[Economic and socio-behavioural issues related to highly active antiretroviral therapies for HIV infection: the contribution of social science research].
This article presents a synthesis of the main topics covered by social science research (SSR) on HIV/AIDS, since the advent of highly active antiretroviral therapies (HAART) in 1996. SSR has shown that non-adherence cannot be reliably <<predicted>> on the sole basis of a few a priori patient characteristics that clinicians could easily identify before initiation of HAART, and that a dynamic approach to adherence, continuously monitoring the impact of patients' subjective experience with HAART is needed. In relationship with the evolution of HIV infection toward a <<chronic disease>>, SSR has dealt with the impact of HAART on all aspects of patients' daily lives (from employment and professional status to sexuality). It has also emphasised the potential contradictions between the hopes generated by these cost-effective therapeutic advances, on the one hand, and the high social vulnerability of a growing proportion of people living with HIV-AIDS, on the other hand. Finally, SSR suggests recommendations for <<normalising>> AIDS public policies without losing the potential for innovations that the fight against this epidemic has introduced in health care and <<Social Security>> systems, as well as physician-patient's relationships.
Moatti
Jean-Paul
JP
Inserm U.379, Sciences sociales appliquées à l'innovation médicale, Institut Paoli-Calmettes, 232, boulevard de Sainte-Marguerite, 13273 Marseille Cedex 09, France. moatti@marseille.inserm.fr
Spire
Bruno
B
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000191:economics / Q000523:psychology; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects / Q000191:economics* / Q000523:psychology*; D001519:Behavior; D006801:Humans; D010349:Patient Compliance; D016896:Treatment Outcome