and staff of the APA Office on AIDS are currently considering revising the proposal and submitting it to the Gates Foundation. 
 
Collaboration with National Association of People with AIDS (NAPWA)

During the spring and fall consolidated meetings in 2008, members of COPA met with representatives from NAPWA to explore possible areas of collaboration. During those meetings, it was agreed that:

  1. COPA and staff of the APA Office on AIDS would develop and sponsor a workshop on mental health and HIV/AIDS at the regional meeting of NAPWA in Miami in July 2008.  

  2. COPA and staff of the APA Office on AIDS would develop and deliver a program of mental health screening as well as a workshop on empirically-based approaches to coping with HIV/AIDS at regional meetings of NAPWA in 2009; Members of COPA as well as staff of the APA Office on AIDS and NAPWA would develop and implement a national needs assessment survey of the mental health and substance abuse needs and experiences of people living with HIV/AIDS. The survey would be disseminated through the large electronic listserve operated by POZ magazine which is widely read by PLWHAs in the U.S.; and, 

  3. A former member of COPA as well as staff of the APA Office on AIDS and NAPWA will analyze and summarize data from the survey for use in developing a COPA/NAPWA-sponsored briefing for the Senate HELP Committee in April of 2009. 

Consultation to APA Offices and Governance Groups

COPA members provided written feedback to APA governance boards and committees who placed items on the Cross-Cutting Agenda during the 2008 spring and fall consolidated board and committee meetings.

COPA members provided feedback to APA Office on AIDS staff regarding the ongoing activities of two federally-funded training and technical assistance programs administered through the Office on AIDS (i.e., the HOPE Program, funded by the Center for Mental Health Services; and, the BSSV Program funded by the Centers for Disease Control and Prevention).  

Annual APA Convention

Members of COPA worked with the Committee on Aging (CONA) to develop a proposal for a symposium on integrated health care at the 2008 APA Convention.   Members of COPA submitted two additional proposals for symposia at the 2008 APA Convention – one on trauma and HIV/AIDS and one on the use of consumers in HIV/AIDS research – and both were accepted and presented at the 2008 APA Convention in Boston.

Members of COPA submitted one proposal for the 2009 APA Convention in Toronto – a symposium on personality disorders and HIV. COPA members and APA AIDS Office staff also worked with APA President James Bray to develop a community conference on family HIV/AIDS for the 2009 APA Convention in Toronto.  

Psychology and AIDS Exchange

COPA members assisted Office on AIDS staff in providing HIV/AIDS updates for the field through its newsletter entitled, The Psychology and AIDS Exchange. This publication provides APA members and others with breaking developments in HIV/AIDS practice, research, education, and policy. During the past year, COPA members took the lead in developing two theme-based editions: (1) an edition on trauma and HIV under the direction of Dr. Gore-Felton; and, (2) an edition on men who have sex with men under the direction of Dr. Brady.

Future Directions

Psychologists, as scientists with expertise in the integration of research and practice, have a critical role to play in the worldwide pandemic of HIV infection by providing technical assistance to countries around the world.  COPA will continue to play a lead role in encouraging and supporting psychologists to partner and consult with governments, national-based organizations (NBOs), and community-based organizations (CBOs) to develop interventions that are theoretically-based, culturally sensitive, and empirically validated. COPA will also support training in behavior change, measurement, program design, and evaluation to those countries and organizations worldwide in need of their expertise. The recent overall increase in HIV diagnoses for MSM, coupled with racial disparities, strongly points to a continued need for COPA to advocate for appropriate prevention and education services tailored for specific subgroups of MSM, especially those who are members of minority races/ethnicities.

In the United States emerging adolescent populations are predominantly female and African-American. Furthermore HIV positive youth in the U. S. are unlikely to be aware of their diagnosis.  COPA will continue to promote psychologists’ expertise in prevention science, community centered models, and technical assistance systems for prevention programs should be utilized to prevent and treat this vulnerable population.

Neurodevelopment and neuropsychological deficits exist in long-term survivors of HIV. Although cognition is improved with the administration of antiretroviral treatment, cognitive deficits nevertheless persist. Psychologists provide psychological and neuropsychological evaluations to better understand the impact of these deficits, they help those with deficits develop compensatory strategies, and they educate families and health care providers about effective ways of managing neuropsychological sequelae. COPA will continue to support research, practice and leadership in this area which is likely to become increasingly important for maintaining the quality of life of long-term survivors.

Prison populations in the U. S. have a higher rate of HIV infection than found in the general public.  Psychologists have an important role as forensic psychologists in prison settings to adapt previous knowledge of effective HIV programs to this community. COPA will advocate for changes in prison policy that are barriers to effective prevention of the spread of HIV in prison settings.  Such advocacy is consistent with APA’s ethical principles addressing discrimination.

Emerging evidence suggests that childhood trauma (i.e., childhood sexual abuse) may be a precursor to adult distress, substance abuse, and high-risk sexual. COPA will encourage and support psychologists to investigate the links among these variables and to use their understanding to develop and validate appropriate interventions.

As treatments have evolved, people living with HIV have started to live longer, higher quality lives.  Along with this increased longevity have come additional issues related to living with HIV such as housing, employment with HIV, long-term medication adherence, and cardiovascular risk. COPA will highlight the ways in which psychologists’ previous research in these areas should provide the basis for adaptation and expansion of this research to address their roles in the prolonged lives of people with HIV/AIDS.