My research focuses broadly on the facilitators and barriers to HIV prevention behaviors, examined at both the individual/psychological level and at the structural/policy level.
A primary line of work involves understanding and developing the potential for delivering interventions to individuals who are newly infected with HIV (within the first 10 weeks of infection). Epidemiological and modeling data have suggested that people are up to 11 times more infectious when they first acquire HIV than at later stages in the disease course. As such, interventions to reduce HIV transmission risk behaviors during those initial weeks of infection could have a significant impact on the epidemic. I am involved in an NIMH-funded multi-site study (Morin, Protocol Chair) to examine the psychological and behavioral characteristics of people who are acutely infected with HIV (i.e., diagnosed within four weeks of infection). Participants in the study complete interviews and assessments shortly after diagnosis and then again eight weeks later. The interviews focus on why the participants sought HIV testing, what they understand about the unique characteristics of acute HIV infection, and how their sexual and needle-sharing behaviors have changed since diagnosis. Quantitative assessments focus on enumerating transmission risk behaviors before and after diagnosis, and on measuring a variety of psychological constructs.
A second line of research focuses on how proposed changes to the Ryan White Program (RWP) affect funding allocations for States and Eligible Metropolitan Areas. The RWP is the primary source of revenue for many programs to treat people with HIV disease, and substantial shifts in funding would affect dramatically service delivery efforts across the country. The 2006 reauthorization introduced one definitive change and one potential change. The definitive change involves the use of HIV and AIDS case counts to determine allocations, as opposed to only AIDS case counts. With funding from the University of California ‘s Universitywide AIDS Research Program (S. Morin, PI), I develop models prior to the reauthorization that examined how this shift in case definitions would affect formula awards. (This work was distributed publicly at:http://www.ari.ucsf.edu/programs/policy_reauthorization.aspx ). The second, potential change introduced by the new reauthorization is the introduction of a Severity of Need Index (SONI), which would weight case counts by the estimated burden of care and the cost of delivering care in each state. I am in the process of developing models to examine the likely effect of introducing this index.
Yet a third line of research examines the effects of HIV-related stigma on healthcare decision-making in South India , part of a larger NIMH-funded study on antiretroviral adherence (M. Ekstrand, PI). My colleagues and I have developed instruments to assess various facets of stigma. These instruments are being field tested in a cohort of HIV-infected patients who are interviewed quarterly.
HIV prevention research, HIV-related policy research, acute HIV infection, behavioral intervention, evaluation, health-related decision making, message framing and persuasion.
- California State Office of AIDS Evaluating HIV Prevention in California
- Adherence to HAART in Bangalore, India
- Context and Correlates of Health Behaviors in South India
- Understanding the Social and Psychological Context of Acute HIV Infection
- California Health Care Financing and Policy Research Initiative; Severity of Need
- 2007, Fellow (HIV Prevention and Policy Research), University of California,
San Francisco, Center for AIDS Prevention Studies
- 2003, M.P.H.(Epidemiology), University of California, Berkeley
- 2002, Ph.D. (Psychology), Yale University, New Haven, CT
- 2000, M.Phil. (Psychology), Yale University, New Haven, CT
- 1999, M.S. (Psychology), Yale University, New Haven, CT
- 1997, B.A. (Psychology) magna cum laude, Columbia University, New York, NY
Articles by Wayne T Steward.
Last modified: December 4, 2014