1. We recommend that the President direct the Secretary of HHS, with the NIH, OAR, and the CDC, to develop a coordinated and comprehensive prevention science agenda that includes biomedical, behavioral, and social science interventions.
A. The NIH and OAR must make an increased commitment to research on sexual behavior and sexuality as indicators of high risk for HIV transmission. Basic research on the underlying mechanisms for sexual and drug-using behavior clearly related to HIV transmission must immediately be solicited and supported at increased levels.
B. Due to the paucity of data, increased efforts should be made and funded to accurately assess the risk of oral sex. Studies should be funded to assess the potential safety and efficacy of anal usage of insertive condoms.
2. The OAR should develop research initiatives that seek to identify successful models for behavior change in minority populations. Within communities of color, this population-based research should focus especially on women and gay men, the growing edge of this epidemic.
3. The limited availability of methadone and other effective substance abuse treatment modalities in many areas, especially rural regions, poses a major challenge for HIV prevention among needle users. The Secretary of HHS should order a formal review of federal regulations concerning access to methadone and other effective substance abuse treatment modalities, to consider ways in which those regulations might be changed to allow greater access to methadone without an adverse impact on substance abuse treatment.
4. The President should instruct the Secretary of HHS to ensure that federally funded research on HIV prevention interventions include specific mechanisms for rapid dissemination of findings, including resources to allow replication of programs with demonstrated effectiveness.
a) Allocate funding for training of front-line prevention workers in application of relevant research findings.
b) The Public Health Service should be directed to establish formal mechanisms for dissemination of accurate and up-to-date information to community and consumers in a way that is rapid, easily understandable, and widely accessible.