ODU's Yang Helping to Chart National Course of AIDS Research

Physicians, biologists and chemists may have led the fight against HIV/AIDS, but another avenue of research, the sort pursued by Old Dominion University social scientist Xiushi Yang, is contributing valuable insight into the persistence of the disease.

Now Yang has been recruited by the National Institutes of Health (NIH) to help determine how federal dollars are allocated to social and biomedical scientists who want to do AIDS-related research.

The ODU faculty member was invited last summer to serve a term on the Behavioral and Social Science Approaches to Preventing HIV/AIDS Study Section of NIH's Center for Scientific Review. His four-year term as a grant reviewer extends through June 2013.

When Dr. Toni Scarpa, director of the Center for Scientific Review, notified Chandra de Silva, dean of the ODU College of Arts and Letters, about Yang's acceptance of the reviewer's position, she said his service would involve "a major commitment of professional time and energy as well as a unique opportunity to contribute to the national biomedical research effort."

So far, Yang has found both parts of that statement to be true.

"For each review meeting, the typical load is seven grant proposals, for which you are assigned as the primary, secondary or third reviewer, and, as such, you are required to prepare written critiques for each of the assigned proposals," Yang explained. "It takes quite a lot of time to review the proposals and write evaluations. My experience so far is an average of eight to 10 days - of doing almost nothing else - to complete the task."

The total annual commitment reaches more than the equivalent of six work weeks because Yang is expected to attend three review sessions each year and also occasionally to serve on NIH special emphasis panels that can be held anytime throughout the year.

Nevertheless, the ODU professor in the Department of Sociology and Criminal Justice said he is honored to have been invited to become a reviewer and inspired by the challenges the new role brings.

The research that has lifted him to prominence - and that led the NIH to seek his service - includes a recent set of analytical studies of data obtained in a 2003 survey in southwest China. Much of this work focuses on the internal migration within China, which has been increasing rapidly since the early 1980s and has seen many millions of rural residents move to urban centers in search of better education, jobs and modern conveniences. In fact, whereas less than 18 percent of China's population was urban in 1978, the portion living in cities by 2050 is projected to be around 70 percent.

With this rural-urban migration and rapid urbanization has come a spike in HIV/AIDS cases, and studies by a number of researchers have established a direct relationship between migration and the spread of the disease. Most of this research, however, also has pegged migrants merely as vectors for the spread of the disease.

"Migration has been seen as bringing more people into close contact and creating a greater mixing of people, which provides the ready environment for viral transmissions," Yang said. "However, the transmission of HIV to others requires intimate personal contact. Movement of people in itself will not spread HIV. The search for the migration-HIV link must go beyond….to identify and understand ways by which the process of migration renders migrants vulnerable to HIV risk behaviors."

Yang's 2009 paper, "Migration, Urbanization, and Drug Use and Casual Sex in China: a Multilevel Analysis," hones in on sexual-behavior patterns as a cause of increased HIV risk to migrants and finds less of a contribution from shared needles and other aspects of drug use. He found that casual sex is brought on by, among other things, loneliness or anonymity and release from family-community purview. Also, the data showed that women migrants are more likely than men to exercise their newfound freedom and engage in high-risk sexual behavior.

This research has suggested numerous public-policy and educational adaptations that could help combat HIV/AIDS. The NIH continues to support similar novel social and behavioral research on HIV/AIDS.

"NIH emphasizes innovation and impact, so any new ideas or approaches to studying HIV risk behaviors and prevention intervention will be reviewed more favorably," Yang said.

He believes some research topics and techniques are gaining traction in the United States. "We are seeing more proposals on the elderly and high-risk minority groups, including sexual minorities such as bisexual and transgender populations." He also said the research that is being proposed currently is more likely to integrate quantitative and qualitative methods, employ longitudinal designs, or take into consideration the contextual/environmental influences on HIV risk behaviors.

The ODU researcher also believes that his work in China has given him insights into impediments that must be overcome by social scientists doing research on HIV/AIDS.

"Stigma and discrimination have been and will continue to be barriers to effective AIDS research," he said. "Stereotyping or labeling HIV/AIDS patients as immoral, homosexual or drug user, as well as discrimination in the work place and social life causes people not to come forward to be tested or to hide the fact that they are infected. Also, where controlled-drug use and commercial sex are illegal, it is very difficult for researchers to approach these high-risk groups."

Valerian Derlega, an ODU professor of psychology, and Yang collaborated on another analysis of the 2003 data from southwestern China that turned up one more hurdle faced by researchers. That analysis suggested that misconceptions surrounding HIV - especially those held by women - can turn the focus of the public away from the actual causes of the disease. A surprising number of women thought, for example, that HIV could be transmitted by sharing an office (26.8 percent), sharing clothes (38.3 percent) or sharing eating utensils (40.2).