Center for Global Health, Massachusetts General Hospital, Boston, MA, USA.
Department of Medicine, Harvard Medical School, Boston, MA, USA.
J Int AIDS Soc. 2021 Aug;24(8):e25771. doi: 10.1002/jia2.25771.
COVID-19 parallels HIV in many ways. Socio-behavioural science has been critical in elucidating the context and factors surrounding individual levels of engagement with known effective prevention and treatment tools for HIV, thus offering important lessons for ongoing efforts to combat the COVID-19 pandemic.
Non-adherence to effective disease mitigation strategies (e.g. condoms for HIV and masks for COVID-19) can be attributed in part to prioritizing comfort, convenience and individual autonomy over public health. Importantly, misinformation can fuel denialism and conspiracies that discredit scientific knowledge and motivate nonadherence. These preferences and the extent to which individuals can act on their preferences may be constrained by the structures and culture in which they live. Both HIV and COVID-19 have been politicized and influenced by evolving recommendations from scientists, clinicians, policymakers and politically motivated organizations. While vaccines are vital for ending both pandemics, their impact will depend on availability and uptake. Four decades of experience with the HIV epidemic have shown that information alone is insufficient to overcome these challenges; interventions must address the underlying, often complex factors that influence human behaviour. This article builds from socio-behavioural science theory and describes practical and successful approaches to enable and support adherence to prevention and treatment strategies, including vaccine adoption. Key methods include reframing tools to enhance motivation, promoting centralized sources of trusted information, strategic development and messaging with and within key populations (e.g. through social media) and appealing to self-empowerment, altruism and informed decision making. Orchestrated evidence-based activism is needed to overcome manipulative politicization, while consistent transparent messaging around scientific discoveries and clinical recommendations are critical for public acceptance and support. Ultimately, the effectiveness of COVID-19 vaccines will depend on our ability to engender trust in the communities most affected.
Many lessons learned from socio-behavioural science in the HIV pandemic are applicable to the COVID-19 pandemic. Individual behaviour must be understood within its interpersonal and societal context to address the current barriers to adherence to disease-mitigating strategies and promote an effective response to the COVID-19 pandemic, which is likely to be endured for the foreseeable future.
新冠病毒在许多方面与艾滋病病毒相似。社会行为科学在阐明与个人对艾滋病病毒已知有效预防和治疗工具的参与程度相关的背景和因素方面发挥了关键作用，从而为正在进行的抗击新冠疫情大流行的努力提供了重要经验教训。
未能遵守有效的疾病缓解策略（例如，艾滋病病毒用避孕套和新冠病毒用口罩）部分归因于人们优先考虑舒适、便利和个人自主权，而不是公共卫生。重要的是，错误信息可能会助长否认主义和阴谋论，从而使人们怀疑科学知识，并促使人们不遵守规定。这些偏好以及个人能够根据自己的偏好行事的程度，可能受到他们所处的结构和文化的限制。艾滋病病毒和新冠病毒都被政治化，并受到科学家、临床医生、政策制定者和出于政治动机的组织不断变化的建议的影响。虽然疫苗对于结束这两种大流行至关重要，但它们的效果将取决于疫苗的供应和接种情况。艾滋病流行四十年的经验表明，仅靠信息不足以克服这些挑战；干预措施必须解决影响人类行为的潜在的、往往是复杂的因素。本文从社会行为科学理论出发，描述了实用且成功的方法，以促进和支持预防和治疗策略的实施，包括疫苗接种。关键方法包括重新构建工具以增强动机，促进可信信息的集中来源，通过社交媒体在关键人群中进行战略制定和信息传播，并呼吁自我赋权、利他主义和明智决策。需要有组织的循证行动来克服操纵性的政治化，而围绕科学发现和临床建议进行一致、透明的信息传播对于公众的接受和支持至关重要。最终，新冠疫苗的有效性将取决于我们在受影响最严重的社区中建立信任的能力。
从艾滋病病毒大流行中的社会行为科学中吸取了许多经验教训，这些经验教训适用于新冠疫情。必须在人际和社会背景下理解个人行为，以解决当前阻碍人们遵守疾病缓解策略的障碍，并促进对新冠疫情的有效应对，而这种应对很可能在可预见的未来持续存在。
